Administering medicines when a person is away from their usual care setting

There will be times when people spend time away from their residential care setting.

When this happens, it is vital to consider the safe continuity of medicines supply. NICE guidance says that care home providers should consider safe processes as part of medicines management.

Information staff should share

When a person is away from their usual care setting, it is important that staff give the following information to the person or their carers:

• the names of the medicines the person is taking with them
• clear directions and advice on how, when, and how much of each medicine the person should take
• the time of the last dose taken and next due dose of each medicine
• contact details for any queries such as the care home, the supplying pharmacy or the GP surgery

Considerations for providers

Care home providers should consider:

• assessing the risks, identifying and minimising any potential problems - for example, the risk assessment should identify issues related to controlled drugs or other medicines liable to abuse
• whether the person can take their medicines without support - if not, who will support them while they are away?
• how they will make sure medicines are safely supplied
• how the person will store their medicines - for example, will they need refrigeration?
• how the person, family member or carers will access the prescriber’s instructions - the prescriber or supplying pharmacy may be able to assist with some solutions for this. You should have a written procedure to support staff to be safe and consistent when doing this
• if any medicines are to be taken 'when required', there should be clear instructions provided on when to take the medicine
• how to train and support staff to make sure people in their care receive medicines safely

Secondary dispensing

The Royal Pharmaceutical Society (RPS) has defined secondary dispensing as ‘re-packaging a medicine that has already been dispensed by a pharmacist or a dispensing doctor’. This is not good practice. Supplied medicines need to be labelled in line with legislation or the dose administered immediately. There will be unavoidable circumstances when you need to supply medicines at short notice. If the prescriber or supplying pharmacy are unable to provide a solution, you may need to consider alternative measures to ensure the person does not miss any doses. Seek advice from the prescriber on how this can be done legally and safely. You must assess the risk of these measures. You must fully document any decisions taken.

Summary

Any decisions about using medicines while a person is away from their usual care setting should be in a care plan.

Secondary dispensing is not good practice. An alternative should be sought wherever possible due to the associated risks.

Where there is a need for secondary dispensary, a standard operating procedure and risk assessment should be in place.

People should have appropriate information to help them to take their medicines safely.

Staff should have a clear understanding of their role in supporting people to take their medicines when they are away from the home.