Administration in Care Homes

Many authorised care home staff can quickly, safely and securely order their resident’s medications online. This saves the care home, pharmacy and GP practice staff time. It also makes the dispensing of individual medicines easier and creates an automatic audit trail.

To help, the Local Government Association and NHS have published a step-by-step guide. It takes care homes through setting up and granting authorised care home staff proxy access to their resident’s GP online services account.

Prescribing and Compliance Aids –  All settings

Guidance for Optimising Medicines Support for Patients – Seven Day Prescribing & Multi-compartment Compliance Aids (MCA) Best Practice.

MCAs are also known as blister packs or dossette boxes.

Click here for an information leaflet on supply of Multi-compartment Compliance Aids (MCA)

Key points and Changes
  • The community pharmacist is under no obligation under the Equality Act to supply patients with an MCA (dossette box) who have paid carers that administer the medicines, including in Care Homes
  • Community pharmacy will only provide MCAs (dossette boxes) free of charge to those who are assessed under the Equality Act criteria. Where there is no NHS funding other patients may be given an alternative aid to assist their compliance or be charged a fee.
  • 7-day prescriptions are only needed if a decision has been made by the prescriber e.g. GP on clinical and patient safety grounds that medication should be issued to the patient on a weekly basis. Prescribers will determine the prescription duration.
  • It is the dispensing pharmacist’s responsibility to determine how to apply “reasonable adjustment” to patients, to help support safe self- administration. Examples may include; use of large, bold font on labels; use of winged bottle caps or supply an appropriate compliance aid e.g. dossette boxes and eye drop dispensers.
  • The community pharmacy can provide further information on the range of compliance aids and devices available.
  • HCC will be notified if care agencies/staff request dossette boxes for staff to administer from as this is not supported in the HCC medicines policy

Medication Administration Record (MAR)

Effective record keeping helps ensure that citizens and individuals are always receiving the best possible care and allows for mistakes and concerns to be addressed quickly. Medication Administration Records (MAR) are vital to ensuring staff understand patient’s medical needs and are able to administer the correct medications safely.

Paper based or electronic medicines administration records should:

  • Be legible
  • Be signed by the care home staff or care workers
  • Be clear and accurate
  • Have the correct date and time (either the exact time or the time of day the medicine was taken)
  • Be completed as soon as possible after the person has taken the medicine
  • Avoid jargon and abbreviations

» CQC what good looks like for digital records in adult social care
» CQC Guidance about MARs