Today, the BBC is reporting on a research study from the University of London which finds that seven out of ten residents out of the 256 residents in 55 different care homes were subject to errors in their medication regime.
The summary of the report suggests that the reasons for this are
inadequate information, over-worked staff, poor teamwork and often complex courses of medication
I wonder how much of these issues could be addressed by better training and better staffing levels – the things that often can be the most costly.
I spent 7 years working in residential homes before I qualified (and while I was training). I know that however good the regulation is, there is always scope for errors and rushed jobs because unless CCTV cameras are placed in all areas, there is a lot of scope for people to work individually and to make mistakes – sometimes the mistakes are honest and due to wholly understandable issues, noone can legislate for human error, but sometimes they are due to tiredness due to packing in tons of overtime as the pay is so poor, sometimes because there is a lack of knowledge and system management to ensure that medication management is prioritised and sometimes it is down to staff just plain not caring enough to do a good job although that is by no means the only reason.
Looking at the errors picked up most frequently in this study, they are
wrong dosages, insufficient monitoring of residents after medication had been taken and people being given the drug at the wrong time
I’m not sure how wrong dosages can be explained away but I can understand insufficient monitoring and drugs given at the wrong times because those can often be matters of staffing levels, especially in some of the larger care homes. I worked in a small home where there were five residents and there were always between two and three members of staff on duty at any given time, so medication management could be individualised and monitored but in some of the care homes I visit now with up to 80 residents, the level of staffing may not allow for such individualised care. It isn’t right, but it is cheaper.
This is also an issue which is brought up by the changing and more complex needs of those who are needing residential and nursing care. Whereas in the past, the idea of a convalescent or rest home was more of a longer term stay issue, now it is only people who can no longer be supported at home due to complex needs that are accessing residential care, meaning that there are more extensive medication needs.
At least a report that highlights this can focus some more attention on the needs of those who do need residential care. Hopefully, it will concentrate the minds of those who commission services and provide placements as well.