Why January 2020 was a bad month for care homes
So far 2020 has seen a run of bad luck for care homes as multiple closures, a council investigation and a poor CQC rating hit three areas in the space of a few weeks. Third inadequate rating in a row St Nicholas Care Home in Sheringham, Norfolk was shut down on 24 January following its third consecutive ‘inadequate’ CQC rating.The care home was operated by ADR Care Homes, which also runs Hill House and Keneydon House – rated by the CQC as ‘good’ and ‘requires improvement’ respectively.Following the most recent inspection, carried out in November but only published last week, the CQC report began: “At this inspection we found a continuation of failings at this service. Sufficient action had still not been taken to address the seven breaches of the regulations we found at our previous inspections in November 2018 and May 2019. At this inspection in November 2019, we found an additional breach of the regulations.”Continued breaches concerned failures to implement robust governance systems, which included a manager in post for 9 months who had not been registered as a care home manager with the CQC. Residents’ care records contained “incorrect and inconsistent” information and a safeguarding incident had not been reported.As well as failures over privacy and leadership, the report said cleanliness was an issue and infection control measures were poor. Seven care homes in one area set to close Over in Chesterfield, Derbyshire, an online petition was launched by relatives of those living in The Spinney after the council moved to close the facility along with six others.Put on the chopping block by Derbyshire Council Council (DCC) due to the need for extensive repairs, the Spinney was deemed to have been below the required standard for local residents.Surveys carried out in the seven homes found that even after remedial repair work was carried out, standards were still low and the layout of the homes impractical for use with disabled residents.Karen Tracey, who started the Change.org petition to save The Spinney as her grandmother resides there, said: “When we heard the news that The Spinney, amongst other local care homes, was likely going to be closed we were very upset. Not just for the residents, who will likely need to be placed elsewhere, breaking up friendships and social bonds, but also for the dedicated staff who work there.”Helen Jones, DCC’s head of adult and social care, said the closures were “regrettable” but cited a number of health and safety risks, including faulty electrics and roofing, as the reason for the decision.As the seven care homes are under threat of closure, three have been earmarked for refurbishment to improve standards. A consultation with the public is launching on 31 January. Legionella risk at care home Meanwhile, a Shrewsbury care home was rated ‘inadequate’ due to poor medicine storage and the potential risk of Legionella in unflushed water pipes.Although the caring, responsiveness and effectiveness of Coton Hill House was deemed to be good, the overall CQC rating was ‘requires improvement’ as safety and leadership were called into question during the inspection on 2 January.Coton Hill House, which is run by Coverage Care Services Limited, had failed to record the required safety checks for Legionella – despite some rooms with sinks and taps remaining vacant for long periods, which creates the perfect environment for Legionella to thrive.Medicine had also been stored in a fridge past the recommended 90 days after opening, and then given to a resident.The report said: “These issues were a breach of regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.”
How can care homes attract more staff?
Emma Platt, division manager of White Recruitment Health & Social Care, one of the UK’s foremost recruiters for care homes, discusses recruiting and retaining good-quality staff members… As the UK healthcare sector continues to suffer from the worst staffing crisis in recent memory, more and more care homes are being forced to shut down. In addition to this, with an ageing population, the strain on these institutions is only set to increase. However, despite an unfavourable staffing situation, there are still many things that care homes can do to attract more nurses. CPD Offering and encouraging nurses to pursue training and development helps greatly with attraction, and also retention – with one survey suggesting 70% of workers will remain in their roles due to job-related training and development. By becoming known as a care home that gives nurses the chance to progress through the ranks, and actively encouraging them to take charge of their careers – you will be seen as a far more appealing place to work. Mentoring Tying in closely with CPD, mentoring is another key approach to boost attraction. By being known as an organisation that gives mentoring to young employees, provides them with feedback, guidance, and the opportunity to soak up the valuable experience within your workforce, you can take advantage of an easy, cost-effective way to bring more nurses into the fold. Flexible working It’s vital to offer employees as much as possible in terms of work-life balance, as the excessively demanding schedules of care workers are in part contributing to the current crisis. This can be done by introducing non-traditional working arrangements such as flexible working. The desire for this is clear, especially amongst younger workers, with 67% of millennials claiming ‘flexi-time’ was something they expected as standard from a job. Technological advances, such as e-rostering and e-job planning, should make this easier to implement. Employer Brand A strong employer brand is key to talent attraction, and retention. Research shows 63% of employees admit that a trusted employer increases job satisfaction. Care homes need to build a relevant Employee Value Proposition (EVP) for potential recruits. This can be achieved in a number of ways, such as finding a recruitment partner that is well placed to assist with communicating an authentic, attractive employer brand. Ultimately, with plenty of more ‘fashionable’ brands to compete with, care homes must take action to get in front of young audiences and give people a glimpse of some of the high-tech, cutting edge work going in the sector. Communicate your purpose Any employer brand must also communicate your purpose across all touchpoints. Many workers nowadays, especially millennials and gen Z, are value-driven and committed to finding a company that aligns with their beliefs. By emphasising the ethical, socially minded aspects of working in a care home, and the difference that can be made in patients’ lives – recruitment will be a far easier job. Highlight the ways your organisation gives back and is actively engaged in the community, and make sure you are vocal about your core values – and that this is integrated into any employer branding. No ‘one size fits all’ approach Ultimately, there is no magic solution for solving the current staffing crisis in care homes. However, by embracing the above methods, those in the sector can begin turning things around. Fortunately, these solutions are interchangeable, and by embracing any one method, you will be going some way to implementing the others. For instance, by investing in flexible working solutions, your employer brand will benefit.
Hiring temporary contractors – understanding tax rules IR35
Are you aware of the recent change in law regarding temporary contractors? Here the team at Lawspeed, the UK’s leading Law Consultancy dedicated to the recruitment industry, discuss the new tax rules… Some of you will have heard recently about new tax rules known as IR35 relating to the use of temporary contractors, and due to apply in April 2020. Under current proposals businesses with a turnover of less than £10m, a balance sheet of £5m or fewer than 50 employees (excluded businesses) need not be concerned, but the rules should be noted by all other businesses that hire contractors. IR35 is the name given to an Inland Revenue notice (Inland Revenue number 35) which explains obligations on contractors to pay tax in a different way whenever the contractor provides services through a third party, usually a personal service company (PSC). These obligations have existed since 2000. If the rules apply, the contractor has been required to pay employment taxes and NICs on the whole of the income it receives from a posting or assignment, with a top slice allowance of 5%. As this means that the individual receives a net amount far less than if normal company tax rules apply, most temporary contractors have worked hard to avoid application of the rules, and HMRC believes that there has been serial tax avoidance in this area. To address this, in 2017 HMRC changed the rules where a contractor is hired by a public authority, and it now plans to extend those changes to the private sector, so affecting all businesses except the smallest companies. So when do the rules apply? They do not apply to self-employed individuals who are not operating through a PSC (there is a misconception around this!). Because of a fear of employment rights claims and also the desire of the hired individual to maximise net returns, it has become common practice to engage locums and temporary support individuals via their own PSCs. It is these arrangements that the rules attack. What do the rules require? Where the working arrangements are such that, if there were no PSC, the individual would be regarded for tax purposes as employed, someone has to account for employed levels of tax and NICs on invoiced sums for work done/time spent. This also means that someone has to make a decision as to whether they apply. The ‘someone’ used to be the contractor, but is now switching to the hirer or other party who pays the contractor, for example an employment business that supplies the contractor to you. This party is known as the Fee Payer, who is now also to be responsible for payment of PAYE and NICs wherever the rules apply. The decision – ‘employed’ or not Assessing employment status is notoriously hard except in the most obvious of circumstances. There has been a plethora of cases over the last few decades which have always been about unclear arrangements, not the obvious ones. Much has been written about mutuality of obligation, direction, supervision, control and so on, and to address these intensely legal and argued over elements would mean this article would end up the size of a book! However in terms of key considerations, a business to business arrangement for a defined project as agreed at the outset is an excellent start. The tax and other ramifications Where the status decision is ‘employed’, you, as the hirer (or a third party, e.g. an agency if involved), are the Fee Payer and have to pay contractor invoices in a specific way. Because HMRC regards the arrangement as deemed employment, the invoice is treated as the salary of the individual. This means that the whole of the invoiced sum, excluding VAT, allowed expenses and cost of materials, must be treated as employment income subject to normal PAYE and NIC deductions. The company invoice must be paid net of PAYE and NICs and the Fee Payer must account to HMRC for the PAYE and employee and employer NICs on the invoiced sum. The result – a cost hike for you of some 13.8%, increased payroll admin for what was previously a simple supplier payment, and a lower net income for the contractor. It’s not surprising therefore that some trade associations are warning that there may be a drop in available locums and contractors. What can you do regarding temporary contractors? First, recognise that individuals who put themselves out to work temporarily will still be around. Whilst some may start to look for regular employment, finding it may be easier said than done! Also not everyone is determined to minimise tax payments as before. Some may be happy to work through agencies on their payroll or sign up to temporary employment contracts with you. If the engagement is for a period of time rather than specific tasks, and the contractor still wishes to operate through a PSC you can either accept the cost of employer NICs or negotiate a new rate. The contractor could work for you as self-employed without any PSC involvement, and you could keep the same rate of pay; however in this case you run the risk that HMRC (as above), or indeed the contractor, could argue that the arrangement is actually one of employment. Normal Employment Tribunal limitations apply to claims by the contractor. For those you assess as not ‘deemed’ employees it is critical that the contract you use is properly formulated and that the specified work to be undertaken is fully and properly described. The actual working arrangements throughout the assignment should be in line with the contract, so discuss with line managers to ensure there is no conflict. You should also keep a note of how and why you concluded there is no deemed employment in case HMRC investigates as the risk of an investigation exists for up to 6 years after the event. Conclusion This is a proposed invasive new method of taxing contractors that will affect hirers and those in a worker supply chain.
Care homes invited to take part in annual ‘road’ cycling event
Motitech, the Norwegian startup motivating older people and those with dementia in care homes to engage in more physical activity, has announced its partnership with British Cycling and Sport England. The partnership will support Motitech in delivering opportunities for older people to remain active through cycling. This includes the Road Worlds for Seniors 2019 cycling event that takes place throughout the month of September. Road Worlds for Seniors is Motitech’s global activity programme for cycling within care homes and care centres, which will run throughout September alongside the UCI Road World Championships in Yorkshire. It will set the focus on physical activity for older people using its concept, Motiview, in which older people cycle through a choice of 1,700 locations on stationary bikes via a video projection that plays whilst the person pedals. The combination of exercise and visual stimulation increases activity levels in older people, and gives them the opportunity to revisit familiar places from their childhoods and other important points in their lives. This element of Motivew is especially important for those who live with dementia, as it provokes fond memories of familiar locations, such as their home town, or favourite holiday location, sparking conversations that bring the memories back to life. Everyone who participates will be rewarded for their efforts, with additional awards going to those who have cycled the furthest, and the care teams that have provided the best support. But this isn’t just a one-off event. The five-year partnership will see British Cycling and Sport England support the project through their Places to Ride capital grants programme, designed to deliver a lasting legacy from the 2019 Road World Championships by funding the development of multi-use facilities as well as facility improvement and equipment. The programme will engage with a broad spectrum of cyclists – encouraging people who have never cycled before to get on their bikes. Places to Ride has been made possible through a new £15m commitment from the UK Government, and will be delivered over the next three years through a unique partnership between British Cycling, Sport England and the Department for Digital, Culture, Media & Sport (DCMS). For Motitech, it means that the company will be able to provide equipment to an increased number of care homes, encouraging as many people as possible to get involved in physical activity in general, which has a significant, positive impact on physical and mental wellbeing. British Cycling will also be supporting the marketing and communications for the Road Worlds for Seniors. Road Worlds for Seniors creates friendly competition “We are incredibly excited to be able to announce the partnership with British Cycling and Sport England ahead of Road Worlds for Seniors this year”, says Jan Inge Ebbesvik, President of Road Worlds for Seniors at Motitech. “The support means that we can get even more people and care homes involved in Road Worlds for Seniors across the world, and create that feeling of friendly competition and community. We want to encourage older people to compete, have fun and get active at the same time. Through the combination of exercise, support from friends, families, and carers, as well as the support provided by British Cycling and Sport England, this year’s event is set to establish the unique application of technology to benefit older people as an initiative in parallel to existing cycling competitions, and a special fixture of the British sporting calendar.” “We are proud to be a key partner of Motitech’s cycling activity programme and the Road Worlds for Seniors”, adds Julie Harrington, British Cycling CEO. “It is vital that everyone has opportunities to remain physically active throughout their life, and the Motiview concept brings people together, forming new communities that may have never existed. We want people to get physically active and feel motivated to take part and cannot wait to see where, around the world, Motiview takes them.” Sports Minister Mims Davies said: “Sport has an incredible power to boost people’s mental well-being, as well as their physical health. I am delighted that our investment in this innovative project will help older people, and those with dementia, to get and enjoy being active.” Sport England’s Director of Facilities Charles Johnston said: “The benefits of physical activity for older people are considerable but often there are limited opportunities, especially for people living in care. We are pleased to have supported Motitech in bringing their innovative concept to the UK and are delighted to now be part of their long term partnership with British Cycling. The project will build a lasting legacy from the 2019 Road World Championships and accelerate access to opportunities for people living in care, across England, to have more opportunities to be physically active as part of their daily lives.” Jan from Motitech added: “We would love to have even more participants in this year’s Road Worlds for Seniors championship and anyone who is interested in finding out more, or even taking part, can email us at email@motitech.co.uk.”
Implementing effective infection control
Clare Long, business account manager for care at the Professional Division of Miele, discusses effective infection control for care facilities… An infection control plan is a series of policies and procedures that every care home should have in place to ensure hygienic standards, prevent the spread of infection and keep residents, staff and visitors safe in the care environment. Even the most conscientious team can struggle to control infectious diseases if they don’t have guidelines to follow, and this is where your documented infection control plan comes in really useful. Here are some of the factors and regulations to take into account when introducing or revising your infection control plan for laundry procedures: 1. Hand hygiene This is the single most important factor for preventing the spread of infection and should underpin the rest of your policy. It’s vital for staff, visitors and residents to effectively wash and disinfect their hands to ensure they’re not transferring harmful germs or micro-organisms to other people, equipment or surfaces. Your individual policy should define the process that should be followed and when, for example after ‘hands-on’ contact with a resident. 2. Personal protection Your plan needs to define if and when staff should use personal protection. Carefully consider all the instances where personal protection measures may need to be taken and define the process. For example, an employee may need to use gloves and an apron to load soiled laundry into the washing machine. They should remove these and dispose of them safely before handling clean laundry at the end of the cycle or moving onto a different task. 3. Effective decontamination Dealing with waste and potentially infectious substances as a carer is often inevitable, but it’s vital to make sure that any soiled items are effectively decontaminated. Consider a sluice sink to remove as much residue as possible from soiled materials before entering the washing cycle. Ensure you’re equipped with quality commercial machines that are capable of handling larger loads and consistently washing to a safe standard. Once the washing cycle has finished, take care to prevent cross-contamination by ensuring clean washing does not come into contact with dirty items. 4. Regulation of infection control It’s vital to ensure industry guidelines and regulations are being met across different operations and the infection control plan is an effective way of ensuring your processes comply. The NHS infection control guidelines (HTM 01-04) define the decontamination of linen for health and social care. Your appliances should be tested and approved as being able to meet these conditions and be able to hold washing at either 10 minutes at 65⁰C or over, three minutes at 75⁰C or over or one minute at 85⁰C or over. 5. Brief staff Employees need to be thoroughly briefed and up-to-date with the correct procedures, particularly in the operational areas that might experience higher-than-usual staff turnover, like the laundry room. Ensure your infection control plan is properly communicated, easy to understand and accessible at all times. See miele.co.uk for information on cleaning products, domestic appliances and infection control.
Reducing staff turnover in the care industry
Colin Stevenson, the founder of Notable Change International recruitment and consultancy services, tells editor Victoria Galligan the need for selecting the right candidate through an effective screening process to make the much-needed changes in the care industry. Currently the care industry as a whole has an extremely high turnover of staff, especially true for the businesses employing care workers. The usual recruitment process at the moment is: advertise for the role, sift through CVs, carry out credentials and qualifications checks or a reference check, interview, possibly offer a second interview, then a job offer. If using a recruitment consultancy, employers are passed on applicants based on their CV and interview bias (if the consultancy likes someone and think they will suit the role, they will be passed to the employer). If recruiting in-house, it is the same process. If the CV, face and interview fits, a position will be offered. This is how it is in most industries – but this inefficient method is costing the care industry a fortune in both time and money. Personality traits, both internal and external, mean a picture presented in the interview process may not be a candidate’s true self. Internal traits make up who we are, while external traits are who we would like people to think we are in order to get somewhere or acquire something. As a result, many staff leave or are asked to leave their roles within a short period of time. From this we have a clear picture that something has to be done to ensure maximum time and money can be spent on service users rather than a failing recruitment process. How does this happen in the care industry? The interview process is the same, an applicant who does well in an interview shows their external traits, maybe exaggerates or even makes up traits to suit the position. What is hidden is their internal traits which will determine how they work, interact and most importantly care for the service users. The applicant sails the CV sift, sails the qualifications, sails the interview and becomes employed by the company. However, soon the employer finds the applicant is over-dominant, which can mean they are hard to manage, or has a low-patience threshold with service users – and traits such as these usually cause work-based conflict. A CV, two interviews and a qualification paper would not have recognised this. Hiring this person would have caused upset to the workplace dynamics, staff and service users, and inevitably the staff member would leave or be asked to leave as they were unsuitable for the position and the process will begin again – trying to look for a suitable staff member. Notable Change uses a profiling system for applicants, finding out their internal and external traits after the interview process to ensure the applicant will suit the role and the care home dynamics through answering a series of questions that produces a report. To make this even better, an employer can design their ideal candidate, using the model of their best member of staff or creating a profile with traits they wish their ideal candidate to have. This ‘ideal candidate profile’ will be used as a template for future candidates, to ensure complete peace of mind, close the profitability gap and most importantly allow employers to spend the time and money saved on recruitment on the service users, without hiring the ‘wrong applicant’ for the job. See notablechangeintl.com for more details.
Improved access to shift schedules can reduce turnover among home care workers
Cristian Grossmann, CEO and Co-Founder of Beekeeper – a digital workforce management platform – on retaining home care workers through better access to shift schedules… It’s no secret that the UK care and nursing home industry typically has a higher rate of staff vacancies compared to others. A recent report showed that the vacancy rate in the adult social care sector was 6.6%, higher than the national average of 2.6%. Just as worrying, staff turnover in the adult care sector has climbed to 27.8% and has been steadily increasing since 2012. Stem the flow of high turnover among your care workers The industry must stem the flow of high turnover by investing in improving morale amongst employees and increasing retention rates of adult social care workers. One way to do this is to provide workers with earlier access to shift schedules to help them improve their work/life balance. Early access to work schedules changes lives This recent study highlighted how a fluctuating work schedule combined with last-minute shift changes can negatively impact workers. Unpredictable shift patterns create an inability to plan for needed childcare, medical appointments or socialising, as workers simply don’t have enough time to anticipate these needs. This causes employees to feel dissatisfied and stressed and less likely to stay with their job. The study also found that offering employees access to shift schedules just two weeks in advance made a huge difference in the quality of life for workers. There’s an app for that Technology can address the problem of high turnover with an internal communications platform that employees can access via an app or desktop, in which shift schedules are migrated from paper or email into an easy-to-access digital hub. The result of digitising schedules is that workers have improved access to their shifts, which prevents communication delays typical with the traditional approach to scheduling. Additionally, internal communication platforms offer home care shift workers the ability to instantly request schedule changes to management, enabling faster response times to requests and improving management’s ability to quickly find cover. This allows employees to have more control over their work schedules, which can dramatically improve overall job satisfaction. In addition to operational tools such as shift schedules, an internal communications platform like Beekeeper also offers instant access to one-on-one and group messaging, information sharing, surveys, training guides and health and safety information — all of which employees find extremely beneficial. In our experience, staff retention improves very quickly when employees have a platform that offers easy shift scheduling, access to information, and an immediate way to connect with management. It’s important to remember that your staff are your best asset and by investing in technology that makes their working life more harmonious, you will retain more talent, and build a happier, more productive workforce. For more information on improving shift pattern access for care workers, see Beekeeper
Busting the myths around the DBS check
As most people working within the care industry will know, all staff in care homes, hospitals and working as care providers in someone else’s home are subject to a DBS (Disclosure & Barring Service) check. Employers can encounter staffing problems if DBS checks aren’t done quickly and efficiently. Here, Care & Nursing Essentials editor Victoria Galligan busts some of the myths regarding DBS checks and explores what a DBS check actually is, who needs one and how to avoid costly delays when applying… There is only one level of DBS check for care workers Yes – for general employees in England and Wales there are three levels of DBS check – Basic, Standard and Enhanced. However, an Enhanced with DBS Barred List check is required for all staff carrying out “regulated activity” who work with vulnerable adults who fall into the definition of adults set out in section 59 of the Safeguarding Vulnerable Groups Act 2006 (before it was amended by the PoFA). Not all elderly people are classed as vulnerable adults True – but those requiring care are. The DBS clarify what a vulnerable adult is on their website, and the term ‘vulnerable adult’ was amended after it was felt to be inappropriate to label an adult as vulnerable solely due to their circumstances, age or disability. It states that, in general terms, a person aged 18 or over is classed as vulnerable when they are receiving one of the following services: All care work is classed as regulated activity True. Regulated activity – which a barred person is prohibited from doing – is clarified by the Department of Health document Regulated Activity (Adults) and there are six categories within the new definition of regulated activity which are listed above. There are similar rules concerning care employees working with children and the government document Regulated Activity in Relation to Children: Scope clarifies what is considered regulated activity which a barred person must not do. This is important to check, as regulated activity does not cover certain activity if it is supervised by another adult. But generally, all forms of health care relating to physical or mental health – including palliative care and procedures similar to medical or surgical care, advice or guidance provided for children relating to their physical, emotional or educational well-being and personal care cannot be carried out by someone on the barred list. If someone only works with vulnerable adults occasionally, it’s not regulated activity False: the Department of Health states: “There is no longer a requirement for a person to carry out the activities a certain number of times before they are engaging in regulated activity. Any time a person engages in the activities [listed above], they are engaging in regulated activity.” Staff such as porters and cleaners don’t need a DBS check It depends – any member of staff who carries out regulated activity with vulnerable adults needs an Enhanced DBS check. The DBS checking service check.co.uk clarifies: “This includes porters who transport patients around a hospital, as ‘conveying’ those who are receiving healthcare is listed as part of the definition of regulated activity.” However, people working for care homes who have access to care facilities but do not carry out a regulated activity – in roles such as food, cleaning, office work or maintenance – will likely be eligible for a Standard DBS check. Volunteers don’t need a DBS check Wrong – volunteers are under the same rules as paid workers but they can apply for a DBS check free of charge. The DBS checking service CRBS says of Enhanced DBS checks: “This level of check is only available to request on behalf of applicants who are working or volunteering in certain roles. For Enhanced DBS checks, this typically includes those interacting with children or vulnerable adults.” Employers have to pay for staff members’ DBS checks Not necessarily – it’s up to the employer whether or not to foot the bill. One DBS advisory service, clear check.co.uk. states: “There is no law which states that employers should be the ones who cover the cost of having a DBS check done, it’s just good practice for the employer to shoulder the cost. Not all employers take this approach though, and some may ask employees to stump up the cash themselves. For people who move jobs regularly of have more than one employer might then find themselves quite out of pocket, so if applying for a job which requires DBS checks it is worth enquiring about the process at the interview stage.” The answer to this may be to take out an Enhanced with DBS Barred List check, which costs £44, and pay the extra £13 to be added to the Update Service. This £13 is a yearly fee which will allow the applicant to make changes, and for the employer to make a status check of the certificate to see if changes have been made. And remember, with NHS staff complaining in the media recently that they are having to pay their own fees in some roles, employers have the opportunity to show how much the employee is valued by covering the cost. Employees can transfer their DBS check from job to job Possibly. If employees opt to be added to the Update Service, a new DBS check is not necessarily required for each place they work in – it’s up to the new employer. The Update Service website says employees will only need a new DBS check if: Employees can process a DBS check themselves Not for an Enhanced or Standard DBS check – they can only be done via the employer, who must use an “umbrella body” company to process the applications. They umbrella body can help avoid mistakes and omissions and generally speed up the time taken from application to receipt of the DBS certificate. And remember checks should be done on a regular basis to ensure they are still current – another reason to opt for the Update Service which will list new criminal convictions. The
Medical Refrigeration in Care Homes: Safety, Stability, Quality and Reliability
Medical refrigeration is a topic that any hospital, pharmacy or medical facility must take seriously. The same applies to care homes, which handle and manage medication on a daily basis for their residents. The correct storage of medicines and vaccines is essential to ensure drugs maintain their effectiveness, and failure to store them properly can lead to serious problems. Care homes must follow the same rules and procedures as hospitals and other medical facilities to ensure they are storing medicines safely. According to The National Institute for Health and Care Excellence (NICE), all care homes should adhere to a written policy, which gives staff information on how to; o Share information about medicines o Keep records about medicines o Deal with any mistakes that may happen o Review and accurately list the medicines o Order, receive, store and disposal o Give medicines to people in their care Former Health Secretary, Jeremy Hunt, recognised the problem in February, after a study revealed that drug errors in England were causing harm and – in some cases – death. It reported that pharmacists, hospitals and care homes may be making as many as 237 million errors a year – the equivalent of one mistake made for every five drugs handed out. Why Correct Storage Is Essential Not only can storing certain medicines at the wrong temperature shorten their shelf life by affecting the composition of the drugs, but it can even be dangerous to the end user. If drugs are not stored correctly, they can quickly become ineffective. This may waste considerable amounts of money when batches are ruined and have to be disposed of. All medication in care home facilities must be safely stored under lock and key, so that only authorised persons can have access. Common medications in care homes which must be refrigerated include insulin, eye/ear/nose drops, injections, creams and even vaccines. The only safe way to store certain medications and vaccinations is in a medical refrigeration unit. Even slight temperature deviations can ruin medications, so only the very best medical refrigeration products should be used. This means standard domestic fridges designed for storing food and drink must never be used for this purpose. They simply cannot provide the same strict temperature control and monitoring that specialist medical fridges offer. What to Look For in a Medical Fridge There are many factors that make refrigerators suitable for storing medicines and vaccinations. Firstly, a medical fridge will have very strict temperature controls. A suitable fridge keeps the temperature stable and prevents it from fluctuating too much, which is a common problem with standard fridges. Secondly, a medical fridge will not only measure the temperature of the air inside the fridge; it will also measure the temperature of the medication itself. This is the temperature that really matters and it must be kept stable, so measuring the air temperature alone is not sufficient. The temperature should be recorded on a daily basis by staff. How to Store Medicines Correctly As you probably know, storing medicines is not the same as storing food and drink in a normal domestic fridge. There are a few rules to follow to ensure your medicines and vaccinations are stored properly, as follows: Always keep medicines in their original packaging to protect them from the light and make them easy to identify alongside other medicines. This will help staff identify who the medicine is for. Never overfill the fridge. The maximum capacity should remain at 75%, and storing the fridge with more medicines than this could lead to a build-up of ice that can affect the temperature control. Pay close attention to the position of medicines and vaccines inside the refrigerator. They should be carefully placed so they are not touching the back wall, which can adversely affect their temperature. There should also be a 1cm gap between them; again, this helps to keep the temperature stable. Correct Fridge Maintenance Guidance While all medical fridges are different, there are a few guidelines to follow with whichever one you use to make sure you look after it and ensure the integrity of the medicines kept within. Electrical safety is imperative in a care home, make sure your medical fridge is in good working order. You should always check the wires regularly and carry out an annual servicing or calibration using an expert service. Also check the integrity of your electricity supply – sockets and switches in particular – to ensure they are safe to use. Also check for the build-up of ice. As mentioned, this can become a problem, especially if the fridge is filled to over 75% capacity. Ice can affect the temperature control of the medicines, so defrost the fridge if you need to. If there is a build-up of ice inside the appliance, check the door seal to see if it has been crushed and is therefore not sealing properly. It is also worth considering taking out a maintenance contract to ensure that your fridge is serviced regularly and works as it should. Advantages of Choosing the Right Fridge Choosing the right fridge for your care home is essential. Doing so will help to prevent vaccines and other valuable medicines from being ruined. Losing vaccines and medicines can be expensive as well as dangerous and a good quality fridge will greatly reduce the risk. By keeping your medicines fresh and safe, you will be able to give the best possible care to your residents. Using suitable medical refrigeration in your facility should be considered essential to prevent problems with your medicines and make financial savings. www.coolmed.co.uk
