Controlled drugs in home care

The Misuse of Drugs Act 1971 places controls on certain medicines. We call these 'controlled drugs' (controlled drugs).

The Misuse of Drugs Regulations 2001 split controlled drugs into five schedules. The schedules correspond to therapeutic usefulness and misuse potential. The Home Office has produced a list of the most commonly prescribed controlled drugs.

You must have a policy or standard operating procedure which details how you manage medicines. This must include controlled drugs.

You should assess what medicines support a person needs as part of their general assessment. This must include support with controlled drugs. Record the outcome of the assessment in their care plan.

If you are responsible for ordering and collecting medicines for a person you must document this in their care plan.

Prescriptions for controlled drugs are valid for 28 days after the date on the prescription.

The Department of Health and Social Care strongly recommends that the maximum quantity of controlled drugs prescribed should not exceed 30 days.

Emergency supplies are not permitted, there must be a valid controlled drug prescription to get supplies from a pharmacy. Staff must make sure ordering processes are robust enough so that people do not run out of these medicines.

Staff collecting controlled drugs from a pharmacy may be asked to provide personal identification.

A risk assessment should be completed if you are transporting controlled drugs. This should also consider what happens if staff are not going straight from the supplying pharmacy to the person’s home. For example, if there are other support calls to make in between.

Storing controlled drugs

The controlled drugs belong to the person and are being stored in their own home. Unless the risk assessment highlights a need, there is no legal requirement for these medicines to be treated differently or stored separately from other medicines. The storage should be risk assessed in line with NICE guidance NG67. There is no requirement to keep a controlled drug cupboard or register in a person’s own home.

Keeping records

Staff administering medicines including controlled drugs must be trained and assessed as competent to do so. There is no legal requirement for a second member of staff to witness and sign for the administration or support of controlled drugs in a person’s own home.

Care providers should have policies and procedures that include information on record keeping for their staff to follow. Keep detailed records when administering topical controlled drugs, for example, patches. These should include the site of application and the frequency of rotation of the site.

Disposing of controlled drugs

If controlled drugs need to be disposed of, agree with the person on whom will dispose of medicines in line with the risk assessment. This should be recorded in the care plan. They will need to be returned to a community pharmacy. Your medicines policy should include the process for disposing medicines and the records which need to be kept.

Medicinal and food grade cannabis products

Cannabis based products for medicinal use (CBPMs) are controlled drugs. This means they can only be prescribed by a specialist doctor. They must have specialist knowledge and expertise. And they must be on the specialist register of the General Medical Council.

People can buy food grade cannabis products over the counter (for example cannabidiol, CBD and hemp oil products) as food supplements. These products are not medicines and therefore cannot make health claims. As with other over the counter products, care staff should take medical advice if people want medicines support to use food grade cannabis products. This is in case there are any issues, for example, interactions with prescribed medicines. A GP would not usually have to authorise the use of food grade cannabis products. But if a GP is involved, this could reduce any risks to the person concerned.

If care staff are supporting people with food grade cannabis products for their own (or a relative's) use, the service should do their own risk assessment.

Self administration

There is no extra requirement for controlled drugs to be treated differently if people are self administering them.