Adult social care workers are administering medicines without any formal training, analysis has shown.
The Care Quality Commission (CQC) found that some providers were not carrying out competency assessments or regular checks in line with NICE guidance that states staff should have an annual review of their skills. This meant operators were unable to demonstrate that their staff were competent to administer medicines safely.
One inspection report highlighted that several medicines incidents had occurred, and staff training and competency had not been reviewed.
The review found that administering an incorrect dose of medication was the most commonly-reported error in adult social care services. This sometimes happened when members of staff did not check the medicines administration record (MAR) chart before issuing the medicine.
A number of incidents described staff administering a second dose of medicine in error, as the original dose had not been signed as being administered on the MAR chart.
The main factor for errors was poor record keeping, with records either not completed, or not accurate.
Discontinued medicines and incorrect strengths of medicines were also found on MAR charts. These errors were more likely when MAR charts were hand-written.
The findings were based on an analysis of 55 inspection reports (including a mix of care homes, care homes with nursing and domiciliary home care services for older people and people with a learning disability), 50 enforcement notices and 405 statutory notifications that the regulator received.
The CQC’s report titled, Medicines in health and adult social care: Learning from risks and sharing good practice for better outcomes, presents a cross-sector picture in England of the risks associated with medicines in the different types health and adult social care services.
Some providers were also found to not have a medicines policy and in other cases, staff did not always follow policies.
The CQC is encouraging providers to adopt best practice guidance for managing medicines in care homes and in the community; consider having a pharmacist to support staff with issues around the use of medicines; train staff and assess their competency in handling and administering medicines as an ongoing priority; and be clear who is responsible for training staff about medicines and that they are kept up to date.