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Care assistants can administer drugs in nursing homes ‘with right training’

  • 11 Comments

Guidance on when care assistants can administer medicines to nursing home residents has been launched in a bid to clear up confusion in the sector.

The guidance, which was developed by the University of Leeds for the Department of Health, makes it clear care assistants can administer medication with the right training and assessment.

Enabling support workers to give medicines can free up registered nurses employed in homes to do other essential care tasks. However, concerns about whether this is legal or appropriate have prevented some settings from doing this.

“The guidance makes it clear that it is legal for care assistants to undertake this enhanced role, as long as they have been appropriately trained and their competence is regularly assessed,” said Professor Karen Spilsbury, who was involved in writing the document.

“This will free up time for registered nurses, so they can engage with residents and spend time on other important areas of work,” said Professor Spilsbury who is investment chair in nursing at the university’s school of healthcare.

She cited caring for residents with complex care needs, managing complex therapy and medication regimes or supervising other care staff as examples.

A review found there was no evidence administration of medicines by care assistants increased the number of medication errors as long as they had the right training, assessment and support – alongside robust procedures for reporting any issues.

“It provides much-needed clarity not just across the care home sector”

Sharon Blackburn

As a minimum, the guidance said training should cover the supply, storage and disposal of medicines, as well as how to administer them safely and keep accurate records and issues like accountability and confidentiality.

Training should also include common issues linked with errors such as the need to check allergies and drug sensitivities, the fact errors are more common in the morning and that interruptions during preparing and administering medicine are more likely to lead to mistakes.

The guidance has been welcomed by care home providers and regulators.

Andrea Sutcliffe, the Care Quality Commission chief inspector of adult social care, said: “This new guidance reinforced the importance of providers making sure care assistants are trained and supported to carry out medicine tasks in a safe and effective manner for the benefit of the people they are caring for.”

Andrea Sutcliffe

Andrea Sutcliffe

Andrea Sutcliffe

The National Care Forum, which represents not-for-profit health and care providers, also gave the guidance its backing.

“It provides much-needed clarity not just across the care home sector but also the wider health and social car system,” said policy and communications manager Sharon Blackburn. “It is good for residents, care staff and nurses.”

However, she noted that many of the body’s members already had protocols in place to support care assistants to administer medication.

  • 11 Comments

Readers' comments (11)

  • michael stone

    Administering the medication, is a level of complexity down from prescribing the medication - which, in turn, is a level of complexity down from diagnosing the illness.

    While there are obvious dangers in allowing new HCAs to administer medication, it seems much more reasonable if experienced and suitably trained HCAs are allowed to do it.

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  • Hi Michael,
    This not new, this directive came out years ago, in ordinary Care Homes the staff do all medication it is the Managers Duty to ensure that all dispensing staff our fully trained.
    Bye the way I personally find your contributions very interesting as your viewpoints are from an unusual perspective, I believe your intentions are honorable if not always fully informed , looking forward to more chats.
    For the Michael knockers out there, why don't you try to understand the message and give Michael an informed argument, this way we might all be enlightened.

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  • Identification of capable staff, appropriate training and ongoing support is key to safe, effective and appropriate medication administration in any setting. Care staff have been administering medication within the setting for many years. Furthermore community carers have championed this role for many years prior to that. Of course with corporate responsibility there is caution. In our care home staff don't automatically "do" medication administration- the person is assessed to see if that is an area that they need support with. It would be interesting to have some discussion on how well prepared people who are self-medicating feel?

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  • Giving a drug is a piece of pie. Parents and carers do it at home. the skill is in looking for interactions, side effects etc and knoowing about the actions and contraindications etc. Calculating doses in children is a bit more difficult but not rocket science. given the number of medication errors by nurses I would like to see triennial assessments and ad hoc checks on them too.....

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  • michael stone

    Anonymous 9 June, 2016 6:18 pm

    I'm frequently not very informed about clinical things, but you would surprised by how many doctors are 'not very informed' about legal things - see the reply to a student nurse I've just posted on NT:

    https://www.nursingtimes.net/student-nt/people-die-alone-and-scared-whilst-in-our-care-and-it-is-unacceptable/7005354.article?blocktitle=Student-Editors%27-blog&contentID=9329

    Anonymous10 June, 2016 8:55 am

    Yes - 'the skill is in looking for interactions, side effects etc and knoowing about the actions and contraindications etc'. I decided, in the interests of brevity, to not include the 'spotting the side effects' aspect, although part of your sentence would fall within my 'prescribing the medication' comment.

    As people are pointing out, HCAs already do administer medication - a very sound reason, for making sure (or trying to) that this is done competently.

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  • From a personal experience as working as a carer who did administer medication in the community in a residential home, the process is similar to that of a nurse but nowhere near as complex.
    The medications are prescribed for the individual patient for example with the dose as "2 Tablets" instead of 600mg. There are no dose calculations and many also come in blister packs.
    Of course the usual checks of right patient,right time, right medication etc. are still carried but as I am now a student nurse I can safely say the role is very different. Like you would with your own medication you check the patient information leaflet for side effects and contact the GP for advice if necessary.

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  • The nmc guidelines states that a nurse can delegate to a competent person. It's down to professional judgement and accountability of that judgement. I would like to think that no organisation in their right mind would expect a new hca to complete this task, entirely unrealistic. Senior HCA's are more suitable having completed nvq 3, medication safety ncfe, cross referenced their care certificate mandatory course and completed a competency framework which would comprise of supervisions and assessments in practice.
    Afterall TAP's already have this skill in hospitals. There are TAP's in care homes too.

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  • Stoned! Cheeky monkey. You know nothing about the subject or professional healthcare as your commentary persistently demonstrates.

    Interesting how in the mid- 1990s when law and medicine was a newly taught course in uni for higher degrees with an examination and thesis at the end and very few textbooks on the subject. It was a mutual learning experience for us as senior medical professionals and for our lecturer from the legal profession whose eyes we opened when it came to explaining to him practice in hospitals and with much focus on EOLC where every single one of our patients was always offered the highest standards of individualised care which, wherever possible as should go without saying, (but you need every detail spelt out to satisfy your morbid and nosey mind) incorporated the patients' or their representatives' wishes (surprise obviously to you). Now please run along little fellow and see what you can submit to your comics although even there it requires talent, and stop wasting everybody else's time!

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  • Anonymous16 June, 2016 9:21 am
    Well I go back to the 80s and I remember the Cinderella geareactric wards with Consultants in charge, they were appalling so please stop your bigotted attack on Michael as it is these sort of people that are forcing change not the likes of you.
    There is still a long way to go just refer to the Mid Staffs Hospital "Care of the Elderly"

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  • 16 th June 6.26 pm

    No idea what you consider 'the likes of you' but it sounds you are rather anti professionalism and advancing the highest standards of care and within legal frameworks. Shame, for you as that is the way the 'business' of care is conducted in Britain and other leading healthcare systems.

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