A
- Adult Social Care support plan
A support plan for adults is a document that outlines the specific needs, goals, and support services required for an individual to maintain their well-being and independence
- As required/ variable dosage medications - also referred to as ‘PRN’s
‘As required’ medications are prescribed medications which are intended to be taken or used when they are needed rather than at specific times, for example to relieve pain, indigestion or itching.
‘Variable dosage’ medications have a variable rather than a fixed dose, for example 1 or 2 tablets.
Assisting in this policy means that carers will provide practical help with anything that people cannot physically manage for themselves. For example, carers might remove tablets from a blister pack; shake a medication bottle, remove the lid and measure a dose; move medications to and from secure storage; or provide other practical assistance.
B
Section 4 of the Mental Capacity Act has a best interests checklist. This outlines what someone needs to consider before taking an action or making a decision for some while they lack capacity. They should:
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- Consider the person’s wishes and feelings. This means current wishes and those expressed before losing capacity to make the decision. It also includes any beliefs and values that are important to them
- Consider all the circumstances relevant to the person. This includes the type of mental health problem or physical illness someone has, and how long it’s going to last. It also includes:
- Age
- Whether they would normally take this decision themselves
- Whether they’re likely to recover capacity in the near future
- Who's caring for them now or has cared for them in the past
- Consider whether they’ll have capacity to make the decision in the future. This may include assessing whether the decision can be put off in the short-term
- Support involvement in acts done for the person and decisions affecting them
- Consider the views of carers, family or other people who may have an interest in the person’s welfare. Or anyone appointed to act for them
- Consider if there are other questions relevant to their situation
C
- Capacity (mental capacity)
Mental capacity is a person’s ability to make a specific decision at a specific time.
In this policy, ‘with capacity’ means that the person has the ability to make their own decisions about their health and their medications
People may lack capacity because of a wide range of conditions including dementia, a learning disability, mental health problems, a brain injury or stroke. Just because a person has a diagnosis does not mean they lack capacity.
A lack of capacity can be temporary, for example when someone has been in an accident and is unconscious.
A legal definition is contained in Section 2 of the Mental Capacity Act 2005.GSL will assume that people have capacity to make their own decisions until we have established that they do not. We follow the Gloucestershire Multi Agency Mental Capacity Act policy and guidance if capacity is in doubt.
An electronic file, held by the council, with the individual's care and support needs as defined by the Care Act 2014. This includes details from assessments, care plans, reviews, and any other relevant data collected by Gloucestershire County Council.
- Care Quality Commission (CQC)
CQC are the independent regulator of health and social care in England. They make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.
Controlled drugs are regulated, classified prescribed medications. Legal requirements apply to controlled drugs to prevent them from being misused, obtained illegally or causing harm. Carers collecting a controlled drug for a person are legally required to show the pharmacist proof of identity if asked and for certain medications will need a letter of authorisation. The pharmacist will explain what is required.
A list of the most common controlled drugs is available at
https://www.gov.uk/government/publications/controlled-drugs-list--2
Covert administration means that a medication is disguised and administered to someone without their knowledge and consent, for example in food and drink.
D
The Data Protection Act 2018 is a UK law that sets out how personal data must be processed, collected, and stored to protect individuals' privacy.
Usually a plastic container with different compartments for storing medication by time of day and days of the week.
GSL has a duty of candour to be open and honest when a notifiable incident occurs. This means that we will:
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- tell the person and / or their representative / family without delay and in person about what has happened and provide support
- provide all known facts, explain what further enquiries are appropriate and offer an apology
- provide the same information in writing and update the person on enquiries into the incident
- keep written records of all communication with the person
E
- Eligible health or social care need
An eligible health or social care need, under the Care Act 2014 in England, is one that arises from or is related to a physical or mental impairment or illness, and which causes a person to be unable to achieve at least two specified outcomes in their daily life, significantly impacting their wellbeing. This means the need must be directly linked to a health condition, not just a lack of resources or other factors.
G
A GSL arrangement is when someone aged 18 or over with assessed needs is supported by a GSL carer. Support can be for a few hours, a few days or the person may live on an ongoing basis in the GSL carer’s home as part of their family.
GSL carers are approved by GSL to provide personal care and support in GSL arrangements. Some experienced carers are approved to provide emergency care.
GSL officers are employed by Gloucestershire County Council to:
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- recruit, approve and train GSL carers
- set up, support, monitor and review GSL arrangements
L
- Legally appointed representatives
A legally appointed representative is someone who is authorised to make personal welfare decisions on behalf of an adult who lacks capacity, i.e.
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- someone who holds a lasting / enduring power of attorney given to them by the person before they lost capacity, or
- a deputy appointed by the Court of Protection
M
- Medication Administration Record (MAR sheet)
The MAR sheet details the medication(s) prescribed for the person, the dose, when the medication must be given and any special instructions. It is a running record of what medication the carer has administered, remaining stocks of medications and any carer observations. The record may be in paper or digital form.
Carers keep a separate MAR sheet for each medication that the person takes. Carers must follow the GSL MAR protocol at all times and keep the record up to date.
A record of all the medication the person in the GAL arrangement is currently taking.
- Medications where the dosage is dependent on blood test results
Dosage for some medications (for example lithium, warfarin) is dependent on blood test results.
Blood test results and the required dosage are updated in the person’s record book and are confirmed by a health professional.
- Mental Capacity Act (2005)
The Mental Capacity Act 2005 is a UK law that provides a legal framework for acting and making decisions on behalf of adults who lack the capacity to make those decisions for themselves. It applies in England and Wales to individuals aged 16 and over who are unable to make decisions due to mental impairment or inability to communicate. The Act emphasizes the importance of supporting individuals to make their own decisions, and when this is not possible, ensuring that decisions made on their behalf are in their best interests
- Mental Capacity Act Code of Practice
Practical guidance to explain how to Mental Capacity Act 2005 will operate on a day to day basis and offers examples of best practice to carers and practitioners.
The My Shared Lives Plan is a plan developed between the person, the carer and GSL to support the person in the GSL arrangement.
Among other things, the plan details any support the person needs to take their medication safely.
N
- National Institute for Health and Care Excellence (NICE)
NICE guidelines are evidence-based recommendations for health and care in England and Wales. They help health and social care professionals to prevent ill health, promote good health and improve the quality of care and services.
- National Patient Safety Agency
The National Patient Safety Agency was a special health authority of the National Health Service in England. It was established in 2001 to monitor patient safety incidents, including medication and prescribing error reporting, in the NHS
A notifiable incident is a serious and unintended or unexpected incident that a health care professional believes has resulted in / requires treatment from a health professional to prevent:
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- death
- impairment of sensory, motor or intellectual functions that has lasted or is likely to last for at least 28 consecutive days
- changes to the structure of the body
- experiencing prolonged pain or psychological harm
- shortening life expectancy
Incidents which require police involvement and /or incidents which may indicate a safeguarding concern are also notifiable.
The GSL Registered Manager is legally responsible for how the service is run and for the quality of care provided. The Registered Manager must report any notifiable incident to the Care Quality Commission (CQC).
O
- Over the counter medication
‘Over the counter’ medications are used to treat minor ailments and can be bought without a doctor’s prescription, for example paracetamol, herbal, homeopathic and Ayurvedic remedies. Some over the counter medications, including herbal products and some traditional Chinese medications, can interact with prescribed medication and cause harm
P
- Positive Behavioural Support (PBS)
A person-centred approach that aims to understand the reasons behind behaviour that are sometimes seen as challenging, often viewing it as a form of communication for unmet needs, and then developing strategies to meet those needs more effectively
A PRN medication is a medication that is not required on a regular basis. It is important that these medicines have a person-centred PRN protocol: A document on how and when this medication should be administered.
Prescribed medication is medicine by a healthcare professional (e.g doctor) has given you a prescription for it. Usually following a clinical assessment.
The prescriber is the professional who prescribes the person’s medication. This is usually their GP but it could be another health professional.
Prompting means that where necessary carers will remind people about their medication, for example to take it at a particular time or with food.
R
Reactive strategies are actions taken in response to problems or behaviours that have already occurred. They aim to manage situations or de-escalate tension after a challenge has arisen. Reactive strategies tend to focus on immediate solutions rather than long-term prevention
Changes that council have to make for people with a disability to prevent disabilities disadvantaged access when compared with others who are not disabled.
Reasonable adjustments include:
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- Making changes to the way things are organised or done if they currently put disabled people at a substantial disadvantage
- Making changes to the built environment or physical features around you, such as the physical features of a public building that put a disabled person at substantial disadvantage
- Providing aids and services for you to overcome the substantial disadvantage
- Registered Manager
A key individual in regulated care services, holding legal responsibility for the quality and safety of care provided
To ensure safe medication management, a risk assessment identifies some risks, risk reduction measures and documents this
- Royal Pharmaceutical Society
Professional leadership body for pharmacists and pharmaceutical scientists.
S
People with a learning disability are thought to be 16 times more likely and autistic people 7 times more likely to be prescribed an antipsychotic than the general population. Stopping over medication of people with a learning disability and autistic people (STOMP) is a national NHS England work programme to stop the inappropriate prescribing of psychotropic medications. People should only be given psychotropic medication for the right reasons, in the lowest dose, for the shortest time.
W
Wellbeing under the Care Act relates to:
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- personal dignity and the right to be treated with respect
- physical and mental health and emotional wellbeing
- protection from abuse and neglect
- the person’s control over day to day life, including over any care and support provided and the way it is provided
- participation in work, education, training or recreation
- social and economic wellbeing
- domestic, family and personal relationships
- suitability of living accommodation
- the person’s contribution to society
