Over the counter medicines and homely remedies

Over-the-counter (OTC) medicines and nutritional supplements can be purchased from a pharmacy, any general store or online.

The General Pharmaceutical Council has produced guidance on how to buy a medicine safely online.

Over-the-counter products include:

• medicines that:
  • ease the symptoms of a condition that is self-limiting
  • treat a condition when the person does not normally need to seek medical care or treatment
• nutritional supplements such as vitamins and minerals that a person may choose to take to supplement their diet.

Supporting people to self care

People should be supported to manage their own care. Giving people access to over-the-counter products and enabling them to choose is an issue of equality. You should therefore make adjustments to support all people to access them.

You should have a policy to support people who wish to self care or who need to manage their own care. This should include the necessary safeguards to support a person to get access to over-the-counter products, or to support their carer or relatives to provide them. For example, the policy could include how you protect people who may lack mental capacity to make decisions. Staff must be trained and competent to support a person to self care with over-the-counter products.

It is good practice to discuss health needs and medicines with the person and their family. This could be on admission to the care home or when a home care service is provided. The discussion should also include the use of over-the-counter products.

There should be a clear care plan that includes how to trigger a review. This will make sure that over-the-counter products given are safe and still appropriate. Care plans should include how staff will support people to self care. Staff should consider people’s religious beliefs, dietary preferences, intolerances or allergies, and swallowing difficulties.

A person or their relatives may provide their own over-the-counter products. These are not for general use and must remain the property of that person.

A healthcare professional may recommend a specific product to treat a minor condition that does not require ongoing treatment, which the person, their relatives or care staff can buy. For example, athletes foot cream. You must record verbal or written instructions in the person’s care plan.

All over-the-counter products purchased on behalf of the person or brought into a care setting should be:

• checked with an appropriate healthcare professional to make sure they are suitable
• in date
• stored according to the manufacturer’s guidance
• recorded in care plans

Any support provided by care staff to help people use OTC products must be recorded. If care staff are responsible for administration, record this on a medicines administration record in line with policy.

Homely remedies in care homes

A homely remedy is a medicine used to treat minor ailments. They are purchased over the counter and do not need to be prescribed. They are kept as stock in a care home to give people access to medicines that would commonly be available in any household such as mild pain relief, treatment for coughs or indigestion.

If you are offering people treatment for minor ailments with homely remedies, you should have a policy for how to do this safely. You should follow the recommendations described in NICE guideline SC1 on managing medicines in care homes.

Food supplements

We check whether providers are meeting people’s nutritional and hydration needs under Regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People who use services must have adequate nutrition and hydration to sustain life and good health. This regulation aims to reduce the risks of malnutrition and dehydration for people who receive care and treatment.

You must make sure that people have enough to eat and drink to meet their nutrition and hydration needs. This may include support to take nutritional supplements, for example vitamin D.

Some people will not get enough vitamin D from sunlight because they have little or no exposure to sunlight. The Department of Health and Social Care recommends that some people take vitamin D supplements throughout the whole year, including:

• people who live in a care home
• people who are not often outdoors, for example because they are frail or housebound
• people whose clothes cover most of their skin when outside.

People from ethnic groups with a darker skin pigmentation may also need to take vitamin D all year, as they may not produce enough vitamin D, even if they spend time outside. If people receiving care choose to take a vitamin D supplement, staff should support them to take it safely.