React Homecare
CM31 – Safe Disposal of Medication Policy and Procedure
1. Purpose
1.1 To safely dispose of unused or expired medication.
1.2 To meet the legal requirements of the regulated activities that React Homecare is registered to provide:
o The Controlled Waste (England and Wales) Regulations 2012
o Care Quality Commission (Registration) Regulations 2009
o Medical Act 1983
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 Registered Manager
o Other management
o Care 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 Commissioners
o External health professionals
o Local Authority
o NHS
3. Objectives
3.1 To minimise and avoid unnecessary medicines waste, whilst maintaining confidentiality.
3.2 To promote safe practice and the efficient and effective management of medications, whilst complying with the 'Managing medicines for adults receiving social care in the community' NICE guideline [NG67].
4. Policy
4.1 This policy must be read with the Overarching Medication Policy and Procedure It will support any locally required policies and procedures. The policy, associated policies and procedures apply to all Care staff working within React Homecare and must be read and followed.
4.2 React Homecare understands that medicines that have been prescribed for, and dispensed to individual Service Users, remain their property and that React Homecare has responsibility for transporting, storing and disposing of
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medicines. Where there is a requirement to support with the administration of medication, consent must be sought before disposal of medicines takes place and React Homecare will ensure that staff are aware and follow the procedures for the safe disposal of medication.
4.3 React Homecare will agree with the Service User and/or their family members or carers as to who will be responsible for transporting medicines to or from the Service User's home. If React Homecare is involved, a risk assessment of transport arrangements will be carried out alongside the medication risk assessment at React Homecare.
4.4 COVID-19
There may be exceptional circumstances surrounding the disposal of medications during the COVID-19 pandemic, and these may include:
o Community pharmacies may not be able to accept returned medicines as they have previously done due to the COVID-19 pandemic reducing their capacity, or due to the specific infection control measures they have established
o This change in practice during the pandemic may also apply to licensed collection agencies that the Service User may have engaged for the collection of medications no longer in use
o As a result, the Service User may have to store increased amounts of medications due for disposal or return. If this is the case, additional secure storage space should be made available, a suitable risk assessment undertaken and accurate records maintained of the medication waiting for disposal or return
5. Procedure
5.1 General Disposal Procedures
Where the administration of medication is required as part of the Care Plan:
o Medicines no longer required by the Service User will be disposed of, with their consent, by returning to the dispensing pharmacy or Doctor
o At no time may one Service User's prescribed medication be used for any other person
o No medicines will be thrown in the bin or down a sink or toilet. Any sharp objects (e.g., needles) or other clinical waste will be disposed of into designated bags/containers if these have been made available
o No out-of-date medicines or discontinued medicines are to be kept. Out-of-date medicines for disposal must be kept separate from medicines in use
5.2 Disposal applies to:
o Medication that has been discontinued
o Medication remaining due to a Service User's treatment having been changed or discontinued
o Dispensed doses that have been refused
o Medication that is past the expiry date
o Medication remaining after a Service User has died
A record of the medication for disposal must be kept by React Homecare, and must include:
o The date
o The name of the Service User
o The name, form (e.g., tablets), strength and quantity of the medication to be disposed of
o The name of the member of staff disposing of the medication
5.3 Disposal of Medication from a Monitored Dosage System (MDS) or Packaging Strip
o It will be noted that unused medicines dispensed in a monitored dosage system must be discarded no later than eight weeks after the dispensing date
o Any unused tablets/capsules removed from an MDS or packaging strip by a Care Worker will ideally be placed in a sealed envelope or something similar with the following information added:
Service User’s name
Date
Time
Reason (e.g., refused, dropped on the floor)
Care Worker's name and signature
The Care Worker must contact the office and obtain consent from them and from the Service User to take the medication to a pharmacy for disposal. A Medication Return Form must be completed and an entry made in the Care Worker Communication and Visit Log of actions taken. The Medication Return Form must be sent to the office for placing in the Service User's file
5.4 PRN Medication
When required, “PRN” medications in bottles or packs will be checked for expiry dates and sent back to the Pharmacist when out of date. Any out-ofdate items will be re-ordered from the individual Service User's GP if still required.
5.5 Controlled Drugs (CDs)
CDs will be returned to the Pharmacist or dispensing Doctor at the earliest opportunity for safe disposal. When CDs are returned for disposal, a record of the return will be made using a Returns Sheet and the Pharmacist or dispensing Doctor asked for a signature to note their return.
5.6 Disposal of Patches
Old patches will be disposed of by folding back and sticking the adhesive sides together and then disposing of them safely as directed in the Patient Information Leaflet.
5.7 Sharps Disposal
Where a Service User’s medication support generates ‘sharps’ (needles, syringes, lancets for finger pricking for testing blood) then these must be disposed of in a designated ‘sharps bin’ supplied through the GP or Community Nursing Team. Care Workers will only be providing support with this if it has been agreed as part of the Care Plan, a risk assessment is in place and specific additional training has been undertaken.
5.8 Disposal of Liquid Medication
In the event of a Care Worker measuring a dose of oral liquid medication and the Service User then refusing to take it, the following actions will be taken:
Do not return the dose to the medicine bottle
Place it in a suitable container, as available
Mark it as waste and name the medicine
If it will not be going to the pharmacy immediately, ensure that it is stored securely and removed asap
The Care Worker must make an entry in the Communication and the Visit Log indicating that the dose has been disposed of, and the appropriate record will also be made on the MAR. The Care Worker must also inform React Homecare.
5.9 Deceased Service Users
Medication belonging to recently deceased Service Users must be kept for seven days before being returned to the Pharmacist for disposal. This is in case the Coroner's Office, Police or courts require them as evidence as part of any investigation into the death of the Service User.
5.10 Communication
React Homecare will ensure that the Service User's GP and Community Pharmacist have the details of React Homecare so that prescribers can communicate changes to a Service User's medication (e.g., when stopping or starting a medicine) by:
Informing the Service User or their named contact, and
Providing written instructions of the change or issuing a new prescription, and
Informing the Service User's supplying pharmacy, if this is needed and agreed with the Service User and/or their family members or carers
6. Definitions
6.1 Monitored Dosage System (MDS)
o A 'Monitored Dosage System' is a term associated with the way that a Service User can receive their medicines which have been 'repackaged' by the Community Pharmacist into a 'box' or 'blister system' which indicates the days of the week and times of day medicines should be taken
6.2 PRN Medication
o Abbreviation meaning 'when necessary' (from the Latin 'pro re nata'), for when required or as needed
6.3 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
6.4 Pandemic
o A pandemic is the worldwide spread of a new disease
o 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:
All staff with responsibility for medication administration will be aware and knowledgeable of the method of destruction of unused/date expired drugs
Medication belongs to the Service User and consent will be obtained before it is destroyed or returned to the pharmacy
Medication belonging to a Service User will never be used for someone else
React Homecare will keep records of medicines (including Controlled Drugs) that have been disposed of, or are awaiting disposal
8. Key Facts - People Affected by the Service
People affected by this service should be aware of the following:
Any unused medicines in monitored dosage systems will be returned to the pharmacy after eight weeks
Your medication will not be given to anyone else and it belongs to you
If you have any queries relating to your medication, please speak to staff at React Homecare
9. Further Reading
We recommend that you add to your understanding in this policy area by considering the following materials:
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
Policies and Procedures at React Homecare:
o Overarching Medication Policy and Procedure
o Controlled Drugs Policy and Procedure
o Training and Competency on Medications Policy and Procedure
10.Outstanding Practice
To be ‘outstanding’ in this policy area you could provide evidence that:
Service Users are supported to self-manage their medication where they have been assessed as having the capacity to do so. Staff understand the Mental Capacity Act and can apply it in practice
Records surrounding medication disposal, return or refusal are extremely clear, well ordered and provide a robust audit trail
There is evidence that staff understand the Mental Capacity Act and the need to obtain consent when disposing of medication. Where Service Users lack capacity, best interest decisions are 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