The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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Working closely with the psychiatrist to manage medicines
Staff had achieved outstanding outcomes for autistic people by supporting medical professionals to reduce or stop a reliance on medicines and explore alternative ways to help people manage their needs.
The provider identified a previously unrecognised negative impact on a person's wellbeing due to the side effect of an anti-psychotic medicine. Staff worked closely with the psychiatrist to develop a support plan and provide additional staffing to allow the person to reduce the use of this medicine.
This improved the person's wellbeing in other areas of their life. Only one antipsychotic medicine remained for the person, so the staff team then worked with the psychiatrist to remove this, resulting in the autistic person being free of all antipsychotic medicines and their case closed to psychiatry services after decades of treatment. The person was able to live successfully in their community with a reduced support package.
Read more about the service here.
Care provider: Avenues South East
Date published: November 2022
Using NICE guidance to support collaborative working with specialists
This provider implemented new medicines policies using NICE guidance on managing medicines in the community. To ensure their medicines procedures were stringent, they worked with pharmacists to incorporate specialised knowledge. Throughout, their service they have found NICE’s shared remit for producing guidance across health and social care enabled strong collaboration with other professionals including social workers, commissioners, GPs, nurses, dentists, and more.
See also: NICE social care quick guides
Giving medicines covertly
Effective record keeping and ordering of medicines
Discussing and planning medicines support
Care provider: Anonymous
Date published: January 2022
Using NICE guidance to safely manage medicines in homecare
Services use NICE guidance on managing medicines in the community to develop a medicines policy for their home care network. This ensured best, safe and robust practice for their home care network, leading to positive outcomes for their clients. The NICE guidance are easy to follow and a great resource for medicines policy development.
See also: NICE social care quick guides
Giving medicines covertly
Effective record keeping and ordering of medicines
Discussing and planning medicines support
Care provider: Anonymous
Date published: November 2021
Working closely with the local system Medicine Optimisation in Care Homes team
The service had worked with the local Medicine Optimisation in Care Homes team (MOCH) to improve medicine practise in the service.
The MOCH team’s feedback to the CQC stated: “Davers Court is one of the most engaged care homes that we’ve visited. The management and staff have always been keen to learn and have certainly encouraged the residents (where capacity is present) to participate in conversations about their medications. I’d go so far as to say that the medication rounds observed, the processes and procedures followed, and the conversations had with residents around the taking of medications were exemplary.”
Read more about this service here.
Care provider: Davers Court - Care UK Community Partnerships Ltd
Date published: March 2020
Managing medication effectively to improve behaviour
Staff supported one person who had very challenging behaviour and wanted to stay in bed all day. Staff displayed great passion and commitment to improve this person's life. They explained how they advocated for the person challenging other healthcare professionals to change the person’s medication and level of one-to-one support they required. As a result, the person’s behaviour has now totally changed; they’ve been able to go on holiday and the service is now looking at moving them to a supported living service.
Read more about this service here.
Care provider: Landermeads Care Home
Date published: March 2020
Medication champion
There was a medication champion amongst the staff team. This staff member was responsible for overseeing the medicine processes and procedures and researching the latest and best practice. This included ensuring training was up-to-date, ordering and checking in medicines, conducting monthly spot checks and audits, reviewing new projects, and sourcing guidance and research in relation to medicines in care home settings, such as STOMP.
Read more about this service here.
Care provider: SENSE - 89 Hastings Avenue
Date published: April 2019
Stomping out over medication
The service had signed up to the STOMP pledge (Stopping the Over Medication of People with a learning disability, autism or both), an initiative set up by the NHS. STOMP is a national initiative.
The registered manager worked with the lead NHS STOMP nurse. The training was then provided to all staff by a local training company, and provided details of what medicines were used for, and support with the confidence to challenge whether the medicines were needed.
The service developed a STOMP champion role so that staff were informed and advised of best practice. An audit of psychotropic (any medication capable of affecting the mind, emotions, and behaviour) drug use was undertaken to inform the STOMP pledge and staff training.
Read more about the service here.
Care provider: Community Support Service (D.D.H. Services Ltd)
Date published: March 2019
Designing your processes around NICE guidelines
The lead nurse devised a practical assessment tool in-line with NICE guidelines to ensure all staff administering medicines were assessed every three months against all aspects. This included storage and disposal, as well as administration.
Care provider: Anonymous
Date published: April 2018
Self-medication plans
Each person wishing to manage their medicines had a self-medication plan containing information as to: “what’s important to me regarding medication?”, “what do I need to do around medication?” and “how can staff support me with medication?”
Care provider: Anonymous
Date published: April 2018
Using supervision to investigate medication incidents
After any medication-related incident, the service responds quickly to arrange a special supervision with the care worker involved. The aim of the supervision is to review the circumstances and identify support needed.
Prior to the latest registered manager joining, the service would’ve simply asked the care worker to refresh their training rather than focus in on the specific issue that caused the incident. However, it was found that with effective supervision, this wasn’t needed, and the manager can help to correct their practice.
Care provider: Anonymous
Date published: April 2018
Instant access to electronic MARs records
People’s medicine administration records (MARs) are now documented electronically on the providers’ electronic care records system. Care workers have instant access to information about people’s medicines and are kept informed of any changes, such as commencing antibiotics. The system reduces the risk of errors by providing up-to-date information.
Care provider: Anonymous
Date published: April 2018
Best-interest decisions
One person was declining their medicines and the registered manager, with input from the GP, had assessed the person’s capacity to see if they understood the risks of not taking their medicines. The assessment detailed the most suitable environment for the conversation and the best time of day had been considered. The person was assessed as not having the capacity. A best-interest decision meeting was held with a multidisciplinary team, including the person’s family and GP, where a decision was reached and recorded.
Care provider: Anonymous
Date published: April 2018