Medicines Management

Person-Centred Competency Assessment

Framework

Information Booklet

Introduction In order to meet their regulatory and contractual responsibilities care providers need to ensure and evidence that their workforce are competent in the administration and management of medicines. Currently, for most organisations, competence is only assessed as a part of qualification frameworks and is not ongoing. A significant proportion of care providers translate this need to have a competent workforce into having a trained one. Evidence to demonstrate the meeting of such requirements is then production of annual certificates of attendance on medicines management training courses. The majority of such courses do not verify competence and in fact research suggests skills and knowledge learned during training are often not transferred into everyday working practice. This person-centred medicines management competency assessment framework, developed by Optimum Workforce Leadership aims to ensure competence through the development and maintenance of person-centred behaviours and practice. In addition to ensure standards of practice within participating organisations the framework helps make best use of provider resources by reducing the need for any unnecessary training.

Where the framework started Two groups of both residential and domiciliary care provider organisations worked with Optimum and a specialist medicines management training organisation to develop the framework, create supporting documentation and pilot the scheme. The groups’ first job was to identify the key medicines management competencies required of care workers. The following 20 activities were agreed;

1. Knowledge of own policy/procedure 2. Knowledge of person’s medication care plan 3. Knowledge of each person’s medication 4. Preparation of equipment and environment 5. Hand washing procedures 6. Use of MAR sheets 7. Consent 8. Correct medication 9. The 5 Rs are checked 10. Expiry and use by dates 11. Dispensing of medication 12. How the person is supported to take their medication 13. The person is observed/monitored throughout administration 14. Effective communication 15. Privacy and dignity 16. PRN medication 17. Signing and completion of MAR sheet 18. Medication and MAR sheets are stored correctly 19. Employer checks 20. Knowledge and understanding of how/when to seek advice

For each of the 20 activities above, each was given a person-centred competence statement to embed positive, neutral and negative person-centred actions and behaviours. Guidance was then developed to support the training and assessment process, together with the agreement of knowledge questions to form part of the assessment toolkit. The framework requires a person centred approach to be embedded into medicines management practices which are respectful, promote independence, ensure the maintenance of dignity and safeguard individuals from the risk of abuse associated with poor practice.

How it works Participating organisations nominate their key people to become medicines management trainer/assessors (see trainer/assessor criteria). These people then undertake 4 days training which includes significant background learning and the completion of a workbook prior to completing the training. This training equips participants with all the skills and knowledge necessary to disseminate and assess best medicines management practice in the workplace. There are 5 assessed elements to the course, each is given a weighting and participants are required to achieve 90% in each element in order to pass. Please note that course participants will be made aware of pass/fail after the 4 days training have taken place. Full completion of the course will occur once the assessor/trainer has completed the competence element of the course in their workplace.

All assessor/trainers must attend all 4 days of the course, and achieve 90% over all of the assessed tasks as below.

Completed Work Weighting

Completion of the Medicines Awareness Workbook

10%

Completion of individual Case Study

10%

Presentations and Action Plan

20%

Knowledge Questions

20% (pass mark 15/20)

Competency Assessment

40%

In order to complete some of the tasks, participants will have to undertake some research both in and out of the workplace. Resources and research links are provided.

Medicines Awareness workbook

All participants will complete the medication awareness book in order to understand the level of theory learning that staff should have undertaken prior to administrating medicines in the workplace.

Individual case study

All participants will complete a case study on 2 people in their service who currently take medication. This will require additional reading and research. References of research should be recorded in your case study.

Presentations

These will take place in the classroom within the group in pairs.

Each pair will be given a case study on Day 3 which they will work together to evaluate. They will then present this case study to the group for a minimum of 10 minutes on Day 4. Time will be allocated for the planning and preparation of this task.

The rest of the group will be observers and provide constructive feedback at the end. The presentations will be recorded and marked individually with a total of 20% pass rate, of which a % will include your presentation plan and case study action plan.

Knowledge Questions

There will be a knowledge test at the end of the course comprising of 20 knowledge questions. You will be expected to pass 15 out or 20 questions which will be randomly selected from the list of 40 knowledge questions included in the toolkit.

Competency Assessment

Each participant will be observed by a competent healthcare practitioner administering medicines within the 4 days under assimilated conditions. This observation will be recorded and any actions noted. A pass mark needs to be achieved

All participants will be supported to pass and when the required level is not achieved help and support will be provided for participants redoing any element. During the course each trainer/assessor is given a toolkit with the following contents and they are also familiarised with its use:

• Key competencies practice guidance • Competency assessment sheets and assessor guidance • Knowledge questions • Assessment action plans • Competency certificates • Legislation and guidance documentation.

In addition to receiving this as a hard copy toolkit for reference, electronic versions of the toolkit are also provided, providing everything necessary to assess the competence of people undertaking medicines management.

In the workplace Following the training successful trainer/assessors will return to the workplace and start to assess competence and action plan for individual staff members. For each of the 20 activities assessors have the option of the following ratings:

• Positive • Neutral • Negative

The medicines management trainer/assessors are NOT considered to be competent to train their staff from scratch and ALL employees who administer medicines in the organisation MUST have received medicines awareness training, prior to being assessed against the framework. This training MUST be through a recognised training method and preferably through a medicines awareness course that has been accredited by the Pharmaceutical Society. If you are not sure whether the training you are providing your staff in this respect qualifies, please submit the outline of the training to Optimum for further guidance. Where the training does not comply with the above this will invalidate the registration of the Trainer/Assessor with Optimum. A plan of action is then agreed within specific timescales and when competent, each staff member is given a certificate to acknowledge their skills and achievement. Where training is necessary the trainer/assessor can then target sessions to the specific needs of the individual. The completed assessment sheets provide the necessary evidence of competence for the regulating body. Each staff member is assessed on at least an annual basis on all the competencies relevant to their role. In order to continue to be a trainer/assessor, recertification courses must be attended every three years. Additionally trainer/assessor peer support meetings are arranged to assist with problem solving, to share ideas and to also ensure skills are maintained these should be attended 6 monthly. In order to register as an Optimum medicines management trainer assessor, people must complete the activity profile. This means that have to confirm that they are implementing the framework in their care setting. They also have the option to join a list of trainer/assessors and work with Optimum as a medicines management champion in a variety of ways. These are optional and although the form MUST be returned to become registered there is no need to

sign up to become a Champion unless you are keen to work with Optimum in any of these ways. Within larger participating organisations having trainer/assessors working across establishments ensures the provision of consistent good practice.

What we learned from the pilot

• Aims and objectives of the course met with very positive feedback on the competency toolkit and on the training course.

• Student evaluated the toolkit well on a range of aspects such as easy to use, simple and clear instructions to follow, fit for purpose and could be implemented in in the organisation. This applied to both homecare and residential care settings.

• It was assessed as providing value for money as evidence of person-

centred competence would be recorded and only areas of skill in which learning needs were identified would be targeted. In addition the toolkit comes with a procedure for use, which if followed and employees are assessed with the toolkit annually then medication awareness training will only be required every 3 years.

• During the training it was apparent that what people considered best practice varied greatly. Some were trained in and therefore using very poor practice when assisting people to move.

• Care home managers have embraced the concept and are keen to roll

out the programme in their homes to upskill staff and ensure all their competency skills are assessed on a regular basis

• The evaluation at the beginning of the project showed not all of the

participating organisations routinely assessed the competence of their staff, and few had built any person-centred behaviours into their process. However, most were aware of their legal and regulatory requirement to have a competent workforce.

• As a result of the training all participating organisations felt the

standards of medicines management and administration within their organisations would improve significantly.

Benefits of the framework

Here are some of the benefits to using the framework;

• Best practice in medicines management reduces the risks of errors in administering medicines, reduces waste and promotes positive outcomes for all involved in the process.

• Organisations are able to evidence the meeting of the requirement to have a competent workforce.

• Resources are more effectively used by targeting training to meet

individual need, avoiding the need for standard annual refreshers. Providing savings in time and money.

• Providing a person centred approach to medicines management supports

dignity, is respectful, promotes well-being, independence and safeguards service users against the risk of abuse associated with poor practice.

Costs

Places are available on open courses for £500 + vat per trainer/assessor. As the course requires re certification every 3 years this amount equates to £183 + vat for each of the first 3 years. The annual cost of medicines awareness training is around £33 per person per year. By implementing the competence framework and undertaking to assess competence of all staff administering medication against the framework this managers will be committing themselves to re training staff every 3 years, reducing the cost of training by £60 per person over this period. For larger organisations or groups, in house training can be provided within your own establishments. The cost of an in-house event is £3,000 + vat for up to 12 trainer/assessors. Please note when your own establishment is the venue for training then it must be fit for purpose where trainers and delegates will not be interrupted. Costs include everything you need to develop, maintain and evidence a workforce competent in person-centred medicines management. This includes both a hardcopy and electronic toolkit that you can personalise with your own company information.

Trainer/assessor criteria

If you can answer yes to the following questions Optimum Workforce Leadership feel you are an ideal candidate to be a Medicines Management trainer/assessor.

1. Are your medicines management skills and knowledge up to date in line with your organisations policy?

2. Are you confident and competent in your daily medicines management

administration and practice?

3. Are you prepared to spend a significant amount of your own time undertaking research/work in preparation for the course?

4. Are you available for the entire duration of the course?

5. Do you have the confidence to present information to a group of people?

6. Could you support others to achieve and maintain high standards?

If you cannot answer yes to all of the above but still feel you have the skills to be a trainer/assessor please contact Optimum Workforce Leadership to discuss all available options.