It is essential in any care setting where medication is administered by staff that a MAR chart is used. The provision of the MAR chart is the responsibility of the care provider (although pharmacies often supply them as a complimentary service). Please see below useful documentation: 

• Example MAR chart for care homes (1)

Care homes in North Yorkshire and York should report incidents involving controlled drugs to the Controlled Drugs Accountable Officer (CDAO) at NHS England using the online reporting tool. Care homes should register and login to the reporting tool, here.

This does not change the requirement to report incidents to CQC/safeguarding/police as appropriate which should still be done.

Pregabalin and gabapentin became schedule 3 controlled drugs on 1st April 2019. There is no change to storage and recording requirements. Storage in a controlled drug cabinet is not required. Records are not required in a controlled drugs register. For care homes with nursing (nursing homes) only: As pregabalin and gabapentin are schedule 3 controlled drugs it is recommended they should be disposed of in a CD denaturing kit before transfer to the waste company. Residential homes and domiciliary care providers should return them to the pharmacy for safe disposal as previously.

Clear and accurate documentation is a fundamental part of safe medication practice. The following forms can be downloaded and used by care providers. Click on the title to download the document.

Supplementary information (Protocol) about when required and variable dose medication – It is essential that staff administering medication prescribed to be taken ‛when required’ know what the medication is for and under what circumstances it may be appropriate to administer a dose. The supplementary information document can also be used for variable dose medication to indicate when a higher or lower dose should be given. The supplementary information document should be reviewed on a regular basis and/or if the person’s circumstances change.

Supplementary information about creams and ointments - It can be helpful to provide extra information about creams and ointments including the use of a body map.

transdermal patch record Ver 4.01 - when administering patches it is important to remove the old patch before applying a new one and to rotate the sites where the patch is applied. This form will support safe recording.

Supplementary Medication Administration Record – *updated August 2020*

This form can be used when space on the traditional MAR chart does not allow all the required information to be recorded. It allows space to record time medication was given, the dose and the quantity remaining as well as the staff signature. It now also includes space for recording the reason an "as required" medication was given. Remember to give details when using this space, for example, write "pain in left knee" rather than just "pain". If using a supplementary record staff must annotate the main MAR chart with ‛see supplementary sheet’ so all staff record the administration in the same place.

Supplementary sheet for the recording of creams and ointments – Administration of prescribed creams/ointments must be recorded. In some circumstances it may be appropriate to use separate documentation to record the administration. In care homes this may be kept in the person’s room. If using a supplementary record staff must annotate the main MAR chart with ‛see supplementary sheet’ so all staff record the administration in the same place.

Supplementary sheet for the recording of nutritional supplements – The administration of nutritional supplements such as Fortisip and Ensure must be recorded. In some circumstances it may be appropriate to use separate documentation to record the administration. If using a supplementary record staff must annotate the main MAR chart with ‛see supplementary sheet’ so all staff record the administration in the same place.

Medicines Refrigerator – Temperature Recording Chart – In care homes the maximum and minimum temperature of the fridge should be recorded daily. Staff must ensure that they always reset the thermometer once the reading has been taken. If the fridge temperature is outside of the required range then action must be taken.

Recording of medicines taken on short periods away from the home – Care homes must be able to account for all the medication for which they are responsible. This form can be used to document medication which the person takes with them for periods away from the home, for example, weekend visits to family.

It is the responsibility of managers to assess the competency of staff before they are allowed to administer medication – competency assessment tools to support this are available below:

• Competency assessment (care homes)

• Competency assessment for staff (domiciliary)

For Vale of York CCG information, visit their website, here. For further information or queries please email nyccg.rxline@nhs.net. For national resources, click here.