Administering medicines when a person is away from their usual care setting

People will sometimes spend time away from their residential care setting.

When this happens, it is vital that they have a safe supply of their medicines for continuity. NICE guidance says that care home providers should consider safe processes as part of medicines management.

Any decisions about using medicines while a person is away from their usual care setting should be in a care plan.

Information staff should share

When a person is away from their usual care setting, it is important that staff provide information to them or their carers, including:

• the names of the medicines the person is taking with them
• clear instructions for each medicine, including:
  • how to take it
  • when to take it
  • the correct dosage
• timing information of each medicine, including:
  • the time of the last dose taken
  • the time of the next dose due
• contact details in case of any queries, such as the care home, the supplying pharmacy or the GP surgery.

What to consider 

Care home providers should consider various issues, including:

• Assessing the risks and identifying and minimising any potential problems. For example, the risk assessment should identify issues related to controlled drugs or other medicines liable to misuse.
• Whether the person can take their medicines without support, and if not, the person who will support them while they are away.
• How to ensure medicines are safely supplied and appropriately labelled.
• How the person will store their medicines, for example whether they need refrigeration.
• How the person, family member or carers will access the prescriber’s instructions. Consider seeking help from the prescriber or supplying pharmacy to give advice in specific circumstances. There should be a written procedure to support staff to be safe and consistent when doing this.
• Whether any medicines are to be taken 'when required'. If so, there should be clear instructions provided on when to take the medicine.
• Training and support for staff to make sure people in their care receive medicines safely. Staff should have a clear understanding of their role in supporting people to take their medicines when they are away from the care home.
• How staff will record the quantities of medicines supplied to take out and those returned to the service.
• Processes to assess medicines being returned to the service to ensure they are suitable for use.

Secondary dispensing

The Royal Pharmaceutical Society (RPS) has defined secondary dispensing as ”re-packaging a medicine that has already been dispensed by a pharmacist or a dispensing doctor”.

This is not good practice because secondary dispensing removes vital safety checks and increases the risk of errors.

The person using the product will no longer have access to the prescriber’s instructions, which give the authority to administer and may not have access to any additional labels or warnings. Supplied medicines need to be labelled in line with legislation or the dose administered immediately.

Sometimes you will need to supply medicines at short notice. If the prescriber or supplying pharmacy are unable to provide a solution, you may need to consider alternative measures to ensure the person does not miss any doses. Ask the prescriber for advice on how to do this legally and safely. You must assess the risk of these measures and fully document any decisions taken.

People should always have appropriate information to help them to take their medicines safely. Where there is a need for secondary dispensing, you should have a standard operating procedure and risk assessment to make sure this is safe and in the person’s best interest.