Medicines Optimisation in Care Homes (MOCH)

The Medicines Optimisation in Care Homes (MOCH) Team has been created as part of NHS England’s Medicines Optimisation in Care Homes programme in line with the Framework for Enhanced Health in Care Homes.

Pharmacists & pharmacy technicians can play a significant role in reducing the use of unnecessary and sometimes harmful medicines, through regular reviews of medicines taken by residents. Our role is to support prescribers, general practice staff and care home staff in improving the health of their care home patients through the rational and safe use of medicines, and the development and implementation of safe medicines optimisation systems.

As a team, our objectives include:

  • achieving medicines optimisation for care home residents through access to a clinical pharmacy team with the supporting infrastructure
  • ensuring that residents and/or the families or carers are given the opportunity to be fully involved in decisions about their medicines
  • improving health outcomes for care home residents

** The MOCH team do not process care home prescription requests. If your query relates to a POD matter, for example, medication requests or missing cycle items, please contact the POD on welaccg.carehomes@nhs.net**


Frequently Asked Questions

Medicines Administration Only those staff who have been trained to administer medication by means of an accredited course should have responsibility for handling medication. If any errors are identified on the MAR, the dispensing pharmacist must be informed immediately to ensure appropriate action is taken.

Buccal Administration – West Lancashire Medicines Optimisation in Care Homes ‘Buccal Midazolam Guidance

Carrying forward medication – West Lancashire Medicines Optimisation in Care Homes document: ‘Carrying Forward Medication in Care Homes – Best Practice Guidance’

Covert administration – West Lancashire Medicines Optimisation in Care Homes document: ‘Covert Administration of Medicines – Best Practice Guidance‘. The Covert Medication Flow Chart illustrates the decision pathway for prescribers and care home staff. The flow chat should be used in conjunction with the MOCH team document, Guidance to support covert administration of medicines in adult health & social care settings.

Handwritten MARs – West Lancashire Medicines Optimisation in Care Homes document: ‘Handwritten Medicines Administration Records (MARs) – Best Practice Guidance

Refused and omitted doses – West Lancashire Medicines Optimisation in Care Homes document: ‘Missed Doses of Medication in Care Homes – Best Practice Guidance

Reordering interim/acute medicines – The interim/acute reorder form should be used when reordering items not on repeat medication list via the POD/practice.

‘When required’ (PRN) medicines – West Lancashire Medicines Optimisation in Care Homes document: ‘When Required (PRN) Medicines – Best Practice Guidance‘. Other resources included in the document, ‘When Required (PRN) Medication Plan’ document and the Challening Behaviour Document

Controlled Drugs Refer to care home policy

West Lancashire Medicines Optimisation in Care Homes document: ‘Controlled Drugs – Best Practice Guidance

Providers should use this advice in conjunction with ‘The Handling of Medicines in Social Care’ (RPSGB 2007) and should check the CQC website for recent updates and refer to NICE Guidance ‘Managing Medicines in Care Homes’ SC1

Coronavirus (COVID-19) Care Homes Resources
Medication Oral Nutritional Supplements (ONS) – West Lancashire Medicines Optimisation in Care Homes document: ‘Oral Nutritional Supplement (ONS) in Care Homes – Best Practice Guidance

Thickeners – West Lancashire Medicines Optimisation in Care Homes document: ‘Thickeners in Care Homes – Best Practice Guidance

Topical Medicines – West Lancashire Medicines Optimisation in Care Homes document: ‘Application of Topical Medicines – Best Practice Guidance‘. To support better practice with record keeping, NHS England, in collaboration with other CCGs, have developed an all-in-one Topical MAR chart.

Vitamin D in Care Homes – The Government Vitamin D scheme in January 2021 provided a one-off supply of vitamin D to all care home residents in England for 4 months. PHE and NICE guidance advises care home residents take vitamin D supplements (10mcg) throughout the year. Where appropriate using the DHSC guidance, this supply should be provided by the care home as self-care and is not to be prescribed by the GP. CQC has produced a useful guide for care homes and the MOCH team have gathered resources here.

Medication Errors Medication errors can happen even in the best run care service. It is important that any medication errors are reported immediately so appropriate action can be taken. The care home should have robust systems in place to highlight the steps when raising medication errors.

The Lancashire Safeguarding Adults Board has produced a ‘Guidance for Safeguarding Concerns‘ document to support care homes. Further resources regarding safeguarding and medications can be found on PrescQIPP

NHSmail The Digital Social Care Team website has several videos and guides on how to solve frequently asked questions about NHSmail. You can also download
their NHSmail User Guide for Care Providers.NHS England and NHS Improvement has also developed a NHSmail FAQs (Updated 01-Nov-21)Barclays Digital Eagles offer support to NHS staff to improve their basic digital skills and encourage care homes to embrace a more efficient digital way of working. Find out more here.
Proxy Ordering in Care Homes Proxy ordering – West Lancashire Medicines Optimisation in Care Homes document: Proxy Ordering of Medication in Care Homes – Best Practice Guidance

Please also see the West Lancashire CCG Policy for Care Home Use of Proxy Access

Reordering interim/acute medicines in care homes – Care homes will still be expected to use the interim/acute reorder form when reordering items not on repeat medication list via the POD/practice.

Training All staff should read their care home medication policy as part of their induction. All staff should be offered training by the provider covering basic information about common medicines and how to recognise and deal with medication problems

PrescQIPP: Healthier Lancashire and South Cumbria ICS were successful in accessing funding for all Care Homes across Lancashire and South Cumbria to access free training around medicines for all their staff. This is a wonderful opportunity for Care Home staff to enhance their skills. The training is all online and there are 3 courses, each broken down to smaller modules. Staff can save their work and access the training at times that suit them.

PrescQIPP care homes e-learning – Course overview

The CCG Medicines Optimisation in Care Homes (MOCH) team are not accredited learning providers or competence assessors. We can provide guidance sessions, but care homes will still be required to have competency assessed by an accredited provider. The Skills for Care website recognises learning providers who deliver high quality learning and development to the social care sector.

Further Resources Principles of Safe Medicines Administration in Care Home setting – Interactive Guide – The purpose of this document is to provide recommendations for good practice on the systems and processes for managing medicines in care homes and is intended to be useful for staff who support individuals with medicines in care homes. Each chapter provides a summary of the key principles and is supported by further guidance where applicable. The document is intended to be used as an additional resource as the care settings feel appropriate. Audit templates and supplementary charts are available to download from www.cdreporting.co.uk. In order to access these access these templates, care home staff will need to register on the home page www.cdreporting.co.uk and go to the section called ‘Useful Resources’.

NICE SC1 ‘Managing medicines in care homes’: This guideline covers good practice for managing medicines in care homes. It aims to promote the safe and effective use of medicines in care homes by advising on processes for prescribing, handling and administering medicines. It also recommends how care and services relating to medicines should be provided to people living in care homes.

 

Last updated on 27 January 2022 at 13:09 by Samantha Russell