Frequently Asked Questions

Problems identified

Medication ordering process. Refer to care home policy.

For interim/acute items please use the care home InterimAcute request form

Repeat orders of medication should be requested during the second week of the care home’s cycle via the POD care home email

Particular attention must be taken when ordering PRN medication with a view to be preventing excess stock

If medication stock is current and within manufacturer’s date, carry stock forward to next monthly cycle to avoid unnecessary waste

Raise concerns directly with POD/community pharmacy

Receiving medication at the home If any errors are identified, the dispensing pharmacist must be informed immediately to ensure appropriate action is taken and that the service user has a supply of the correct medication

Ensure the documentation for the service user is accurate and up to date

  • Contact the community pharmacy if any information is missing or incorrect i.e. allergies, GP details or room numbers
Storage Refer to care home policy

CQC offer guidance for storing medicines:

Administration Only those staff who have been trained to administer medication by means of an accredited course should have responsibility for handling medication

  • Ensure staff competency and medication training is valid and up to date.

Check the MAR chart carefully:

  • to confirm which medicines are to be given
  • to confirm that none of the doses due have already been given
  • that they are to be given at the time indicated
  • that none of the prescribed doses have been changed

If there are any discrepancies, then staff should check with their community pharmacy before proceeding

Medication errors Refer to care home policy

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

All medication errors should be fully and carefully investigated taking full account of the context, the circumstances and the details of all staff involved

Further resources:

Refusals of medication. Refer to care home policy

Attempt to establish reasons for refusal

Offer medication again at a later interval

Inform relevant parties including the service user’s GP, Advanced Nurse Practitioner or MOCH Team if medication is continually refused

Swallowing difficulties Never attempt to crush tablets or open capsules if a service user is unable to swallow them

Refer to the care home manager or medicines lead for discussion with the MOCH Team

Covert medication administration Refer to care home policy

An assessment of mental capacity and best interest meeting, as specified in the Mental Capacity Act 2005, should always be completed before the use of covert medication is considered

Please see the MOCH Team’s Best Practice Guidance: Covert Administration of Medicines

Controlled Drugs Refer to care home policy

Further resources:

Medication to be ‘taken as required’ or ‘PRN’ Refer to care home policy

To ensure the medication is given as intended, a specific plan for each PRN medication should be recorded in the service user’s care plan and kept with their MAR charts. This includes:

  • inhalers
  • creams/gels
  • analgesia – e.g. Paracetamol, Co-codamol

Further resources

Medication when the service user spends periods away from the home and needs to continue taking prescribed medication that would otherwise be administered by the home’s staff Refer to care home policy

Ensure agreement with the designated carer before they leave that they will be responsible for the resident taking their prescribed medication safely in line with the prescription and care plan – give copies if necessary

Ensure documentation is relevant and up to date:

  • Information of designated carer – i.e. relative or friend
  • Medication information – including quantity given
Homely Remedies Refer to care home policy

Homely remedies should be used to treat minor ailments for residents who do not need immediate consultation with a GP, if the GP has consented to their use in principle

Homely remedies should be recorded on the service user’s MAR chart and a homely remedies record form that is kept at the home

Training All staff should read their care home 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: Staff will have to register for the website and choose the CCG area they are in.

  • There are two courses for domiciliary care: Managing medicines for adults receiving social care in the community Courses 1 and 2 – these are free
  • There are three courses for care homes: Medicines use in care homes Course 1, 2 and 3 – most of which have been purchased on behalf of care homes by CCGs

The link to the HEE e-learning is here and this is free:

Some community pharmacies offer free medicines management training

The MOCH team are unable to carry out training sessions currently. However, we are constantly updating the MOCH Team web page to provide guidance on ‘hot topics’ suggested by our homes. Please contact the MOCH Team to discuss and suggest any topics

Further information about a medication British National Formulary (BNF)

National Institute for Health and Care Excellence (NICE):

Care Quality Commission (CQC)

Last updated on 30 November 2020 at 09:27 by Samantha Russell