What is the Care at Home Service?
The Care at Home Service complements existing medication compliance support arrangements, including the provision of Medication Administration Record (MAR) charts and reimbursement for Multi-Compartment Compliance Aids (MDS packs). The main part of the service supports patients aged 65 years and over who require ongoing medicines management within their own home. Participating community pharmacies receive an annual service fee in recognition of the continued monitoring, review, and support provided to eligible patients to promote the safe and effective use of medicines.
Compliance Support Solutions
Service specification
Compliance Support Solutions in the Community Pharmacy are specialised services and tools designed to help pharmacies meet strict regulatory requirements, prevent legal risks, and ensure patient safety.
Why is it important?
Ensures patients receive appropriate, safe, and personalised support with their medications.
Prevents medication errors, reduces the risk of non-adherence-related complications, and fosters collaborative care between pharmacists, patients, carers, and prescribers.
How It Works:
Firstly, when a patient is identified as needing more support with managing their medications, a Compliance Needs Assessment is carried out by the pharmacist. A Compliance Needs Assessment in Community Pharmacy is a structured evaluation conducted by the pharmacist to identify and support patients who struggle to manage or adhere to their prescribed medications. The purpose of the form is to pinpoint patients having trouble with medication management (often due to complex regimens, cognitive issues, or dexterity challenges) and to determine the best methods to support them
The form can be found in the following document:
Role of Care at Home staff in the management of medicines
There are many possible routes that may come from performing a Compliance Needs Assessment:
The patient may need reminders for their medication or support with ordering. Some pharmacies offer Repeat Medication Systems which can help in this instance.
The patient may need support with ordering and regular reviews. The Medication Care Review (MCR) service can help in some cases. Patients on chronic medication receive a serial prescription that lasts for x number of instalments. Regular reviews provide more support to patients who are struggling. More details on this can be found on the MCR service description.
Patients may require an instalment dispensing prescription if they are not managing their medicines appropriately.
Patients may need larger text on their prescription labels or medicines popped into bottles to aid dexterity issues.
Further conversations with the patients prescriber may be needed to provide more detailed support.
Medication Administration Record (MAR) charts form a key component of the Care at Home Service, supporting the safe administration and monitoring of medicines for patients receiving care in their own homes. Community pharmacies are responsible for producing and maintaining accurate and up-to-date MAR charts that reflect the patient’s current prescribed medication regimen. MAR charts provide a clear record of medicines administered, assist care staff in ensuring medicines are given correctly, and support continuity of care by reducing the risk of medication errors. As part of the service, pharmacies must ensure that MAR charts are updated promptly following any medication changes and are supplied in a timely manner to support effective medicines management in the home setting.
Monitored Dosage System (MDS): are sometimes appropriate following a Compliance Needs Assessment. A MDS box is a compliance aid multi-compartment box. A MDS box should be a last resort for patients.
Advantages:
- Improves adherence
- Simplifies administration
- Reduce risks of missed or double doses
- Useful for patients with cognitive or physical challenges
Disadvantages:
- Not suitable for all medicines
- Complex and time consuming to prepare
- Limited flexibility with medication changes
- Potential for errors if packed incorrectly
- Costly to produce and staff
- Patients may rely on the system and not understand their medicines reducing engagement.
Useful Documents: