The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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Real time eMAR and oversight
The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. The provider had made clear improvements since the last inspection. Records were accurate and updated when people’s medicines changed. Staff completed training and the registered manager ensured all responsible staff had their competency assessed. With the provider’s updated digital monitoring system that had been implemented since the last inspection, medicines information was monitored in real time. Samples of electronic medicines administration records (eMAR) showed the management team was alerted and took appropriate action if any medicines task had not been completed.
Read more about this service .
Care provider: UK Prime Care Services
Date published: December 2024
Competent, STOMP aware medicines oversight
Staff were able to describe in detail how they administered people’s medicines. Staff correctly described the procedures to follow if a medicines error occurred. They were able to confidently tell us how to administer as required (PRN) medicines. Staff who administered medicines confirmed they have had medicines competency assessments carried out.
The manager was able to tell us how they ensured medicines were managed safely. They told us they maintain oversight of the use of sedative / anti-psychotic medicines. The said, “People are supported to have annual medicines reviews with their general practitioner (GP). As an organisation, we have Stopping the over medication of people with a learning disability (STOMP) forums. People we support are on our campaign to change. We have ambassadors and accessible information. The quality assurance audits check for evidence to support STOMP. One of my actions is to raise awareness of medicines within the service.”
Read more about this service .
Care provider: 231 Brook Lane
Date published: October 2024
Safe, competent medicines management
Medicines were ordered, checked and available when people needed them. Medicines were stored, administered, recorded and disposed of safely. Staff were trained and assessed as competent to administer medicines. Robust processes were in place to ensure people received their medicines in line with their prescriptions. The pharmacist told us staff were skilled at identifying any concerns regarding medicines and would raise this promptly to look at what adjustments could be made. This supported people’s safety and well-being. Staff were confident and knowledgeable regarding the medicines they were administering and demonstrated a skilled approach in supporting people. We spot checked medicines against stock lists, we found no concerns.
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Care provider: Manor Lodge
Date published: September 2024
Proactive, confident medicines administration
Staff and the management team told us that some people required support to manage and administer their medicines. They confirmed that regular monitoring and audits were completed by way of checking people’s medication administration records (MAR), spot checks and feedback from clients and their representatives. All the staff we spoke with confirmed they had completed training for medicines management and administration and were confident with this area of responsibility. Staff also understood their responsibility for reporting problems or errors with people’s medicines. One member of staff told us, “I will call the GP if they are still open, if not 111, and discuss the situation; call the office and let them know and follow the instructions given to me. Then I will note in feedback and follow up.” Other staff members made comments such as, “I am very confident towards all clients with their medication.” And “Very confident and if l have any problems l will call the office.”
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Care provider: London Care (Westminster)
Date published: June 2024
Working closely with the psychiatrist to manage medicines
Staff had achieved outstanding outcomes for autistic people by supporting medical professionals to reduce or stop a reliance on medicines and explore alternative ways to help people manage their needs.
The provider identified a previously unrecognised negative impact on a person's wellbeing due to the side effect of an anti-psychotic medicine. Staff worked closely with the psychiatrist to develop a support plan and provide additional staffing to allow the person to reduce the use of this medicine.
This improved the person's wellbeing in other areas of their life. Only one antipsychotic medicine remained for the person, so the staff team then worked with the psychiatrist to remove this, resulting in the autistic person being free of all antipsychotic medicines and their case closed to psychiatry services after decades of treatment. The person was able to live successfully in their community with a reduced support package.
Read more about the service .
Care provider: Avenues South East
Date published: November 2022
Using NICE guidance to support collaborative working with specialists
This provider implemented new medicines policies using . To ensure their medicines procedures were stringent, they worked with pharmacists to incorporate specialised knowledge. Throughout, their service they have found NICE’s shared remit for producing guidance across health and social care enabled strong collaboration with other professionals including social workers, commissioners, GPs, nurses, dentists, and more.
See also: NICE social care quick guides
Care provider: Anonymous
Date published: January 2022
Using NICE guidance to safely manage medicines in homecare
Services use to develop a medicines policy for their home care network. This ensured best, safe and robust practice for their home care network, leading to positive outcomes for their clients. The NICE guidance are easy to follow and a great resource for medicines policy development.
See also: NICE social care quick guides
Care provider: Anonymous
Date published: November 2021
Working closely with the local system Medicine Optimisation in Care 天美mvs team
The service had worked with the local Medicine Optimisation in Care 天美mvs team (MOCH) to improve medicine practise in the service.
The MOCH team’s feedback to the CQC stated: “Davers Court is one of the most engaged care homes that we’ve visited. The management and staff have always been keen to learn and have certainly encouraged the residents (where capacity is present) to participate in conversations about their medications. I’d go so far as to say that the medication rounds observed, the processes and procedures followed, and the conversations had with residents around the taking of medications were exemplary.”
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Care provider: Davers Court - Care UK Community Partnerships Ltd
Date published: March 2020
Managing medication effectively to improve behaviour
Staff supported one person who had very challenging behaviour and wanted to stay in bed all day. Staff displayed great passion and commitment to improve this person's life. They explained how they advocated for the person challenging other healthcare professionals to change the person’s medication and level of one-to-one support they required. As a result, the person’s behaviour has now totally changed; they’ve been able to go on holiday and the service is now looking at moving them to a supported living service.
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Care provider: Landermeads Care 天美mv
Date published: March 2020
Medication champion
There was a medication champion amongst the staff team. This staff member was responsible for overseeing the medicine processes and procedures and researching the latest and best practice. This included ensuring training was up-to-date, ordering and checking in medicines, conducting monthly spot checks and audits, reviewing new projects, and sourcing guidance and research in relation to medicines in care home settings, such as STOMP.
Read more about this service .
Care provider: SENSE - 89 Hastings Avenue
Date published: April 2019
Stomping out over medication
The service had signed up to the STOMP pledge (Stopping the Over Medication of People with a learning disability, autism or both), an initiative set up by the NHS. STOMP is a national initiative.
The registered manager worked with the lead NHS STOMP nurse. The training was then provided to all staff by a local training company, and provided details of what medicines were used for, and support with the confidence to challenge whether the medicines were needed.
The service developed a STOMP champion role so that staff were informed and advised of best practice. An audit of psychotropic (any medication capable of affecting the mind, emotions, and behaviour) drug use was undertaken to inform the STOMP pledge and staff training.
Read more about the service .
Care provider: Community Support Service (D.D.H. Services Ltd)
Date published: March 2019
Designing your processes around NICE guidelines
The lead nurse devised a practical assessment tool in-line with NICE guidelines to ensure all staff administering medicines were assessed every three months against all aspects. This included storage and disposal, as well as administration.
Care provider: Anonymous
Date published: April 2018
Self-medication plans
Each person wishing to manage their medicines had a self-medication plan containing information as to: “what’s important to me regarding medication?”, “what do I need to do around medication?” and “how can staff support me with medication?”
Care provider: Anonymous
Date published: April 2018
Best-interest decisions
One person was declining their medicines and the registered manager, with input from the GP, had assessed the person’s capacity to see if they understood the risks of not taking their medicines. The assessment detailed the most suitable environment for the conversation and the best time of day had been considered. The person was assessed as not having the capacity. A best-interest decision meeting was held with a multidisciplinary team, including the person’s family and GP, where a decision was reached and recorded.
Care provider: Anonymous
Date published: April 2018
Using supervision to investigate medication incidents
After any medication-related incident, the service responds quickly to arrange a special supervision with the care worker involved. The aim of the supervision is to review the circumstances and identify support needed.
Prior to the latest registered manager joining, the service would’ve simply asked the care worker to refresh their training rather than focus in on the specific issue that caused the incident. However, it was found that with effective supervision, this wasn’t needed, and the manager can help to correct their practice.
Care provider: Anonymous
Date published: April 2018
Instant access to electronic MARs records
People’s medicine administration records (MARs) are now documented electronically on the providers’ electronic care records system. Care workers have instant access to information about people’s medicines and are kept informed of any changes, such as commencing antibiotics. The system reduces the risk of errors by providing up-to-date information.
Care provider: Anonymous
Date published: April 2018