Responsibilites

6.1 Registered managers / care managers have overall responsibility for medication safety within services and for delegation and accountability.  They must ensure: 

• compliance with all relevant requirements, for example with this and other relevant council policies, local procedures, the Medicines and Healthcare products Regulatory Agency (MHRA) safety alerts, the law, relevant guidance. Regulated services must meet the requirements of external regulators.
• the service has written medication procedures. These must be reviewed regularly and include:
  • designated key holders for the service recording requirements
  • controls and staff guidance developed in conjunction with a doctor or pharmacist for over-the-counter products if the service offers these for general use.  See Appendix 3 for minimum requirements.

• that roles which involve assisting people with medication are identified and that the service has appropriate arrangements for medication training, competency assessment and alerting staff to changes to requirements
• the service has appropriate arrangements for assessing medication related risks and developing plans for people using services (including children and young people) and keeping these under review.
• that medication stocks into and out of the building are recorded and, medication practices and records are regularly audited.
• Ensure medication errors are reported following the process in section 12
• In children’s services, registered managers must also ensure that medication arrangements reflect the child’s placement plan, delegated authority, and that the child’s views, wishes and feelings are taken into account.

6.2 Line managers / shift leaders must ensure that:

• people using the service:
  • have a medication risk assessment (see section 7.1) which is updated as required.
  • have an up-to-date PRN protocol when required. If this is not in place, we may ask the person to attend the adult day centre/short break session at a later time once the protocol has been updated.
  • medication must not be administered until an appropriate PRN protocol is in place.
  • have a plan which confirms the exact nature of medication support (if any) the person requires from staff. The plan must be kept under review.
  • If attending as part of an adult’s services, the person must have provided their consent to any necessary support with medication. Where relevant, consent may be provided by a representative or agreed through a best interest decision.
  • If attending as part of Children's Services a competent child aged 16 or over or under 16 who is Gilick competent must have provided consent to any necessary support with medication. Where a child lacks capacity or competence consent needs to be obtained by those holding parental responsibility for the child. For looked after children, decisions must align with delegated authority arrangements and the child's care planning. Consent arrangements must be clearly recorded. Where there is a disagreement in relation to medical administration between those holding parental responsibility for a child in these circumstances legal advice should be sought.
  • Where the person is a child or young person, plans and risk assessments must also consider the safety of others in shared living environments.

• care and support staff:
  • understand their role and responsibilities and what records they must keep.
  • complete all medication training required by the council and undergo regular assessment of medication competency.
  • receive appropriate information, instructions and support for their role.
  • consult and follow the requirements of the medication administration record (MAR), plans and other relevant medication instructions.  

6.3 Care and support staff must:

• administer medication safely and as required by this policy and local procedures
• consult and follow the instructions in the person’s plan and MAR
• check for and follow amended instructions. These must be recorded in the communications / message book or in handover records
• follow the prescriber’s instructions and seek advice from the prescriber or a pharmacist as required
• alert a line manager / health professional as appropriate where there are concerns about the person’s health or safety. Staff are not permitted to make clinical judgements and must seek advice from an appropriate health professional as needed
• keep accurate, complete and up to date records of all medication related activities
• alert their line manager if they believe they need more support or additional training in order to safely manage medication
• consider if tasks are ‘delegated healthcare’ and speak with their line managers if they have concerns

6.4 The person, their family, carers or those with parental responsibility must:

• bring their medication and safety information sheets/patient information leaflet with them
• take their medication as prescribed where they are able to do this independently or with agreed support
• provide up to date information about their medication including any changes made by their GP or healthcare professional
• have an up-to-date PRN (as required) protocol where this applies, emergency medication protocols must be reviewed in line with their review period or services will be stopped until such a time they are reviewed
• inform staff if they feel unwell, have missed a medication dose or have any concerns about their medication to allow staff to gain advice from a healthcare professional
• store their medication safely following agreements with the service
• work with staff to make sure medication support is provided in line with their care plan and personal preferences.
• ensure where a person uses a swallowing aid and has over the counter medication, any medication interactions should be discussed with a healthcare professional, with this information provided to the service