Medicines

This page is for support workers. It covers the medicines list on a visit, recording what happened to each dose, controlled drugs, as needed doses, and changing an answer you have already given.

Before you start

If the client has allergies recorded, they appear in a red box above the medicines, on every visit. Read it before any dose.

The medicines list

Under the tasks, the visit sheet has a section headed “Medications”. Each line shows:

• the medicine and its dose
• “No longer prescribed” if it has since been taken off the client’s list, and you are only seeing it because this visit already has an answer for it
• the level of support, one of “Prompt”, “Assist” or “Administer”
• the times it is due between, when a coordinator has set a window
• “Outside window” once an answer has been recorded after the window closed
• any special instructions from the client’s record, underneath

Each medicine gets one answer for this visit.

Recording a dose

You must check in before you can answer. Until you do, the line reads “Check in to record” instead of buttons.

Given

Tap “Given”. That is the whole answer for a medicine that is not a controlled drug.

Not given

1. Tap “Not given”.
2. Choose the reason: “Refused”, “Unavailable” or “Withheld”.
3. Type what happened in the note box.
4. Tap “Record”.

The note box is labelled “Why not given” for anything other than “Given”, and it has to be filled in. Say what actually happened, for example that the client was asleep or the blister pack was empty. The note goes on the record and on the medication exceptions report the office reads.

Recording a dose as anything other than given tells the coordinators straight away. It raises an alert row called “Medication not given”, carrying the medicine, the answer and your note, and emails them to say a medication was recorded as not given on that date, with a link to the visit. The email itself names no client and no medicine.

Controlled drugs

A medicine marked as a controlled drug needs a second signature.

1. Tap “Given”.
2. A “Witnessed by” box appears, starting on “Controlled drug: pick who watched”.
3. Choose the colleague who watched. Only the other people on this visit are listed.
4. Tap “Given” again to record it.

The dose cannot be recorded until a witness is chosen. If you are on your own on the visit there is nobody to pick, so ring the office rather than recording the dose against the wrong answer.

As needed doses (PRN)

A medicine set up as “As needed (PRN)” can be given more than once on a visit. After the first answer, a “Record another dose” button appears on that line.

Each PRN dose is a new line in the record, not a correction of the last one. The MAR chart lists them all.

Changing an answer

If you answered the wrong way, or you have more to add:

1. Tap “Change answer” on that line.
2. Choose the outcome: “Given”, “Refused”, “Unavailable” or “Withheld”.
3. Fill in the note.
4. Tap “Record”.

The new answer supersedes the old one. The old answer is not overwritten and is not deleted: it is marked as entered in error, and the new answer points back at it. On the MAR chart the superseded answer shows struck through beside the one that replaced it.

Correcting only the note does not send the coordinators a second email. They are told again only when the outcome itself changes from given to not given.

The rules the platform holds

• A dose is recorded against a visit you have checked in to.
• The visit must be today or yesterday on your organisation’s clock, because you can only have checked in on its day or the day after.
• The medicine must be on this client’s list. A medicine that has since been taken off the list can still be answered on a visit that already has an answer for it, so an old record stays correctable.
• A controlled drug needs a witness who is on the same visit and is not you.
• The time on every answer is the platform’s clock, never a typed time.

What a coordinator can do

On the visit page a coordinator can correct an answer with “Correct…”, which supersedes it the same way as yours, or remove it so the dose reads as no answer recorded. Removing asks why, and the original answer and their reason stay in the audit trail. They cannot quietly blank a dose.

Where the answers end up

• The client’s “MAR chart”, month by month, corrections included.
• The “Medication exceptions” report, if the dose was not recorded, not given, or given outside its window.
• The coordinators’ morning email and alert with yesterday’s counts.