Lead: Jeanny Jarabejo (BSc Nursing)
Link: TBC
Goal: 2025 Onward
To improve medication compliance for service users, ensuring safer and more effective management of medications for improved health outcomes.
Action 1
Review and Rationalise Medication Plans
What:
Work with GPs and pharmacists to reduce unnecessary medications and simplify regimens where possible.
Why:
Reducing the number of medications and administration times can improve compliance and reduce risks of side effects or errors.
Outcome: Ongoing, as people’s needs change.
All service users who are identified as level 3 or where Social Care Alba (SCA) collects medication on their behalf have moved to pharmacies closer to their home, thereby reducing travel time. Fewer pharmacies have been used, thereby making building relationships with each pharmacy easier. Those service users on a weekly delivery have, where possible moved to a monthly collection, reducing the number of pick ups required and lessening the risk of medications being out of stock.
Jeanny has worked with service users, families, pharmacies and GPs to reduce unnecessary medications. The goal is to have less medication, taken on fewer occasions. Simplifying the medication regime allows people to maintain their independence by managing their own medication, reduces errors and side effects from taking medications which are no longer required.
Jeanny continues to work with service users, families, pharmacies and GPs to reduce unnecessary medications. No further updates are required as this is an ongoing process.
Jeanny continues to work with service users, families, pharmacies and GPs to reduce unnecessary medications. eMAR audits, home safelty assessments and the changing needs of those we support are continually reviewed to ensure medications are appropriate to people’s needs.
Action 2
Ensure Medication Administration Charts (MAR) are available to all Service Users at Level 3
What:
Require that all Level 3 Service Users (SU) have a clear medication administration chart (MAR chart) provided by their pharmacist.
Why:
A MAR chart ensures accurate and consistent medication administration by carers. It acts as a record of the medication delivered by the pharmacy within a set time period. Together these allow easier audit of stock, facilitates the return of old medication, identifies any instructions given by the GP and allows accurate population of electronic medication records (eMAR).
Outcome: Completed
All service users at level 3 have an accompanying MAR supplied by the dispensing pharmacy. MAR charts are photographed and added to SU files on PASS and are used to update the eMAR system. This allows SU, families and SCA to monitor medication prescribed, delivered and taken.
As people move from one level to another Jeanny has requested MAR sheets for those now on medication level 3. These are photographed monthly and uploaded to PASS.
An audit of all service users requiring level 3 medication support was conducted. This included photographing and uploading MAR charts, checking the safe storage of medicines, administration records, availability of medications, pharmacy collections and deliveries.
An audit of all service users requiring level 2 and 3 medication support was conducted. This included photographing and uploading MAR charts, checking the safe storage of medicines, administration records, availability of medications, pharmacy collections and deliveries.
An audit of all service users requiring level 2 and 3 medication support was conducted. This included photographing and uploading MAR charts, checking the safe storage of medicines, administration records, availability of medications, pharmacy collections and deliveries. Ongoing eMAR audits pick up where changes are required and contact with G.P, Pharmacies and Social Care Direct have ensured all those assessed as Level 3 have a MAR sheet.
Action 3
Implement Electronic Medication Recording (eMAR)
What:
Transition to eMAR for all Level 2 and 3 service users to digitise medication records.
Why:
eMAR reduces errors, improves record-keeping, and provides real-time updates for management and families.
Outcome: Completed June 2025.
All SU at level 2 or 3 have access to eMAR. This allows 24/7 real time monitoring of medication administration for S.U, families and care staff.
eMAR remains in place for those on level 2 or 3.
An audit of all eMAR records was conducted with the findings uploaded to service users’ PASS accounts. SCA plans to participate in a trial of a new TEC product from Finland. The product is a medication dispensing robot from Evondos – more information can be found on their website: Medication dispensing service | Evondos
Edinburgh Council has spoken with Stephen and other providers about the benefits and constraints of eMAR systems. The chief pharmacist will meet with providers to discuss whether eMAR should be introduced across all providers.
Action 4
Provide Medication Management training, open to families
What:
Train staff, service users, and their families in medication management, including proper storage, recognising side effects, and the importance of adherence.
Why:
Educating everyone involved reduces errors and increases confidence in managing medications.
Outcome: Ongoing delivery of open training.
All staff including new applicants complete medication training online and by attending medication workshops. Employees undergo observed practise monthly for the first 3 months, then 2 monthly thereafter which includes medication management. All staff are required to read core company policies which includes medication administration. A medication app and training workshops are available on both the staff and SU/Family websites.
Medication management training has been delivered twice in the last quarter, and has been open to families. Future dates will continue to be posted on the website. Martin, who is the Service User advocate, attended the training to give his insights into medication administration, from someone receiving support.
Medication management training has been delivered 3 times in the last quarter, and has been open to families. Future dates will continue to be posted on the website. Martin, who is the Service User advocate, attended the training to give his insights into medication administration, from someone receiving support.
Jeanny provided medication management training 3 times in the last quarter, with the workshops being open to families. Future dates will continue to be posted on the website. .
Jeanny provided medication management training 3 times in the last quarter, with the workshops being open to families. Future dates will continue to be posted on the website. .
Action 5
Conduct Regular Medication Audits
What:
Perform monthly audits of medication administration records to ensure compliance and identify patterns of missed doses.
Why:
Regular audits improve accountability and help identify areas for improvement.
Outcome: Ongoing eMAR reviews according to need.
We undertook a large-scale review of medication administration across all SU, which included wording of medication plans, audit of medication levels, training delivered, pharmacies used, compliance aids, safe storage and medication delivery or mAR supply issues.
As part of a review of all the assessments we use, everyone’s medication assessments were updated and reviewed in the past 4 weeks.
An audit of all service users medications was conducted. This included photographing and uploading MAR charts, checking the safe storage of medicines, administration records, availability of medications, pharmacy collections and deliveries. Where appropriate we have requested medication reviews from G.P.s and reassessments from Social Care Direct.
Medication Audits, know as eMAR Audits form part of both Spot Checks and regular reviews for all Service Users. Those at level 3 have their MAR charts photographed and uploaded to PASS as well as receiving an audit on a monthly basis.
Medication Audits, know as eMAR Audits form part of both Spot Checks and regular reviews for all Service Users. Those at level 3 have their MAR charts photographed and uploaded to PASS as well as receiving an audit on a monthly basis. Those at Level 2 have an audit every quarter.
Action 6
Develop a Medicine Compliance Resource Hub
What:
Provide a centralised resource hub with easy-to-understand guides and videos on medication management.
Why:
Empowering users and families with information promotes independence and compliance.
Outcome: Completed posts, Feb 2025
We created 2 dedicated websites, one for SU/Families the other for Staff. These sites have guidance on apps, training and resources related to medication management. In addition all SU or their families have access to Open PASS which includes medication monitoring through eMAR.
Stephen added to the website details about the differences between medication levels as this was a common question from those we support and their families.
See: Medication Levels: What Do They Mean?
Action 7
Conduct an Impact Review
What:
Evaluate the project’s outcomes through service user and family surveys, compliance statistics, and audits.
Why:
Regular evaluation ensures accountability and identifies areas for improvement.
Outcome:
We continue to schedule regular service reviews, staff observations, medication audits and reports. These are summarised and presented to our Shared Management Team (SMM) every quarter for evaluation. Any amendments to this plan are reflected online within 7 days of agreement.
This Focus Area positively impacted the quality of life for those we support and their families. Over the course of the year it became obvious that the 2025 Goals were largely ongoing because new referrals arrived or the needs of those we already supported changed. Consequently we decided to continue this Focus Area indefinitely, with biannual updates noting any changes.