REFRESHER TRAINING INFORMATION

FIRE SAFETY

The Fire Triangle

In order for a fire to occur, you need three things

Oxygen, present in the air

Fuel such as soft furnishings, wood, paper and flammable liquids

Heat such as a naked flame, hot surfaces or electrical equipment.

Take away any one of these and a fire does not occur.

Fire Extinguishers

Fire Blankets

Fire blankets can be used on fires involving both solids and liquids but are particularly effective on burning liquids such as chip pan fires. They can also be used on people with burning clothes or hair.

What to do in the event of a fire

The first priority in the event of a fire is to evacuate the building by the nearest exit. Staff should try to ensure everybody leaves the building but should not put themselves in danger.
Feel door handles. If they are warm do not open the door.
Close doors behind you.
Do not use lifts.
Ring 999 to alert the fire brigade.
Do not re-enter the building until told it is safe to do so.
Report to the office as soon as possible

What to do if you smell gas

Make sure all gas appliances are turned off and if possible turn the gas off at the mains
Call National grid on 0800111999. This is a 24 hour emergency line.
Open windows and doors to let air in.
Do not turn lights on or off and avoid using other electrical switches or appliances as this could trigger an explosion.
Do not smoke, light a match or any other naked flame.
Report to the office as soon as possible.

HEALTH & SAFETY

There are a number of laws and regulations which govern health and Safety in the workplace these include:

Health and Safety at Work Act 1974
The Control of Substances Hazardous to Health (COSHH) Regulations 2002
Regulatory Reform Fire Safety Order 2005
The Reporting of Injuries, Disease and Dangerous Occurrences Regulations 1995
The Occupational Safety and Health Act
Electricity at Work Regulations 1989

In general your employers duties include:

Making your workplace safe and without risks to health
Ensuring equipment and machinery are safe and those safe systems of work are set and followed
Ensuring articles and substances are moved, stored and used safely
Giving you the information, instruction, training and supervision necessary for your health and safety.
Assess the risks to your health and safety
Make arrangements for implementing the health and safety measures identified as being necessary by the assessment
Draw up a health and safety policy statement
Set up emergency procedures

As an employee you also have legal duties as follows

Take reasonable care for you own health and safety and that of others who may be affected by what you do or do not do
Co-operate with your employer on health and safety
Use work items provided by your employer correctly, including personal protective equipment, in accordance with training or instruction
Not interfering with or misusing anything provided for your health, safety or welfare.

IMPORTANT - IF YOU THINK THERE IS A HEALTH AND SAFETY ISSUE IN YOUR WORKPLACE YOU SHOULD NOTIFY YOUR MANAGER STRAIGHT AWAY

Risk Assessing

If you think there is a health and safety difficulty in your workplace you should discuss it with your employer, supervisor or manager.

It’s important to always assess environmental health and safety risks in your work setting before you start work to ensure you are not putting yourself or other people at risk.

Step 1 – Identify the hazards

Think about how people could be harmed and what could reasonably be expected to cause harm.

Step 2 – Decide who might be harmed and how

Think about people who may be harmed e.g. staff, the service user, members of the public.

Step 3 – Evaluate the risks and decide on precautions

Think about what to do to minimise risk.

Step 4 - Record your findings and implement them

Remember, prioritise and tackle the most important things first

Step 5 - Review your assessment and update if necessary

Work settings can be constantly changing, therefore it is important to review assessments on an ongoing basis.

CONTROL OF SUBSTANCES HAZARDOUS TO HEALTH (COSHH)

The ‘Control of Substances Hazardous to Health (COSHH) Regulations 2002’ provide a legal framework to protect people against the health risks from hazardous substances at work. Hazardous substances can normally be identified by the orange and black warning symbols on containers.

Risks may be controlled by Personal Protective Equipment (PPE) i.e. gloves, aprons etc., or by deciding to use a product in a certain way.

Substances hazardous to health will be mainly domestic cleaning chemicals, chosen by the service user. JRH Support staff will need to be able to assess and control risks as they arise. Staff may also come into contact with spills of bodily fluids such as blood. In these cases staff should always wear disposable gloves and apron to clean up.

Remember that some low risk products may have the power to harm you when used for a long time or frequently throughout the day, unless the proper precautions are taken.

Cleaning products should be kept In a cool dry place away from food and in a locked cupboard or out of reach of children. They should not be kept under the sink unless the cupboard is locked.

Labeling Information Labels should always be read before products are used. The following provides details of some of the common labelling symbols found on hazardous substances:

The following guidelines should always be observed when hazardous substances are used:

Use products or substances that have lower risks in preference to higher risk products, e.g. try to use products which do not have the orange hazard warning symbols on them.

Use the product or substance only for the use intended.Follow precautions specified on the label including the wear of personal protective equipment.

Pay attention to specific label precautions.

If you do not have the PPE listed on the label, you should not use the product.

Hazardous substances - specific products

When using any aerosol products direct the spray away from other people and avoid inhaling the spray. More care will be needed if aerosols are to be used above head height, as there is a risk of drips forming and splashes occurring. Some aerosols should not be used near naked flames and will be labelled flammable.

Bleach

Bleach must never be mixed with other cleaning products, particularly acidic toilet cleaners, e.g. toilet duck. Bleach can be used as a disinfectant to clean spills of blood and body fluids where it assists in the prevention of the spread of infection. However, 5 it must be noted that once a bottle has been opened, it will begin to lose its disinfectant power. An old opened bottle of bleach will have little or no power. Bleach tablets or granules are more effective as these can be diluted as and when required. Bleach is not recommended for whitening fabrics such as dish cloths. White does not automatically equate to clean any more than colour equates to dirty. Dish cloths can be kept clean by regular laundry programme.

Oven Cleaners

Spray and foam oven cleaners must not be used. Ovens and cookers can be cleaned with liquid or gel oven cleaners, liquid detergent, kitchen cleaners and degreasers, hard surface cleaners and abrasive pads, although this may take longer.

Disinfectants

Disinfectants vary considerably in their ability to kill micro-organisms, therefore, never assume you know the concentration/dilution required for a particular job. Always read the label. Spills of body fluids (e.g. blood, urine, vomit, faeces) can be treated with disinfectant at the appropriate dilution (read label), or bleach, depending on the surface to be cleaned. Disinfection with bleach is unsuitable for soft furnishings and carpets.

Fly Sprays

Fly sprays should not be used in kitchen and food preparation areas.

Automatic Dishwashing Chemicals

Automatic dishwashing chemicals are often labelled as hazardous, but packs are designed to minimise skin contact whilst handling.

New Products

Before use, labels should always be read. This is particularly important when new or reformulated products are used.

FIRST AID

Below is a list of actions to take in a situation requiring first aid:

Act quickly, giving priority to the most urgent conditions.
Check that there is no further danger to the casualty or to you.
If breathing has stopped clear the airway and begin resuscitation.
Control bleeding.
Guard against shock.
Give reassurance to the casualty and to onlookers.
Position the casualty correctly.
If you must move the casualty, immobilise factures and dress large wounds.
If needed, get the casualty to hospital for medical treatment as soon as possible.
Observe carefully for any changes in the casualty’s condition.
Do not try to do too much yourself.
Ensure that onlookers give you plenty of room.
Do not give anything by mouth to a casualty who is unconscious or who may need an anaesthetic on arrival at hospital.
Always record emergency incidents accurately and comprehensively.

Checking breathing

To check to see if a casualty is breathing do the following:

Lower your face close to the mouth of the casualty to see if you can hear or feel them breathing.
Look to see if the chest is rising and falling.
Do not check for more than 10 seconds.

Cuts with glass

If a person has a cut with glass in it treat in the following way:

Apply pressure around the edges (not directly on the glass)
Do not remove the glass
Raise the injured part above the level of the heart and continue to apply pressure for five minutes to allow the blood to clot
Call for an ambulance
Build up the padding on either side of the glass until a bandage can cover it without pressing on the glass.

Shock

If someone is in shock you may notice the following symptoms:

Rapid pulse
Grey-blue skin colour
Sweating
Thirst
Cold clammy skin
Nausea

If you suspect a person is in shock, call 999, then immediately take the following steps:

Lay the person down and elevate the legs and feet slightly, unless you think this may cause pain or further injury.
Keep the person still and don't move him or her unless necessary.
Begin CPR if the person shows no signs of life, such as breathing, coughing or movement.
Loosen tight clothing and, if needed, cover the person with a blanket to prevent chilling.
Don't let the person eat or drink anything.
If you suspect that the person is having an allergic reaction, and you have access to an epinephrine autoinjector, use it according to its instructions.
If the person is bleeding, hold pressure over the bleeding area, using a towel or sheet.
If the person vomits or begins bleeding from the mouth, turn him or her onto a side to prevent choking, unless you suspect a spinal injury.

Burns

These can be caused by

Heat (wet or dry)
Chemicals
Electricity
Friction
Cold
Radiation (sunburn)

If someone has a burn it should be held under running water for at least 10 minutes. When dressing a burn you should use a non-fluffy sterile dressing or a clean piece of material (cling film is ideal). You should not dress a facial burn.

Choking

If a casualty is choking you should attempt to dislodge the blockage in the following way:

Bend the casualty forward
Give them five sharp slaps between the shoulder blades using the flat of your hand
Check their mouth
If the blockage has not been dislodged carry out abdominal thrusts.

Crush injury

If a person is trapped and has sustained a crush injury they should not be moved if they have been trapped for more than 15 minutes or if you do not know how long they have been trapped or if attempting to free the casualty could potentially injury somebody else. In this case the emergency services should be notified straight away.

Diabetes

A person suffering from diabetes can sometimes have too much sugar in the blood stream (hyperglycaemia). If this is the case they may have the following symptoms:

Rapid pulse
Laboured breathing
Dry skin
Sweet ‘acetone’ breath
In severe cases unconsciousness

This may be treated with insulin or through eating the correct diet. Exercise and drinking plenty of water can help.

There could also be too little sugar in the blood stream (hypoglycaemia). If this is the case they may have the following symptoms:

Feeling hungry
Trembling or shakiness
Sweating
Anxiety or irritability
Going pale
Fast pulse or palpitations
Difficulty concentrating
Confusion

If this is the case then the person needs to have a short-acting carbohydrate such as

A glass of non-diet soft drink such as cola or lemonade
Three or more glucose tablets
Five sweets such as jelly babies
A glass or carton of fruit juice.

If possible retest the blood sugar levels. If they remain low then repeat the above treatment.

To prevent blood glucose levels dropping again a follow-on longer acting carbohydrate snack may be needed such as

Half a sandwich
Fruit
Small bowl of cereal
Biscuits and milk.

In both hyperglycaemia and hypoglycaemia it may be necessary to seek medical attention if symptoms persist or are severe.

FOOD HYGIENE

The Food Safety Act 1990

This lays out your legal responsibilities. You have a duty to:

Handle food safely and avoid the risk of food poisoning
Keep yourself and your work area clean
Protect food from contamination
Follow correct temperature controls during preparation
Tell your line manager if you have food poisoning symptoms yourself or any infectious disease, illness or infected cuts etc.
Advise the service user if they are endangering their health through poor food hygiene

When to wash your hands

Before

Preparing food
Eating
Caring for sick people, changing dressings, giving medicines etc.

Between

Handling raw foods (meat, fish, poultry and eggs) and touching other food or kitchen utensils.

After

Handling raw foods, particularly meat, fish, poultry and eggs
Going to the toilet
Coughing or sneezing
Touching your hair or face
Touching rubbish/waste bins
Caring for the sick
Handling pets
Gardening
Smoking

A step-by-step guide to effective hand washing

Wet your hands thoroughly under warm running water and squirt liquid soap onto the palm of one hand
Rub your hands together to make a lather
Rub the palm of one hand along the back of the other and along the fingers, then do the same with the other hand
Rub in between each of your fingers on both hands and around your thumbs
Rinse off the soap with clean running water
Dry hands thoroughly on a clean dry towel. Paper towel or air dryer.

The actual hand washing should take about 15 – 20 seconds.

Remember: 1,000 times as many germs spread from damp hands than dry hands.

Food storage and cooking.

At temperatures colder than 5°C and hotter than 63°C, bacterial growth slows down or stops. However most bacteria can survive cold temperatures and resume multiplication once the temperature rises. Freezing can make bacteria dormant but it does not kill them. When frozen food is thawed it is susceptible to the same risks as fresh food.

Cooking at high temperatures kills most bacteria provided that the food is cooked for long enough – for at least 2 minutes at 70°C right through the thickest part of the product. When reheating food it needs to be heated to so that the core temperature is 70°C or above for at least 2 minutes.

Fridge temperatures should be 2-5°C and freezers should be -18°C or below.

Raw meat should be stored on the bottom shelf of the fridge. This is to stop the juices from the raw meat dripping onto other food and to prevent cross contamination. Cross contamination is the contamination of ready to eat food by bacteria from raw food.

Frozen food should be defrosted in the fridge. It should not be left to defrost at room temperature and hot water should never be used to defrost food.

Food poisoning

This can be caused by poor temperature control, poor hygiene or cross contamination.

High risk foods are:

Poultry
Cooked meat
Meat products such as gravy and stock
Dairy produce
Products made from eggs
Seafood including shellfish
Cooked rice.

How contamination occurs

There are three types of contamination:

Direct contamination – when a raw food touches a high risk food.
Indirect contamination – when liquid or juices from a raw food drip on to a high risk food.
Cross-contamination – when bacteria are carried, for instance by hands or utensils, from raw food to high risk food.

People, animals, equipment and utensils are the most usual ways that bacteria are spread in particular:

Hands
Work surfaces, containers, crockery and cutlery
Utensils and equipment such as chopping boards and dish cloths
Any food contact surface that has not been cleaned properly between uses.

Ways of preventing contamination

Keep food covered until use
Use utensil such as forks, tongs and slices to move food.
Wash hands before preparing food
Keep any cuts or other skin problems covered
Separate raw and cooked foods at all times including storage and preparation
Use separate equipment and utensils for the preparation of raw meats and poultry e.g. chopping boards if possible or thoroughly clean in between uses
Wash all raw vegetables, fruit and rice before use
Keep food areas clean.

Symptoms of food poisoning

Nausea
Vomiting
Diarrhoea
Fever

INFECTION CONTROL

Micro-organisms are found virtually everywhere in the natural environment. Most of these are harmless to humans. However, certain micro-organisms can cause disease. Employers have a responsibility to assess the risks involved and to put into place any reasonable measures to control the risk of infection. Employees have the responsibility to ensure that they follow the procedures put in place.

Chain of infection

The process of infection can be represented as a chain – breaking a link in the chain at any point will control the risk of infection.

Source – Transmission - Host

Sources

There are five main sources of infection that need to be considered in the workplace:

Blood and other bodily fluids (e.g. saliva) and sources of blood/body fluids such as human bodies and raw meat.
Human and animal waste products such as faeces, urine and vomit.
Respiratory discharges such as coughs and sneezes.
Skin – direct contact.
Eating or drinking contaminated food and water (this is covered in the food hygiene policy).

Transmission

To become infected the micro-organism has to get from the source into the host by some means. Infection at work can occur via:

Putting contaminated hands and fingers (or pens etc) into the mouth nose or eyes
Breathing in infectious droplets from the air e.g. respiratory discharges, contaminated dust,
Splashes of blood and other bodily fluids into the eye and other mucous membranes such as the nose and mouth,
Broken skin if it comes into direct contact with the micro-organism (or something contaminated by the micro-organism,
A skin penetrating injury e.g. via a contaminated needle or other sharp object or through a bite by an infected animal or insect. Infection can be transmitted person-to-person or animal to person. Remember - needles and other sharp instruments should always we disposed of in a sharps box or if there isn't one a Tupperware container and then take it to the nearest chemist.

Host

Unbroken skin and the lining of the mouth, throat, gut and airways all serve to provide a barrier to infection. The cells of these linings and the substances they produce are the body’s first line of defence. If a micro-organism does manage to cross this barrier the next line of defence is the immune system. Whether or not an infection occurs depends on the contest between the micro-organisms and the immune system. The outward signs and symptoms of disease such as fevers or rashes are a result of this contest.

Preventative measures

Wash hands before eating, drinking, preparing food, taking medicine, putting in contact lenses etc and after any activity where you may have become contaminated e.g. going to the toile, touching raw meat.
Cover wounds with waterproof dressings and/or gloves before starting any work activity where there is a risk of infection being transmitted.
Avoid hand-mouth or hand-eye contact – don’t put pens/pencils in mouths.
Avoid coughing or sneezing over people – encourage the service users to use tissues.
Clean all work surfaces regularly
Ensure equipment is kept clean.
Control pests such as rats and insects within the workplace.
Where a person is bleeding and requires first aid from another person to stop the blood flow, the helper should ensure they wear disposable gloves and cover any wounds with a waterproof dressing,
In the event of an injury involving blood or bodily fluids the following action should be taken:

Wash off splashes on the skin with running water.
Wash out splashes in the eye preferably using eyewash from fresh eye wash bottle (alternatively tap water), or nose or mouth with lots of tap water.
Record the incident.
Inform your Team Leader

Any incident where blood is spilled on a hard surface should be cleaned up quickly using household bleach solution (one part bleach to nine parts water). The person cleaning up the spillage needs to wear disposable gloves.
When disposing of any potentially contaminated waste, staff need to ensure that the waste material is placed in bags and securely binned.
Any linen or clothing that is stained with blood or bodily fluids will be gathered up wearing disposable gloves and washed separately and immediately at a temperature of 60 degrees centigrade.
Any spillage onto furnishings will be washed and cleaned safely (e.g. coverings machine washed at 60 degrees centigrade or thrown away if the blood cannot be washed off safely) • Removal of dirty dressings should be done safely using disposable gloves and waste put immediately into bags and binned.

MOVING & HANDLING

The Eight Basic Steps to Good Moving and Handling Technique

Think – plan the lift. Use appropriate handling aids if appropriate. Remove any obstructions. Do you need help with the load?
Stable base – place the feet apart, giving a balanced and stable base for lifting.
Good grip – The best position and type of grip depends on the circumstances and individual preference, but it must be secure. Lift smoothly without sudden moves.
Keep close to the waist – keep the load close to the trunk/torso in a comfortable position.
Bend knees – when lifting from a low level, bend the knees but do not kneel or over-flex the knee. Keep the back straight, lean forward a little over the load if necessary to get a good grip. Keep the shoulders level and facing in the same direction as the hips.
Good back posture – Maintain the normal curves in your back and face forwards.
Move your feet - Do not twist the trunk when turning to the side, move your feet to turn with the load
Move smoothly – Smooth movements will allow your soft tissues to adapt to movement

The Spine

The spine should have a natural S shape. This shape could be spoiled by slouching, poor posture, inappropriate/bad movement, excessive movement.

A falling person

If you are supporting someone and they fall, you should not try to catch them as this could injure them more or you could injure yourself. You should also not try to move them as again this could cause further injury.

You should provide service users with minimal physical assistance during moving tasks. They should do the heavy work for you.

Moving & handling equipment

Staff should not move people without using moving and handling equipment such as stand and turns, transfer boards, sliding sheets, hoists, bath seats etc.

MEDICATION ADMINISTRATION

Who can write a prescription?

Independent prescribers

These include:

Doctors such as a GP or hospital doctor
Dentists
Nurse independent prescribers
Pharmacist independent prescribers
Optometrist independent prescribers

Supplementary prescribers

Nurses/midwives
Pharmacists
Podiatrists
Physiotherapists

Concerns

If you ever have concerns regarding how a service user is taking medication, you should notify your manager. They will make a judgement about whether to seek further advice from the GP or other healthcare professional. Always document details of what you’ve done and who you’ve spoken to.

Safe practice

THE FIVE RIGHTS

Every time you support a service user with their medication, you must ensure that the FIVE RIGHTS are followed for every individual medicine.

RIGHT SERVICE USER

receives the

RIGHT MEDICINE

with the

RIGHT DOSE

at the

RIGHT TIME

via the

RIGHT ROUTE

The RIGHT SERVICE USER

Confirm the name of the service user (if necessary ask the service user’s family or friend if available) or if appropriate check with a colleague. It is important at this stage to check that the service user has not already taken the dose about to be given.

The RIGHT MEDICINE

Check the medication label to ensure that the service user’s name and the medication name match with the care plan/MAR chart. If available, check that the medication has not exceeded its expiry date. This date can be found on all original containers, but if the medication has been dispensed in either a Monitored Dosage System (MDS) or bottle, then it is important to see when the medication was issued. It is generally thought that if the medication has been out of an original container for longer than 12 months for a solid dose (tablet) or 6 months for a liquid, then a new supply should be obtained from the service user’s pharmacy. For an MDS, the expiry date is even shorter, usually a maximum of 8 weeks. Any MDS container with an issue date of over 8 weeks should be returned to the pharmacy for destruction.

It is also good practice to question any medication that has an issue date of longer than 3 months on the dispensing label. It may be that the service user takes this ‘as required’, which is perfectly acceptable, but it could also indicate that the medication may not be on the current list of the service user’s regular medication (i.e. it may have been stopped or replaced by the prescriber, but the service user still has a stock in their home) in which case advice must be obtained from the prescriber.

Sometimes, a different manufacturer will be used by the pharmacy, and the medication may look different from previous batches. IF IN DOUBT, always check with the issuing pharmacy for clarification.

The RIGHT DOSE

As we have mentioned in a previous module, the dose of a medicine is the amount given to an individual service user. This dose has been specifically decided on by the prescriber and must not be changed unless the prescriber authorises it.

If there are no clear instructions, or if the label states ‘As directed’, ALWAYS check with the prescriber before giving it to the service user. It is important that you get the confirmation of the dose in writing (there is a fax back form available for this purpose, speak to your line manager for further information).

For any medicine with ‘When Required’ on the label, again it is important to have written confirmation from the prescriber with full instructions on when the medication should be given.

The RIGHT TIME

Check the label and MAR chart for directions on when to give the medicine.

The RIGHT ROUTE

Check to see how the medicine gets into the service user’s body, remember that there are many ways of getting a medicine into the body.

Medication Administration Record (MAR) sheets

The MAR sheet details what medication has been prescribed for the service user, when the medication should be given, what the dose is and how it should be taken.

The MAR sheet is used to determine which medication is due at the time of the visit. It should then be used to match up the details of the medication required to the details on each medicine container and/or compliance aid. It must be completed in full each time medication is given or should indicate why a medication has not been given.

The codes used to record how the medication has been administered are on the bottom of the MAR sheet

Support workers can do the following tasks:

Collecting prescriptions from a surgery or medicines from the pharmacy when there is no alternative means of collection and delivery.
Making sure medicines are stored safely and securely in the service user’s own home.
Noting, recording and reporting to your line manager any change in the service user’s ability to manage their medication.
Taking tablets/capsules out of pharmacy labelled containers, removing tablets/capsules from foil strips contained within an original pharmacy labelled pack. (NB assistance with medication must not be given for medicines that are not in their original pharmacy labelled containers).
Shaking bottles of liquid medicines and remove the bottle cap so that the service user can take the required dose.
Pouring liquid into measuring cups, spoons.
Mixing soluble medicines with water.
Inserting an eye drop bottle into a compliance aid so that the service user can self administer their eye drops. Assistance may only be provided for eye drops that have been prescribed by a doctor or non medical prescriber.
Administering eye drops/ointment where the service user requires eye drops that have been prescribed by the service user’s General Practitioner or non medical prescriber. Care workers should not administer drops following an operation on the eye (e.g. after a cataract operation). This is because the condition of the eye will require monitoring. The prescriber’s instructions should always be followed. Prior to the administration of eye drops, the use of an aid to assist with the instillation of eye drops should be tried (e.g. Opticare®, available via prescription) if deemed to be suitable.
Administering ear drops that have been prescribed by the service user’s General Practitioner or non medical prescriber. The prescriber’s instructions should always be followed.
Applying creams and ointments only where the skin is not broken or inflamed and which have been prescribed by a doctor or non-medical prescriber. This should only be undertaken when a service user is unable to do this for him or herself and there is no other appropriate person to assist them.
The following may be applied without being prescribed by a doctor or non-medical prescriber: sun creams, sun blocks, simple moisturisers and emollients e.g. E45 (refer to section 5 of the Medication Procedure for the definition of emollient).
Assisting with the use of inhaler devices by passing the device to the service user and where necessary pressing down the aerosol canister when the inhaler is used in conjunction with a spacer device. Prior to assisting with inhaler devices, the use of a compliance aid should be tried e.g. Haleraid.
Helping to put on surgical stockings provided they have been prescribed by a doctor or non medical prescriber and a shared care agreement is in place with the community nursing team. The agreement would detail reasons for use, the responsibilities of healthcare staff and social care staff

Support workers cannot do the following tasks:

Any invasive procedure including:
Rectal administration of creams, suppositories or enemas
Vaginal administration of creams or pessaries
Wound care: including both simple and complex dressings
Injections or procedures which break the skin
Using syringe drivers
Any procedure that requires the care worker to make medical judgements
Apply transdermal patches – unless specialist training undertaken
Assisting with the putting on of surgical stockings where no shared care agreement exists for each specific service user
Assisting with TED stockings.

REMEMBER – As a support worker you cannot provide support for any medication that has not been prescribed by a doctor, non-medical prescriber or dentist.

Covert medication

All medication should be administered with the full knowledge, agreement, understanding, and consent of the service user, and where appropriate, of their carers, wherever possible and every effort must be made to obtain this consent. Refer to the Company's Covert Medication Policy for more details.

PRN medication

PRN stands for ‘when required’ medication.

If you need to support someone with ‘when required’ medication, clear information should be documented on their PRN medication administration sheet regarding the following information:

How many tablets,
How many times a day,
For what symptoms,
How long an interval before another dose can be given.

Your manager must obtain written conformation of the above information from the GP or pharmacist. You must not provide support with ‘when required’ medicines unless you have this information.

Expiry dates

Some calendar pack medications can have an expiry date of maybe three to four years. This is because they have been packaged in a way that protects the medicine from light and moisture. Alternatively, some loose tablets in a medicine bottle may have only a few weeks’ validity because they are not as well protected and are open to air and moisture e.g. Glyceryl Trinitrate tablets (GTN)

Some medicine will have in very small print ‘do not use 28 days after opening’ on it, so it is vital to make sure that the service user is aware that if a new supply is needed, it should be obtained before the medicine expires.

Always remember to check the expiry date of the medicine EVERY TIME you support a service user with their medication. If the expiry date has passed, or is not obvious you should not administer the medication and should contact your line mana

If Mar sheet not completed for previous visit – line manager - GP