Duty of care in GSL arrangements

GSL officers and carers have a duty of care to ensure the person they support is safe and well, ensuring their house is safe from any hazards, including the accessibility of medication.

Every person supported by GSL must have a completed Medication Profile and Risk Assessment, PRN protocol (where required or appropriate and completed by a healthcare professional (eg GP))

Medication Profile and Risk Assessment must be reviewed annually, or as required by GSL. 

All prescribed and non-prescribed medication for any person (i.e. not just the person who needs care and support) living in a household which supports a GSL arrangement  must be stored in accordance with this policy (see section 10) so that no other person can take or use the medication, either by accident or on purpose.

Carers will support people who express concerns about their health or their medications to seek advice from their GP or pharmacist.   

Carers who are concerned about the health of someone in a GSL arrangement or how they are managing their medication will discuss their concerns directly with the person if the person has capacity.

Carers will raise concerns about health / medication management directly with GSL and the person’s GP / pharmacist if:

• the person lacks capacity, or
• the carer continues to have significant concerns following their discussion with someone who has capacity and there’s indications a person may be putting themselves or someone else at risk 

Carers will record concerns about the person’s health / medications and actions taken to resolve them in the person’s record (see section 12) (required on MAR sheet and referenced in carers in logs as appropriate). 

If someone needs immediate assistance, carers will seek and follow appropriate advice (for example from the person’s GP / pharmacist, the NHS advice line, Accident and Emergency).  As soon as practicable, carers will report what has occurred to GSL.

Examples of when a carer may be concerned about someone in a GSL arrangement or about their medication include but are not limited to when:

• someone who manages their own medication including those dependent on blood test results no longer appears to be taking it as prescribed. For example, they appear to be missing doses, taking the wrong or an additional dose, or not taking doses at the right intervals
• someone who has always taken their medication now refuses it.
• the carer believes that:
  • the person’s capacity to make their own medication decisions has changed or is fluctuating
  • an ‘over the counter’ medication may affect a prescribed medication
• the Medication Profile and Risk Assessment needs to be reviewed 
• there are unexplained changes in the person’s health or behaviour 
• the medication does not appear to be effective or there appear to be side effects or an adverse reaction. Please see also section 15 
• there has been a medication  error, for example a missed or incorrect dose; or a dose given more than once or to the wrong person or at the wrong time
• the medication label has been altered, removed or is hard to read or understand 
• the carer is unsure about  administering an ‘as required or variable dose’ medication or believes that the person is taking an incorrect dose
• the carer is unsure about medication provided in a dosette box
• the carer is concerned about the physical state of a medication or the way in which it has been stored, or is unsure about its shelf life
• there is a notable change to the amount of PRN required and/or the typical pattern of administration