<p>Medicines Management Audit Tool</p><p>Audit is a quality improvement process that aims to improve practice and outcomes by carrying out a review and implementing change. Further monitoring can then be used to confirm the improvements.</p><p>Aims and intended outcome To help you raise your medication standards the following self-audit tool may be used in its entirety or just appropriate sections as deemed necessary. Each point should be considered and spaces are provided for the inclusion of additional questions if deemed necessary to promote ownership of the audit by your care home. </p><p>You may use the self-audit tool as a checklist as frequently as you wish to promote good practice and as a learning tool. </p><p>Disclaimer The questions included in the audit are believed to be appropriate to reflect the literature at the time of writing. However, users should ensure that they are aware of new guidelines and requirements and update the audit questions accordingly. </p><p>1. MEDICINES POLICY Yes No Does the home have a medicines policy that reflects the practice in the home? Does the home have a copy of the RPSGB guidance entitled ‘The Handling of Medicines in Social Care’? Does the home have a copy of the NICE guidance ‘Managing Medicines in Care Homes’? Does the home have copies of the National Care Forum: Medication Safety Resources? Are the staff who are responsible for the administration of medicines in the care home familiar with these guidelines? Problems/comments/advice given 2. STORAGE OF MEDICINES Yes No Brief description of the room in which medicines are stored</p><p>Is this room kept locked? Are medicines stored in locked cupboards? Are medicines stored in a lockable, mobile trolley? Can this trolley be locked so as to immobilise it when not in use? Are internal and external medicines stored separately? Are temperature conditions in the storage area appropriate? Are medicines requiring refrigeration stored in a separate refrigerator? If no, are such medicines segregated in a separate, secure, labelled container? Is the temperature of refrigerators monitored using max/min thermometers? Are refrigerated medicines properly labelled to indicate storage requirements? Are medical oxygen cylinders and any other medical gases securely and safely stored? Are stock levels appropriate? How often are expiry dates checked? Are arrangements for security of keys satisfactory? (Check keyholders /handover of keys procedure/duplicate keys etc) Problems/comments/advice given 3. ADMINISTRATION OF MEDICINES Yes No Are medicines administered from original containers as received from the pharmacy one patient at a time? Are labels printed clearly? Are dosage instructions clear? Have any labels been defaced or changed? Are appropriate cautions and warnings clear? Are all medicines labelled for individual patients? (including medications for external use) If a monitored dosage system (MDS) is in use, are appropriate cautions and warnings clear and appropriate dispensing date on pack currently being used? Is the medication administration record completed correctly? Is there a risk assessment for each resident who self-medicates any of his or her medicines? Are their medicines kept secure and inaccessible to other residents? Does the home have a household remedies policy including a list of medicines that may be given, dose, frequency and contra-indications/special precautions? Are the household remedies in stock on the home’s agreed list? Have staff who give medicines been trained in the home’s policies and procedures for handling and recording medication and been assessed as competent? Are measures in place to identify residents to ensure that they receive the correct drug? Problems/comments/advice given 4. RECORD KEEPING FOR ALL HOMES Yes No Are doses checked for appropriateness? Are checks made for possible interactions? Are allergies or “nil known” recorded on the MAR chart or elsewhere? Is it clear when medicines have been refused or not given? Are there suitable procedures in place for recording medicines receipt and disposal? Problems/comments/advice given</p><p>FOR HOMES WHICH USE MAR (MEDICINE ADMINISTRATION RECORD) CHARTS Yes No Are the directions for using medicines clearly stated including the dose and frequency or time for “as directed” medicines and eye/ear where applicable? Have records been checked for consistency with medicines labels? How many discrepancies are there between the MAR chart and medicine label directions? Is the record initialled by staff administering the medicine? Problems/comments/advice given 5. CONTROLLED DRUGS FOR HOMES WHICH STOCK CONTROLLED DRUGS Yes No Is there secure storage for controlled drugs as specified in the Misuse of Drugs (Safe Custody)(Amendment) Regulations 2007? This is mandatory for every care home. Is the cupboard fixed to a solid wall? Is the CD cupboard used solely for the storage of controlled drugs? Is the CD register in hardback form with numbered pages? Do stock levels agree with the written balance? Are receipt and administration of CD’s clearly and legibly recorded: signed, dated and witnessed? Problems/comments/advice given</p><p>6. DISPOSAL OF MEDICINES Yes No Have all discontinued and/or expired medicines been returned to the pharmacy for disposal and recorded? (Nursing homes are required to make their own arrangements for waste disposal and must keep records). Problems/comments/advice given 7. LEAVE MEDICATION eg ATTENDANCE AT DAY CENTRES etc. Yes No Is there a need for separate dispensing of midday and weekend doses? Is there a procedure for this in the home’s medicines policy? Problems/comments/advice given</p><p>8. ADDITIONAL NOTES (IF ANY)</p>