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Pharmacy inspections

Inspection reports and learning from inspections

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Preparation of medicines for care homes

Pharmacy type


Pharmacy context

A large pharmacy located in a busy shopping centre. The pharmacy serves a mixed range of customers from the local population. The pharmacy dispenses around 14,800 items in a month, 11,000 of which are for patients in 76 care and residential homes. As well as the NHS Essential services, the team deliver Medicine Use Reviews, New Medicines Service, trays for domiciliary patients, supervised consumption of methadone, influenza vaccinations, a hair retention service and a delivery service.

Relevant standards

  • 1.1 - The risks associated with providing pharmacy services are identified and managed
  • 4.2 - Pharmacy services are managed and delivered safely and effectively
  • 4.3 - Medicines and medical devices are: obtained from a reputable source; safe and fit for purpose; stored securely; safeguarded from unauthorized access; supplied to the patient safely; and disposed of safely and securely

Why this is notable practice

A clearly defined and systematic approach is taken to the preparation of medicines for care homes with care staff provided with training and advice to manage medicines administration safely.

How the pharmacy did this

The team used a robust system to deal with the preparation of medicines for the care homes it serves. All the care homes were organised into a four week cycle and a poster for each cycle was displayed in the care home room. The poster charted which stage of preparation each care home was at and when the medicines needed to be delivered. The team also kept a communication book for each care home to log any conversations they had with them. Before dispensing would begin on the prescriptions for care homes, the team labelled the prescriptions and created Medicine Administration Record (MAR) Charts for each patient. They then passed each care homes set of prescriptions and MAR charts to the pharmacist for clinical checking. Once this was done, the prescriptions would be dispensed and prepared fully before being checked by an ACT.

The pharmacy team conducted pharmacy advice visits and audits for anti-psychotic medicines at the care homes. They also provided medicines training for the care workers in the homes which was accredited by the Royal Pharmaceutical Society.

What difference this made to patients

Care home residents are among the most vulnerable patients as they tend to have co-morbidities and reduced capacity to look after themselves. The controls put in place help to minimise risk of errors in dispensing by the pharmacy and administration of medication to residents by care home staff.

Highlighted standards

We have identified the standards most likely and least likely to be met in inspections, and highlighted examples of notable practice for each of these standards; to help everyone learn from others and to support continuous improvement:

  1. 1.1 Risk management
  2. 1.2 Reviewing and monitoring the safety of services
  3. 4.2 Safe and effective service delivery
  4. 4.3 Sourcing and safe, secure management of medicines and devices
  5. 2.2 Staff skills and qualifications