React Homecare
CM30 – Storage of Medication Policy and Procedure
1. Purpose
1.1 To support the safe storage of medication in the Service User's own home.
1.2 To meet the legal requirements of the regulated activities that React Homecare is registered to provide:
o The Care Act 2014
o The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
o Medicines Act 1968
o The Human Medicines Regulations 2012
o Misuse of Drugs Act 1971
o The Misuse of Drugs (Safe Custody) Regulations 1973
o The Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007
2. Scope
2.1 The following roles may be affected by this policy:
o All staff
2.2 The following service users may be affected by this policy:
o Service Users
2.3 The following stakeholders may be affected by this policy:
o Family
o Commissioners
o External health professionals
o Local Authority
o NHS
3. Objectives
3.1 To ensure that Service Users who require medication administration are supported to store their medication safely.
3.2 To ensure that Service Users who self-manage their medication are aware of how to store their medication safely.
4. Policy
4.1 React Homecare will undertake a medication assessment which will include a medication risk assessment in line with the local procedures at React Homecare. When a Service User's needs change or there is an incident or near miss, the risk assessment and Care Plan will be reviewed. The risk assessment will include how medication is stored in the Service User's home.
4.2 Service User consent must be sought before providing any support with medication. Where a Service User is assessed as lacking capacity, a best interest decision will be undertaken and documented.
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4.3 The decision about where to store the medicines in the Service User's home must take into account the Service User's right to choice and their mental capacity.
4.4 Where a Service User is supported with medication and there is a risk of misuse, their medication needs to be kept in a secure place out of their sight and reach where it is only accessible to family, care workers and other healthcare professionals. This will be agreed and noted in the Care Plan.
4.5 When a Service User is assessed as requiring support with administration, all medication will be examined for information about storage conditions and these conditions must be adhered to.
4.6 React Homecare will comply with the Misuse of Drugs Act 1971 and associated regulations when storing controlled drugs.
4.7 Coronavirus (COVID-19)
During the COVID-19 pandemic additional considerations may need to be taken into account, including:
o Medicines used by Service User diagnosed with, or symptomatic of, COVID-19 must be held securely and, if possible, separately from other medications
o If oxygen is used by the Service User then all appropriate measures, as described in the Procedure section of the policy, must be followed
o There may be a wider range of medications used to support Service Users at React Homecare, as such there must be adequate, appropriate and secure storage available
o There may be more Controlled Drugs held in the Service User's home, which must be sufficiently stored to ensure that they are held securely in line with legislation and best practice
o Risk assessments must be updated to cover the issues concerning the storage of medication for Service Users diagnosed with, or symptomatic of, COVID-19
o React Homecare will monitor the ongoing medication requirements of Service Users
5. Procedure
5.1 General Principles
o Keep all medication in the original container in which it was dispensed
o Keep medicines in their original outer packaging to protect from sunlight
o All medicines must be stored in a cool (below 25°C), dry place unless refrigeration is required (between 2°C and 8°C)
o The expiry date of products can change once opened
o Record the date opened and the calculated expiry date on the medicine package/label
o Be vigilant with product expiry dates
o Store as recommended by the manufacturer
o Use disposable gloves when applying creams or ointments (a new pair for each Service User)
o Medication will be user specific and ‘sharing’ of medicines, including creams and ointments, is prohibited
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o Note and act on any specific storage instruction, e.g., 'store in the fridge'
o Rotate stock so that the earliest expiry is at the front and therefore going to be used first, i.e., ‘first in, first out’
o Check expiry dates of medication stock and this includes any blister packs
o Medication is to remain in the container in which it was received –batches must not be mixed
5.2 Service Users who Require Support with Medication Administration
Where other agencies or health professionals are involved in the administration of medication, React Homecare will discuss where medication is to be stored and the Service User will be involved if they have capacity. If family or friends provide assistance with medication, such as ordering or prescription collection, they will be involved in discussions about where medication is stored either with the Service User's consent if they have capacity, or as part of a best interest decision if they lack capacity.
5.3 As Required Medication (PRN)
Be aware of the expiry date of PRNs, especially if they are not used frequently. It is good practice to date and initial on opening all PRN medication for audit trail purposes.
5.4 Storage of Medication Other Than Tablets or Capsules
o Dates of opening, or starting to use the medication, will be recorded on such items that have a short shelf life once opened, e.g., liquids, creams, eye drops
o Periodic checking of expiry dates of all stored medication and dressings will be carried out by trained staff and appropriate records will be kept
o Medications beyond their expiry date will not be used and must be disposed of appropriately
o Where medication is stored in a fridge, the fridge must be checked to ensure that it is in working order
5.5 Storing Medicines Away from Service Users
If there is a risk identified that a Service User would be in danger by accessing their medicines, or of causing themselves harm, then a decision may be needed to store medication securely away from them (for example, in a locked box). This is an important and sensitive decision, which may deny a Service User their rights.
Where the Service User has been assessed as lacking mental capacity, a best interest decision may be required. The decision must be documented on the risk assessment. The decision must be reviewed at least annually and if the risk changes. Any decisions which may breach a Service User's rights will be considered in line with the Mental Capacity Act and Code of Practice.
5.6
Storage of Oxygen
o If a Service User is prescribed oxygen, React Homecare must discuss storage with the company who supplies the oxygen. Their advice will be documented and followed
o A risk assessment must be completed for the storage and use of oxygen, in line with health and safety procedures
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o Oxygen cylinders must be stored safely, under cover and not subject to extreme temperatures. This will be in a dry, clean, well-ventilated area away from highly flammable liquids, combustibles and sources of heat and ignition
o Cylinders must be handled with care, never knocked violently or allowed to fall over. They must be switched off when not in use. Cylinders will only be moved with a trolley specifically designed for the cylinder size unless it is a small portable cylinder
o Oxygen concentrators must be stored upright and plugged directly into the mains socket. Adequate ventilation must be provided around the concentrator. They must always be switched off when not in use
o In the case of fire, it is the responsibility of staff to inform the fire brigade that oxygen cylinders are present and where they are located. When evacuating a Service User from their home, cylinders left in the premises will be switched off, where it is safe to do so, as part of the evacuation process
o Care must be taken where Service Users use dressings, bandages, creams or ointments that contain liquid paraffin as this is highly flammable
5.7 Controlled Drugs
Due to the potent nature of Controlled Drugs, Service Users, their family and/or carers will be given instructions to store the medicines securely within their own home, where they are not on display to others and therefore liable to misuse or diversion. Advice relating to storage will be provided by the practitioner issuing the prescription and the Community Pharmacist supplying the Controlled Drug to the Service User.
React Homecare must also advise the Service User regarding the safe storage of their medication in accordance with the patient information leaflet, and with any instructions on the label.
5.8 Coronavirus (COVID-19)
During pandemic situations, such as COVID-19, government guidelines will be followed when supporting Service Users including in relation to personal protective equipment. The Personal Protective Equipment (PPE) Policy and Procedure at React Homecare can be reviewed for further information in relation to this.
6. Definitions
6.1 Controlled Drugs (CDs)
o Some prescription medicines are controlled under the Misuse of Drugs legislation (and subsequent amendments). These medicines are called controlled medicines or Controlled Drugs
o Examples include morphine, pethidine
6.2 Expiry Date
o The expiry date is the point in time when a pharmaceutical product is no longer within an acceptable condition to be considered effective
o The medication reaches the end of its ‘shelf life’
6.3 As Required (PRN Medication)
o Medicines that are taken 'as needed' are known as 'PRN' medicines
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o PRN is a Latin term that stands for 'pro re nata,' which means 'as the thing is needed'
6.4 Coronavirus (COVID-19)
o Novel coronavirus is a new strain of coronavirus first identified in Wuhan City, China. The virus was named severe acute respiratory coronavirus 2 (SARS-CoV-2). The disease it causes is called COVID19
6.5 Pandemic
o A pandemic is the worldwide spread of a new disease, COVID-19 was characterised as a Pandemic on 11th March 2020
7. Key Facts – Professionals
Professionals providing this service should be aware of the following:
Medicines must be stored in line with guidance on the patient information leaflet
Where too much medicine is stored and there is a risk of errors occurring, React Homecare must work with the Service User to ensure the safe storage of medication
React Homecare will ensure when providing administration support, that too much medicine is not ordered and stored
React Homecare will ensure that expiry dates are monitored and medicines removed when they reach their expiration date
8. Key Facts - People Affected by the Service
People affected by this service should be aware of the following:
You do not have to lock your medicines away. However, you must make sure that all medicines are stored safely and properly
9. Further Reading
We recommend that you add to your understanding in this policy area by considering the following materials:
BOC - The Home Oxygen Handbook: https://www.bochealthcare.co.uk/en/images/ 406900_Healthcare_Patient_Home_Oxygen_Handbook_NHS_A4_RZ_tcm40966361.pdf
NICE: Managing medicines in care homes (although tailored to care homes it is a useful resource to review): https://www.nice.org.uk/guidance/sc1
CQC: Ordering, transporting, storing and disposing of medicines by home care agencies: https://www.cqc.org.uk/guidance-providers/adult-social-care/ordering-transportingstoring-disposing-medicines-home-care
UK Government: Coronavirus (COVID-19): https://www.gov.uk/coronavirus Page 5 of 6
10.Outstanding Practice
To be ‘outstanding’ in this policy area you could provide evidence that:
'Opened' on dates are recorded on medication that have a short shelf life on opening, e.g., drops, liquids, external preparations
Risk assessments are in place for medication administration
When incidents occur, root cause analysis and lessons learnt are applied to ensure continuous improvement
Staff are trained and understand the implications of the Mental Capacity Act and the need to ensure valid consent. Where a Service User lacks capacity, a best interest decision is taken and recorded
Date Policy Reviewed
18th May 2017
8th March 2018
13th March 2019
7th April 2020
30th April 2021
Signature of Reviewer
D Woolley
D Woolley
D Woolley
D Woolley
D Woolley