All individuals living in a care home should receive a high standard of care and support. As a large number of care home residents have health requirements, it is essential that there is a clear understanding over who is legally allowed to administer medication.
The National Institute for Health and Care Excellence (NIHE), has created a set of guidelines for managing medication in care homes. This set of guidelines focuses on ensuring the safe administration of medications, and includes detailed information on all typical medications used within care homes.
If a care home is registered to provide forms of nursing care, then a registered nurse should be the one to provide medication. However, it may be the case that a care home contains health care assistants, who have also been through the necessary training procedures, allowing them to administer certain forms of medications.
Care assistants can legally administer medication, however they must have been professionally trained. Training around medication should include guidance on storage, disposal, record-keeping and administration — ending with a formal assessment to determine confidence. If a care assistant has completed the necessary training but is not fully confident, they should still not be allowed to administer medication. In addition, care assistants should only administer the specific medication that they have received training on. Training carried out by healthcare assistants often covers the following areas:
For those with more complex medical conditions, a registered nurse will usually be in charge of managing and administering the medication. Registered nurses can carry out activities such as:
Registered nurses must oversee all areas of medication management, and are responsible for the overall nursing care of a patient. If they choose to delegate a task to a trained care assistant, it is still their responsibility to supervise and ensure all is managed correctly. Nurses must also carry out additional duties such as assessing care needs of residents, implementing care plans, documenting medical information and overseeing care assistants in their day-to-day tasks.
Every resident within a care home will, of course, require different levels and forms of medication. Registered nurses should continually assess a resident’s care needs each day, and use their clinical skills and training to determine the best course of action. Each individual should receive a personalised care plan, to ensure that they are able to get the exact support or assistance that they require.
In many cases, a Comprehensive Geriatric Assessment (CGA) or Comprehensive Older Age Assessment (COAA) will be carried out before or during a resident’s stay at a care home. A CGA covers the physical, psychological, social and environmental needs of an individual, helping to create the most effective plan of care, which can be implemented by nurses and care assistants.
In other cases, a Care Needs Assessment may be more appropriate for the individual. This can be carried out by a social care professional, prior to entering a care home. This type of assessment focuses on what support someone requires in their everyday life. This could range from struggling to cook, clean or take medication, and can be passed on to care home staff.
Undergoing the correct training is crucial to ensure that medication is managed safely and effectively. As stated within the NIHE guidelines, care home providers should have either an internal or external learning and development programme set up. Usually, care home providers will choose to use an accredited provider, so that an external assessor is able to fairly judge the competency of the staff. Staff should also have regular, internal reviews to assess their skill levels and offer further training if required.