1. identify legislation that governs the use of medication in social care settings
The Misuse of Drugs Act 1971 (and later amendments)
The Misuse of Drugs (Safe Custody) Regulations 1973 (and later amendments)
The Health and Safety at Work Act (1974), COSHH
The Mental Capacity Act (2005)
The Access to health records Act (1990),
The Data Protection Act (1998) plus equality legislation.
2. outline the legal classification system for medication
The classification of medicines are all related to the medicines act 1968, while working with medication it is good to have an understanding and working knowledge of the common types of medication. Controlled drugs (cds) are prescription only medications. Pharmacy only (po) these madications can only be purched from a pharmacy. General sales list ( gsl) these medicines can be purchased from any shop. 3. explain how and why policies and procedures or agreed ways of working must reflect and incorporate legislative requirements. Policies and procedures must reflect and incorporate legislative requirements as the policies and procedures are set out through legislation in the first place.
Policies and procedures which are put in place are to ensure that legislation is being followed so that all people in the care setting are safe and that all needs are being met up to standard and within the law. Policies and procedures must reflect on legislation to ensure they are carrying out tasks such as administrating medication in the correct manner. For example if a medication procedure was put in place and it was not in line with legislation then this could cause the care company or organisation to be punished by the law as it may well cause harm to a customer or member of the public. Outcome 2 Know about common types of medication and their use The learner can:
1. identify common types of medication
Common types of medication go as follows: Capsules, Tablets, Powders, Drops, Liquids, Inhalants and Skin preparations. Other Types of common medications are Analgesics, Antacids, Anti anxiety Drugs, Anti – bacterial, Anticoagulants and Anti depressants. 2. list conditions for which each type
of medication may be prescribe general health medication is prescribed by doctor anti-phycotic medication is issued by phyciatrist general sale’s medication can be obtained over the counter in most shoping outlets 3. describe changes to an individual’s physical or mental well-being that may indicate an adverse reaction to a medication. Two of the most common side effects that people experienced were weight gain and sedation. Weight gain is particularly associated with the use of newer antipsychotics known as atypical antipsychotics. A few people we spoke to experienced sudden and dramatic side effects, or allergic reactions, that felt unfamiliar and frightening.
Outcome 3 Understand roles and responsibilities in the use of medication in social care settings The learner can:
1. describe the roles and responsibilities of those involved in prescribing, dispensing and supporting use of medication
The prescriber must be trained appropriately (may be a GP or nurse prescriber for example) and update themselves as required by any professional body that they might belong to – prescriptions should be written clearly, ensuring the patient understands any side effects and the reasons for the prescription be given to them and how long they should take it for. Medication should only be prescribed after careful consideration of the patient’s best interests – cost, unfortunately (but realistically) may also be a factor to consider. The prescriber should have access to the most up to date version of the British National Formulary (BNF) which is the prescriber’s ‘bible’ (there is a version for prescribing for children and an on line version).
The person dispensing must also be appropriately trained, follow safe systems of work and understand the side effects of various drugs; be able to access appropriate information and understand when to access advice or further information (the dispenser may not necessarily be a trained pharmicist but should be working alongside one).By supporting medication, I’m assuming you mean how does the person administering the medication support an individual to take it?
If so, this is through following care plans or support plans; staying with the person to support them to take it; using appropriate equipment (spoon etc) and a drink of water and of course reassuring communication and of course time. 2. explain where responsibilities lie in relation to use of ‘over the counter’ remedies and supplements. If I saw a client taking over the counter remedies I would ask where they got them from and why they needed to take them, I would then inform the manager and document it in the careplan. If the client was not capable of telling me I would remove the remedy and inform the manager again. Outcome 4 Understand techniques for administering medication
1. demonstrate how to receive supplies of medication in line with agreed ways of working we have the medication deliverd to the home and is taken to the office where two staff members will check the medication and sign off the medication on a delivers of meds chart then the medication is locked in a secure place till they are used. 2. demonstrate how to store medication safely
Medicines must be stored where they are readily accessible to domiciliary care assistants and carers. They should be kept away from excessive heat, humidity and light sources. They must be out of the reach of children.Medicines which need to be stored in a refrigerator should preferably be stored in a sealed plastic box, separate from other foodstuffs at a temperature between 2 and 8 degrees centigrade. Medicines must be stored in the original packaging and not separated from the label or patient information leaflet When a child is the sole or main carer, medicines must be accessible to them as necessary, but care must still be taken to keep medicines away from other children who may visit the home. The hiding of medicines from a service user will Only occur where the risk assessment indicate that this is needed to protect the health and safety of the service user.
The Care Manager must ensure that information on how to access medicines is available to all relevant personnel. demonstrate how to dispose of un-used or unwanted medication safely. The service user and their relatives/carers should be encouraged to return any unwanted or out of date medicines to their community pharmacist. Medicines remain the property of the patient and cannot be removed without consent. In exceptional circumstances (and with the specific permission of their line manager) Care staff may return medicines to a community pharmacist for disposal on behalf of a service user. Consent must be given by the service user and a record must be made on the Medication Profile stating what has been removed and to which community pharmacy .
Outcome 6 Know how to promote the rights of the individual when managing medication
The learner can:
1. explain the importance of the following principles in the use of medication • Consent Medicine, in general, cannot be given to someone without their consent. Specific steps may be taken to administer with the consent of the person in some circumstances, but this is not the usual approach. Of course, prescribed medicines must be offered to the person for whom they have been provided, but they have every right to refuse to take it. Consent, or refusal of consent, should always be a decision that is made with full information.
People should know about the medicines before they decide to take them, and they should also know about the potential consequences if they refuse them.If someone persistently refuses to take medicines after they have had all the information, the refusal should be recorded and their doctor should be informed.Some people may be judged not to have the capacity to make decisions about their medicines; this could be as a result of severe learning disability or because of a progressive condition such as dementia.
• self-medication or active participation
The basic assumption when administering medicines should be that everyone will self-medicate unless there is reason not to. Most people will want to maintain control of their medicines and how and when they take them, but there will be others who will want support with some or all of their medicine management.It is most likely to be a ‘mix and match’ approach rather than one or the other for many people. They may wish to maintain control, but may need help with the actual process of administering the medicine, or some people may like a reminder so they can feel secure that they will not forget. Even when people decide that they need support with their medicines, they may still be able to do some aspects for themselves.
The principle of active participation is that people should do as much as they possibly can for themselves. It is a way of working that recognises an individual’s right to participate in the activities and relationships of everyday life as independently as possible; the individual is regarded as an active partner in their own care or support, rather than a passive recipient. This could mean that people may not actually be able to open containers to take their own medicine, but they can decide when and where they want to have their medicine. Rather than having to fit in with the medicine round, people must be able to have medicines at the time and in the place they choose.
• dignity and privacy
Maintaining people’s dignity is very much part of making sure that they have choice and control. Many people may prefer to have their medicines in their own room rather than in a communal lounge, this is particularly important when creams or ointments are being applied.Wherever possible, staff should avoid handling medicines. If an individual needs support the medicines should be handed to them so they can put them into their own mouth rather than having a care worker ‘pop in a pill’. Similarly residents should be encouraged to apply creams and ointments for themselves. The role of supporting someone to administer medicines should be exactly that – support provided only to do things that people really cannot do for themselves. The best way to maintain a person’s dignity is to give support only where its needed.
People’s medicines are as personal and confidential as any other information about them. Their medical history and prescribed medicines records must be kept securely and not left anywhere they can be seen by people who have no need to see them. In the same way, discussions about medicines should be held in private and not in a public room. It is not acceptable to discuss a person’s medicines with anyone without the person’s consent. Family members may ask questions about medicines and treatments, but these issues cannot be discussed unless the person has agreed and the agreement has been recorded
2. explain how risk assessment can be used to promote an individual’s independence in managing medication Medication Risk / Needs Assessment should be carried out by suitably competent individuals. It is expected thatthe assessment could be carried out by Social Workers, Care Managers or healthcare staff. The Medication Risk Assessment should identify the support needs of the service user. Reference must be made to the relevant health professional (GP, Community Nurse or Community Pharmacist) where further information is needed, or concerns arise
1. describe how ethical issues that may arise over the use of medication can be addressed. One ethical issue which raised its head a few years ago and has resulted in changes to the way medication is administered was the covert crushing of medications and adding them to jam or other foods to disguise them when an individual declined to take them. This was considered unethical, unfair deceitful and often dangerous and is now forbidden. Medication which is crushed can be dangerous (slow release medicines can hit the system all in one go causing collapse and serious illness) and giving it in this hidden manner takes away a person’s right to choose.
Now, I can’t say this doesn’t go on anymore as I am sure it probably does but, a good provider will call a meeting and discuss any difficulties when administering medication with professionals (pharmacist, GP etc) and of course any advocate, family or carers. Other ethical issues around medication might be a person’s strong beliefs around the testing of medicines on animals. Outcome 7 Be able to support use of medication
The learner can:
1. demonstrate how to access information about an individual’s medication The best way to find out about someone’s medicines is to ask them. This may not always be possible, or may not give you information that you can rely on. Permission should always be sought before finding out information about a person’s medicines. With the person’s agreement you should do the following to find out as much as possible:
• Check the MAR to identify the medicines the person is taking.
• Research information about the medicines using the BNF and any other sources.
• Make sure that you know the type, the classification, the dose, the frequency, the formulation, the route of administration, possible side effects and cautions.
• Discuss any issues with the GP if you still do not have all the information you need
2. demonstrate how to support an individual to use medication in ways that promote hygiene, safety, dignity and active participation
All medicines should be administered hygienically. Hands should be washed in running water following the standard procedures to ensure that they are clean before administering medicines. Medicines should not be handled; they should be prepared using a ‘clean’ technique and pushed out of a blister pack straight into a clean medicines pot. If you are handling cytotoxic drugs, you should always wear gloves.
2. demonstrate strategies to ensure that medication is used or administered correctly Make sure that you are giving the right medicine to the right person. Only administer from a pharmacy labelled container and check the person’s name before giving it. New staff and agency workers must be trained and competent in administering medicines. They should also be accompanied by another member of staff or use a system of photographs attached to the MAR chart.
Use the MAR chart to make sure that all the medicines needed at that time of day for that individual are being administered.Check with the person that they want their medicine before removing it from the pack. If a person is going to refuse, it is advised you try several times in supporting the person to have their medicines. If there is a refusal you will have to dispose of medicines that you have taken out of the container or blister pack.
3. demonstrate how to address any practical difficulties that may arise when medication is used Sometimes things do not go according to plan and there are various problems that can arise. It is important that you know how to deal with them.
Refusel of medications
4. demonstrate how and when to access further information or support about the use of medication. If the service user is unfamilyer with the medication or has never had it before.if the service user experiences a reaction to the medication. Outcome 8 Be able to record and report on use of medication The learner can:
1. demonstrate how to record use of medication and any changes in an individual associated with it recoreds must be clear and complete and up to date an audit trail should be maintained for each medication ie meds entering and disposing in care homes CDs must be recorded in CD register as well as on mar chart The mar chart must be supplemented by care plan
2. demonstrate how to report on use of medication and problems associated with medication, in line with agreed ways of working. Reporting of problems with medicines will be in line with the policies of the care setting, but ational requirements must be met such as the requirement to inform the police if CDs are missing and the requirement to make a report via the Yellow Card system for an adverse reaction to a new medicine.