Frequently Asked Questions when supplying Care Homes July 2004 - for Community Pharmacists This document has been developed jointly between East Lancashire LPC and our local CSCI Inspector and is for assistance and guidance. It is not an exhaustive list, professional judgement should always be used in conjunction with the appropriate publications. No legal responsibility can be taken by either the LPC or the CSCI Q) Do Commission for Social Care Inspection (CSCI) inspectors recommend MDS? A) No, as long as a method of dispensing is safe and each tablet is identifiable. Storage and Disposal of medication Q) How long should medication be kept ? A) Dispensed bottles of loose tablets, with no labelled expiry date, for 3 months (whilst this does not mean they are out of date, you need to question whether they are still appropriate?) Blister packed in original manufacturer’s packaging …see the expiry date on the foil (but question appropriate usage after 6 months?) Blister packed from the Pharmacy, for 8 weeks from preparation not from receipt in the home Creams and ointments in a tub/jar, for 3 months and tubes, for 6 months Eye drops, for 28 days Liquid medicines, for 3 months (obviously not reconstituted products e.g. antibiotics!) Q) What about surplus/discontinued medication? A) Any medication , including dressings, that has been discontinued by the Doctor or the patient has died/left the home, must be safely disposed of. Q) What records for medication supply/return need to be kept? A) All medication coming into, or leaving the home must be recorded. The easiest way is via the MAR sheets. A lot of homes use a bound book to record returns. The Fridge Q) What type of fridge should a Care Home have? A) Ideally a locked dedicated medication fridge, or a locked non-metallic container within a fridge. (Domestic fridges are not ideal as they are opened too many times) Q) What medicines go in a Fridge? A) Check the manufacturers packaging (but normally you would have to store it in your own Pharmacy Fridge!) Q) What does not go in the Fridge? A) Not all eye drops require refrigeration eg. Isopto plain/alkaline eye drops, Visco tears. Chloramphenicol Eye Ointment Hydroxocobalamin injections. New-type insulin pens (that are in use!). Lactulose Staff sandwiches Bottles of beer for night staff East Lancashire LPC – Putting Community Pharmacy First ! Q) What temperature should the Fridge be? A) Between 2 to 8 degrees this should be measured using a max/min thermometer and the readings must be recorded daily and the records kept for a minimum of 6 months. Q) Can insulin be drawn up into syringes in advance? A) The practise of District Nurses pre drawing up Insulin into syringes is totally unacceptable. Controlled Drugs(CD) Q) How do you store CDs? A) All CDs are recommended to be stored in a CD Cabinet (including Phenobarbitone) it is strongly recommended that Temazepam is treated as a CD. Homes providing Nursing Care are required to store CDs in an approved cabinet and this is strongly recommended in all other homes. Q) What shouldn’t be stored in a CD cabinet? A) Other valuables, money etc should not be stored in CD or medication cupboards. Q) What type of book can be used as a CD Register? A) CD registers must be a bound, paginated book but do not have to be pre-printed. Q) What stock controls need to be entered? A) Running stock totals should be kept, counted and verified each time a CD is administered. Q) What happens when CDs need to be returned? A) Any CD that leaves the home should be recorded in the register. It is the homes responsibility to counter sign the register but it is good practice for the Pharmacist to sign for any return. PRN When required labels Q) How should prn medicines be labelled? A) They must be clearly labelled e.g. two to be taken for hip pain up to three times a day. Criteria for administration and when it should be given should be clearly documented by the home.(This means that all staff know clearly when the medication can be given!) Miscellaneous Q) Which documents relating to medicines must they have? A) Must have RPSGB documents they can be obtained from the website http://www.rpsgb.org.uk/members/index.html then select publications, then click society publications. The Administration and Control of Medicines In Care Homes and Children's Services Advisory Services to Care Homes Q) What if these FAQ don’t answer my question? A) Any Pharmacists (especially if new to providing services to Care Homes) or that need specific advice can contact Maggy Howells via email to firstname.lastname@example.org East Lancashire LPC – Putting Community Pharmacy First !