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					     Practice No.        Version 3        Page 1 of 3                 Last up-dated
         125                                                            Mar 2009
  Reference: 10/06   HCC AS 06/09    CSCI/CQC: Quality       NMC Code of Professional
                                     Performance and         Conduct
                                     Methods Directorate :   NMC Standards for
                                     The Safe                Medication Management Aug
                                     Management of           2008
                                     Controlled Drugs in     GSCC Code of practice for
                                     Care Homes (Jan 07)     social care workers and
                                                             employers
                                     The Royal Marsden
                                     Hospital Manual of
                                     Clinical Nursing
                                     Procedures


                HANDLING AND USE OF HOMELY REMEDIES


This defines the arrangements for the sourcing, storage and use of Homely
Remedies within the a residential or nursing home:

NB: These guidelines must be read in conjunction with the Medication
Management Policy 60/09

  ‘A homely remedy is a medication that may normally be bought by a person
  without calling a doctor’.


     1. Residents may purchase their own homely remedies, but whenever
        possible they must be encouraged to tell staff what they are taking so that
        a record of their medication can be kept.

     2. Where prescribed medication is also being taken, it will be necessary for
        the home to check with the pharmacist for possible drug interactions. This
        includes herbal and homeopathic remedies as they have the same
        potential for drug interactions and side effects as any other medication.

     3. Where residents are administering their own homely remedies, a full risk
        assessment must be made and recorded in the care plan, and the
        remedies must be kept in the resident’s room in a locked cupboard.

     4. A list of homely remedies which may be made available to residents, must
        be sent to each General Practice which has patients in the home, for the
        doctors to approve, sign and return to the home. This signed authority
        must include details of any resident who may not be given a homely
        remedy. These lists must be kept in the same folder as the Medication
        Administration Record. (MAR sheets)

     5. Homely remedies must be stored in a separate, labelled cupboard from
        prescribed medication. Expiry dates and storage details must be checked
        regularly and unused and expired items returned to the pharmacy in the
        specified way. If a tube of cream is opened for a resident it must be kept
        only for that person and must not used by anyone else.

     6. Homely remedies must only be administered at the request of the resident,
        or by a designated member of staff, for the condition specified on the
                  homely remedy chart.

              7. Before administering a homely remedy, the relevant list must be checked
                 to make sure that the resident’s GP has given permission for the
                 medication to be administered to that individual.

              8. The guidelines for each medication must be followed, and if there is any
                 query a pharmacist must be consulted before the medication is
                 administered.

              9. A record must be kept on the Medication Administration Record sheet of
                 the date, time, quantity of the medication given, and the fact that it was a
                 homely remedy.

              10. Homely remedies may only be given for a maximum of 48 hours. However,
                  if at any time there is concern about the resident’s condition, a doctor must
                  be informed.

              11. If a medication which is included on the ‘Homely Remedy’ list is prescribed
                  by a doctor for a resident, it cannot be used as a homely remedy for that
                  resident, but must be given according to the instructions on the
                  prescription.


              Sample ‘homely’ remedies list

              All doses given must be entered on the MAR sheet, with the quantity, date and
              time. The remedies must be stored in a separate, labelled, locked cupboard
              separate from the resident’s prescribed medication.

                                                      MAX         CONTRA-                       DOCTOR
CONDITION           DRUG           DOSE               DOSE IN     INDICATIONS and               APPROVED
                                                      24          PRECAUTIONS
                                                      HOURS
Constipation        Mist           25-50mls at        50mls       Contraindication: Elderly
                    Magnesium      night                          and debilitated persons,
                    Hydroxide                                     those with Renal
                                                                  impairment or Gastro-
                                                                  intestinal conditions.
                                                                  Caution: May cause
                                                                  colic
Constipation        Senna          One or two         2 tablets   Caution: May colour the
                    Tablets        tablets at night               urine or stools
Constipation        Lactulose      15mls twice        30mls       Caution: May take up to
                                   daily                          48 hours to work.
                                                                  Can cause wind.
Dry Cough           Simple         10mls three        30mls       Caution: Sugar free
                    Linctus        times a day,                   linctus can be given to
                    Sugar-free     can be taken                   diabetics
                                   in warm water
Indigestion         Mist           10mls in water     30mls       Contraindication: Do not
                    Magnesium      three times a                  give within one hour of
                    Trisilicate    day                            Digoxin
                                                                  Caution: May cause
                                                               diarrhoea
Mild Pain       Paracetamol     One or two         8 tablets   Contraindication:
Temperature     500mg           tablets four                   Persons with reduced
                tablets         times a day                    liver function, or already
                                leaving at least               taking other medication
                                four hours                     containing Paracetamol
                                between                        e.g. Co-Proxamol,
                                doses                          Co-Dydramol.

          I authorise the medication indicated to be given to residents at the request of
          the resident or the discretion of the manager.


     DOCTOR……………………………………..

     DATE………………………………...................

     PRACTICE……………………………..............