As part of our ongoing commitment to ensuring the highest quality of care for individuals in Hertfordshire, we would like to share some key updates to the Homecare Medication Policy, as outlined in the 2024 revision. These updates reflect a shift in practice and approach to medication support, focusing on individual empowerment, clearer guidelines for competency, and more structured risk management. Please take note of the most significant changes below to ensure you are aligned with the updated requirements.

1. Focus on Reablement and Independence

The 2024 policy strongly emphasises reablement—supporting individuals to manage their own medications as much as possible. This is in line with Hertfordshire’s “Connected Lives” framework, which promotes independence and community engagement. Homecare providers are encouraged to foster independence in medication management where appropriate, empowering individuals to take control of their own care.

2. Mental Capacity and Consent

Both the 2019 and 2024 policies align with the Mental Capacity Act (MCA), but the 2024 version goes further by providing additional detail on the importance of consent. A key change is the expanded guidance on covert medication (medication given without the individual’s knowledge) and the role of Lasting Power of Attorney (LPA). If covert medication is considered, providers must have clear and documented consent and should refer to the Mental Capacity Act 2005 and Hertfordshire Policy on Mental Capacity or further guidance. 

3. Medication Administration Levels

The 2019 policy outlined four levels of support for medication administration (Level 0 – reminders, Level 1 – assistance, Level 2 – administration, Level 3 – specialist techniques). The updated policy removes these numbered levels but retains the essence of their guidelines. It now emphasises that staff should assess the level of support required for each individual. Key points include:

  • Staff must work within the scope of their training and ensure the level of support they provide aligns with their competencies.
  • For specialist medication techniques, only staff trained and signed off as competent by an appropriate healthcare professional should administer the medication. This competence must be reassessed annually or as needed. If you have questions on appropriate competency, please contact assistance@hcpa.co.uk 

4. Training and Competency

The 2024 policy places greater emphasis on ensuring that staff have relevant training specific to the medication tasks they are responsible for. This includes:

  • Annual competency reassessments, as well as specific training related to specialist techniques for administering certain medications. The NICE guidelines are referenced as the primary resource for training recommendations.
  • Staff must demonstrate they are aware of the limits of their role and can only provide support they are qualified to deliver. If specialist techniques are required, the staff member must be signed off as competent by an appropriate healthcare professional, which may require further clarity on who qualifies as appropriate.

For support with training visit HCPA | Training Zone

5. Handling Medication Errors

The updated policy emphasises that all medication errors must be recorded. The Hertfordshire Medication Errors and Safeguarding Guidance outlines that errors must always be reported, and a log should be kept of all incidents. This guidance includer the link to the provider form for Recording of Non-Safeguarding Medication Errors

6. Removed Guidance and Streamlined Structure

A noticeable change in the 2024 policy is that many detailed guidelines from the 2019 version have been removed in favour of signposting to other resources. For example, detailed medication error procedures are now referenced in separate documents, such as the Medication Errors Policy.

Additionally, the specific levels of support (Level 0-3) from the 2019 policy have been removed. While staff are still expected to detail the level of support required in care and support plans, they no longer need to categorize it within numbered levels. This provides flexibility in how support is recorded and ensures it reflects the individual’s actual needs rather than rigid categories.

7. Next Steps for Homecare Providers

To ensure you are fully compliant with the 2024 policy:

  • Review and update your care and support plans to clearly outline the level of medication support an individual requires. Ensure that this information is shared with Brokerage staff when referring individuals for care services.
  • Ensure your staff are trained according to NICE guidelines and demonstrate ongoing competency through regular assessments.
  • Familiarise yourself with the changes to specialist medication techniques and ensure any staff involved in administering these are trained and signed off by the appropriate healthcare professional.
  • Maintain accurate records of medication errors, ensuring they are documented correctly and referred for safeguarding when necessary.
  • Stay up to date with the Mental Capacity Act and ensure consent is obtained and documented, especially in cases of covert medication.

We understand that these updates may require adjustments to your practices, and we are here to support you through this transition. Should you have any questions or need further guidance, please do not hesitate to contact us.

Thank you for your continued commitment to providing high-quality, safe care to those who rely on your services.