The Patients Association has launched its Care Home Charter for Medications to improve medication practices for people living in care homes across the UK. Developed in collaboration with experts in health and social care and endorsed by the National Institute for Health and Care Excellence and the Royal College of Nursing among other organisations, the Charter aims to help support residents living in care homes to be actively involved in decisions about their care. It also provides a guideline for care home staff to follow in order to improve medication practices.

The Charter consists of a nine-point guideline for care home residents and their families, and is designed to promote and advance shared decision-making and improve patient safety. It emphases the importance of residents being involved in regular monitoring and review of medications, and states that medicines should only be given with a resident’s consent, unless they lack the capacity to provide it. In addition, the Charter also provides a nine-point guideline for care home staff to follow, stating that medicines should not be hidden by staff in food or drink, unless it is in a resident’s best interests and all legal requirements have been met. Other key points include that staff should ensure that an advance care home plan is in place for the resident, and that optimal oral and dental care is provided.

The Charter was developed in collaboration with an expert panel consisting of nurses, pharmacists, care home managers and speech and language therapists, with additional input from representatives from national bodies including NHS England and the Care Quality Commission.

It has been piloted in 22 care homes across England, Wales and Northern Ireland and has been endorsed by several organisations including  the National Institute for Health and Care Excellence (NICE) and the Royal College of Nursing.

The Charter is the culmination of a number of years of work by the Patients Association.

In 2015, after a caller to the Patients Association helpline reported the difficulties a care home resident with dysphagia (swallowing difficulties) was enduring with their medication, the charity conducted a survey to investigate how widespread the problem was. Publishing the findings in a report  that year, the Association found that in some cases, and against medical practice, medicines were being crushed for care home residents with dysphagia to swallow. Worryingly, we also found that some care home staff weren’t trained to spot the signs of a person with swallowing difficulties.

Download the Charter here.

Rachel Power, Chief Executive of the Patients Association, said: “We’re delighted to launch our Care Home Charter, which is the culmination of years of work in this area by an array of experts across multiple disciplines in health and social care. The feedback from our pilot of the Charter in care homes across the UK demonstrates the great potential it has to transform care for residents, with an emphasis on establishing a two-way relationship between those receiving care and those providing it.

“The Government predicts that by 2025 there will be two million people aged over 85 living in care homes, so it’s vitally important that medication practices are improved for both existing and future residents. We hope this Charter will go some way to helping people in care homes, and hope that the document is disseminated widely among healthcare professionals and care homes so it can benefit as many people as possible.”

Nicola Bent, Director of the System Engagement Programme at NICE, said: “People living in care homes have the same right to be involved in decisions about their care and treatment as anyone else and it’s important that they’re supported to do this. We’re therefore pleased to endorse the Patient Association’s Care Home Charter which will support health professionals in implementing our guidance on managing medicines in care homes.”

Kamini Gadhok MBE, Chief Executive of the Royal College of Speech & Language Therapists, said: “I’m delighted that our members have contributed to the charter, it recognises the importance of shared decision-making, communication and swallowing problems for people in care homes and how speech and language therapists can support them. Person-centred care, inclusive and accessible communication, and a multi-disciplinary approach are all at the heart of our profession and this is reflected throughout the charter. It will help improve patient safety and quality of life for people in care homes in the years to come.”

Dr Crystal Oldman CBE, Chief Executive of the Queen’s Nursing Institute, said: “This Charter will be extremely useful to nurses and other staff supporting people in Care Homes. The Charter brings together the wisdom and experience of community nurses and other professionals with that of residents, their carers and families, to produce excellent guidance that is accessible, practical and person-centred.”

Professor Tahir Masud, President of the British Geriatrics Society, said: “This Care Home Charter for Medicines provides valuable advice, for both staff and residents, on how they can work together to improve care for older people living in care homes. Experience tells us that people in residential care are sometimes taking inappropriate medications and the Charter will help raise awareness of this critical issue. Encouraging patients to make shared decisions about medication, as well as highlighting the importance of safe swallowing and optimal oral and dental care, will also help to improve quality of life for care home residents. Professionals working in care homes provide an invaluable service and this Charter will help them continue to deliver the best possible care. The Patients Association is to be congratulated on producing this excellent document.”

The Charter is supported by a number of national organisations including:

  • British Geriatrics Society
  • Care England
  • Care Quality Commission
  • Community Pharmacy Patient Safety Group
  • Jewish Care
  • National Care Forum
  • National Institute for Health and Care Excellence
  • Queens Nursing Institute
  • Royal College of General Practitioners
  • Royal College of Nursing
  • Royal College of Psychiatrists
  • Royal College of Speech and Language Therapists
  • Royal Pharmaceutical Society

23rd September 2019