This page will bring together all the PrescQIPP care homes resources and showcase good practice examples of projects focusing on medicines optimisation in the care homes setting. Each set of resources contains tools that can be adapted for local use before implementation.
Medication in care homes
Care Homes Webkit webinarThis webinar showcased the work we have done so far on Care homes and future plans.
B66: Bulk PrescribingThe bulk prescribing bulletin and briefing give some general advice on the implementation of bulk prescribing for those organisations wishing to do so. Implementation packs for care homes, GPs and Pharmacists provide the tools that would be needed to support the safe and effective implementation of bulk prescribing.
B72: Homely remedies
The homely remedies resources provide advice on implementing a homely remedies policy in care homes. Support tools include advice on implementation, audit tools, agreement forms and information for GPs.
B143: Supporting self administration of medication in the care home
This bulletin supports the implementation self administration of medicines in the care home setting for of residents who are able to. Assessment and implementation tools are provided to support change and an educational slideset is available to support discussion with care home staff.
B174: Compliance aids
The use of compliance aids to support medicines administration is a difficult to resolve problem in care homes and also for domicilliary care. This bulletin supports the review of the use of compliance aids/ monitored dose systems particularly in care homes. The supporting resources provide advice and guidance on changing over to a system where medicines are administered/ dispensed in original packs.
B151: How to use multidisciplinary teams effectively
These resources will support effective working and communication between members of a multidisciplinary teams for care home residents.
B173: Implementation of NICE guidelines
This bulletin discusses the implementation of NICE guidance relevant to medicines optimisation in care homes. A summary of relevant NICE guidance and suggestions to support implementation are offered for each of the relevant NICE guidance. Links to supporting resources are also available. This resource is designed to be shared with care home staff.
B75: Controlled drugs good practice guide
This bulletin is intended to be a supporting guidance document for care home staff on the management of CDs in the care home setting. It can be adapted by care home staff to form a policy for use in individual care homes.
B87: Medication and falls
This resource pack has been produced to raise awareness amongst healthcare professionals of
the medicines that can increase the risk of falls in older people. The aim is that they are taken into consideration when conducting medication reviews and also when deciding whether to initiate medicines if the patient is a known faller or at risk of falls. They can be used both for the care homes setting and outside this setting.
Resources include a medicines and falls risk classification document and key information sheet for GPs, an information sheet for care home staff and a falls risk questionnaire.
B93: Waste reduction
This good practice guide to help reduce waste is aimed at GP practices and care home staff. It provides useful tips to consider when generating prescriptions and when ordering and administering medicines.
B112: Good practice guide to prescribing and medication review
The document covers good practice considerations when prescribing and also for medication review. It suggests appropriate times to begin the medication ordering process for the repeat medication cycle in a care home and also advise on considerations for acute prescribing, review of medicines and medicines reconciliation.
B101: Covert administration
The administration of medicines can present challenges in the care home setting, especially where patients refuse to take medicines or are unable to take their medicines. The resources in this section explore some of these challenges and provide guidance on dealing with them.
B179: Refused or missed doses
This bulletin looks at the issues around refused and missed doses when administering medicines in care homes and provides guidance for healthcare professionals in dealing with these issues. An educational slideset is available to support implementation.
B172: Safeguarding and mediciness
This bulletin discusses the issues around safeguarding in relation to medicines which could include: the deliberate withholding of medicine without a valid reason, incorrect use of medicines, deliberate attempts to harm through use of medicine, or accidental harm caused by incorrect administration or a medication error. Processes around reporting incidents and rear misses are also discussed. An educational slide set and template flow chart are available as supporting implementation tools.
B178: Transferring patients between care settings
There are often issues when patients are transferred to and from care homes settings as communication can be poor and healthcare professionals/care homes staff do not routinely receive the information they need to ensure continuity of care is seamless. The resources in this section explore some of these issues and provide resources to support good practice.
B188: Assisting people with swallowing difficulties
Although the use of thickeners is not just associated with care homes, there are particular concerns around the use of these products in care homes. These resources provide guidance on safe and appropriate use and encourage regular review and ensuring training of staff involved in administering thickeners. The resources are based on the current dysphagia diet food texture descriptors, however both the British Dietetic Association and the Royal College of Speech and Language Therapists have just agreed to adopt the IDDSI framework in the UK (International Dysphagia Diet Standardisation Initiative). This adoption will happen over the next 18 months and the bulletin will be updated in due course to reflect this change when it is common practice.
This section contains our educational slidesets aimed at care home staff. These tools can be complemented by our e-learning resources available on our education hub.
B191: Care Homes Training Package Part 1
The care homes training slidesets and talk notes cover the following topics:
- The role of CQC and the NICE Guideline and Quality Standards
- The management of medicines in care homes
- Management of self-medicating residents
- Administration of inhalers
- Administration of eye drops
- Administration of transdermal patches
- Administration of topical creams
- Administration of 'when required' medicines
These slides are designed for teams that want to deliver face to face training to care home staff and can be complemented by our CPD accredited Medicines use in Care Homes e-learning course which can be accessed on our e-learning hub either as a commissioned tool or a pay per use resource.
B198: Care Homes Training Package Part 2
The second set of care homes training slidesets and talk notes cover the following topics:
- Refused and omitted doses
- Covert administration
- Controlled drugs
- Bulk prescribing
- Homely remedies
- Waste reduction
These slides are designed for teams that want to deliver face to face training to care home staff and can be complemented by our CPD accredited Medicines use in care homes 2 e-learning course which can be accessed on our e-learning hub either as a commissioned tool or a pay per use resource.
Shared care home resources
This section brings together resources to support medicines optimisation in care homes that have been produced by commissioners.
Innovation award winner 2013: Optimising the use of inhalers in the care homes setting
Optimising the use of inhalers in the care homes setting webinar
Innovation award winner 2014: Tool to support Parkinson’s patients in care homes
Tool to support Parkinson’s patients in care homes webinar
Other care homes projects
Reducing Antipsychotic use in Dementia
The use of antipsychotics in dementia to control behavioural and psychological symptoms has been a concern for many years. The PrescQIPP toolkit looks at the safety issues associated with using antipsychotics in this way and also provides practical tools and guidance to support the reduction of use. The toolkit is not just aimed at care homes, however is an important resource to include in the care homes webkit.
T7: Reducing antipsychotics in dementia toolkitThe reducing antipsychotic prescribing in dementia toolkit is a resource aimed at healthcare professionals and carers, which can be used to support the management of behavioural and psychological symptoms of dementia without the use of antipsychotics.
The toolkit contains resources to support assessment of symptoms and non-pharmacological treatment in these patients and also resources to support the reduction in antipsychotic prescribing in those already being prescribed these drugs.
Reducing antipsychotics in dementia webinarThis webinar showcased the resources in the reducing antipsychotics in dementia toolkit and discussed the evidence behind the recommendations.
Integrated care home dementia videoThe video offers expertise from Shane Gordon, North East Essex CCG, Sally Standley, Eastern Academic Health Science Network, Sarah Robinson, NHS England, Carol Roberts, PrescQIPP Strategic Lead, and, the staff involved in delivering and benefiting from two projects in Essex and Norfolk.
The video provides a real 360 view of the projects, their achievements, how they were established and the real benefits they have made to homes dealing with patients on low dose anti-psychotics, and the quality of life for the patients themselves.