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0115 949 5421
Monitored Dosage System
104628 12/05
email: [email protected]
Trust
104628 MDS BOOKLET 1/20/06 9:30 AM Page 1
Boots MonitoredDosage ServiceGroup home service offer
Trust
104628 MDS BOOKLET 1/20/06 9:30 AM Page 2
contents
Summary of offer 3
Monitored Dosage System 5
The Boots service 6
Provision of the MDS system 7
Distribution 8
Storage 9
Training requirements 10
Pharmacist advice 12
Communication and support 13
Agreement review process 14
Policies and procedures 15
104628 MDS BOOKLET 1/20/06 9:30 AM Page 3
•Unrivalled nationwide coverage of the
UK – Boots The Chemists has over
370 stores able to provide a specialised
service to care homes. Each of these
separate units operates with its own
dedicated pharmacy team ensuring
a local, personal service tailored to
the individual requirements of each
care home.
•Our experience – we were the first
major pharmacy chain in the UK to
provide the Monitored Dosage System
to care homes and ours is widely
accepted as the standard system.
We currently service over 30% of the
total care home market. We have an
excellent internal structure of store, area,
regional and national staff to support the
business, giving you peace of mind.
•Recognised system – the MDS is the
system of choice for over 50% of all
care homes. We own and operate the
Manrex system, which we also sell to
independent pharmacies and other
multiple pharmacies nationwide.
The system is approved by the Royal
Pharmaceutical Society of Great
Britain, and meets the requirements
of CSCI and the NMC, giving your
staff confidence.
•An unrivalled market–leading training
package – fulfiling the training need
at every stage.
- Comprehensive systems training,
including certification and a
competency assessment tool for
the home manager.
- On-going and refresher training
for new and existing staff,
ensuring continuity.
- In-house topical training folder
for carers self development.
- Accredited (to national minimum
standards), Care of Medicines
training, helping you to meet
standard 9.7.
summary of offer
104628 MDS BOOKLET 1/20/06 9:30 AM Page 4
4
104628 MDS BOOKLET 1/20/06 9:30 AM Page 5
5
The Boots Monitored Dosage
System is a compliance aid system
introduced in 1989 to help care
homes better manage service
users’ medication.
The system follows the current
guidelines set by the Royal
Pharmaceutical Society of Great
Britain (RPSGB) and the National
Association of Health Authorities
and Trusts. The National Care
Standards Commission (CSCI)
also approve the system.
The Boots MDS System is a unit dose system, which means that
we do not mix medication, making identification of medicines
easier at the time of offering. The system also incorporates
the “five rights” of medication offering, i.e. right person, right
medication offering, ie. right person, right medication, right dose,
right time and right route. It is organised on a regular 28-day cycle
making it easier to plan for the re-ordering of new drugs, without
the worry that you might run out.
In addition our Regional Dispensing Services Advisors provide
support to our new and existing homes and oversee the
operating procedures within our MDS stores to ensure a high
quality service is maintained. The Dispensing Service Advisor
would also be involved in any issues that the MDS store and the
home were unable to resolve.
The MDS system reduces the time taken in drug rounds as
medication is specifically packed for the relevant time of day, in
the order you require them. We also provide each home with a
full set of computer-generated Medication Administration Records
(MARR sheets) every 28 days.
The MARR sheets facilitate a robust auditing procedure for
record keeping, ordering and receiving repeat prescriptions and
stock control.
MDS – Boots Monitored Dosage System
104628 MDS BOOKLET 1/20/06 9:30 AM Page 6
The Boots service was introduced
in 1989. We offer a high quality,
professional service that our
customers compliment us on,
and the fully trained teams in each
of our MDS stores are always
ready to provide help and advice.
The Boots Monitored Dosage System is available nationally
through approximately 370 of our stores. Each store has a
member of the pharmacy team known as a “Key Contact” who is
dedicated to ensuring all of their homes receive the best service
and attention at all times.
In most cases the service that we offer can be adapted to
suit each individual home. Every effort will be made to produce
a tailor made package to incorporate the preferences of the
Home Manager (this would be done at a local level) at the time
of implementation.
Our Regional Dispensing Service Advisors provide support to both
our new and existing homes and oversee the operating
procedures within our MDS stores to ensure a high - quality
service is maintained.
the Boots service
6
104628 MDS BOOKLET 1/20/06 9:30 AM Page 7
Boots will provide each home
with the following equipment
to ensure the system runs
effectively and efficiently.
• Pharmafiles, with pillpacks already racked in the order required
by the home, making it easy to work in a logical order.
• Pillpacks in the appropriate colour for the time of day:
pink (morning), yellow (lunchtime), orange (teatime), blue
(bedtime) and white for PRN medication, so you only
need to pick the relevant file/s for that medication round.
• Medtime cards to identify the correct pharmafile for that time
of day and incorporating any extra details such as unit number
or name.
• Divider cards to identify the correct person and reduce the risk
of error.
• Reminder cards for non-blistered items, incorporating all
medications into the system.
• Alert strips which give you greater flexibility within the
drug round.
• Computer-generated MARR sheets to record drug
administration. The MARR sheets also provide an audit trail and
a Review and Request of the next supply cycle, making sure all
aspects of legislation are complied with.
• MARR sheet folders.
• MARR sheet divider cards.
• Security system for deliveries of medication to the home and
returns from the home to the pharmacy.
• Returned/disposed medication book for recording of
refused medication.
• Returned/disposed medication bags.
• Fridge line labels to identify items that need to be stored in
the refrigerator.
• Controlled drug delivery book. These items need to be checked
at the time of delivery and a signature obtained.
• MDS procedures manual, for on-going reference and
training purposes.
• Quick reference guide, acting as a prompt for staff unfamiliar
with the system.
• Spare equipment.
• Wall planner, which acts as an aid for drug re-ordering.
provision of the Boots Monitored Dosage System (MDS)
7
104628 MDS BOOKLET 1/20/06 9:30 AM Page 8
In accordance with the guidelines
set by the Royal Pharmaceutical
Society of Great Britain (RPSGB),
all prescriptions should be ordered
by the home from the surgery.
Once the prescriptions have been generated and received by the
home, they should be checked and signed ready for collection by
Boots no later than 10 days prior to the next start date. This
procedure ensures that the home has full control of its own
ordering process and demonstrates compliance to best practices.
Boots will deliver the next 28-day supply of medication in the
MDS system to the home no later than 3 days before the next
cycle is due to commence. This gives the person checking the
medication in enough time to intervene should it be necessary to
do so, and gives the home flexibility for staff planning.
The monthly medication will be supplied in security sealed bags
and a representative at the home will be required to sign for each
bag and hand a portion of the tag back to the driver as proof of
delivery.
All controlled drugs will need to be checked and signed for
separately upon receipt. Boots provides each home with its
own controlled drug delivery book to make this process quick
and easy.
All fridge lines will be clearly marked so that they can be easily
identified by the home staff and quickly checked and stored away
in the refrigerator.
The Pharmafiles will be delivered to each home in the order
requested, making the drug round as smooth as possible.
The MARR sheets will also be in the same order, to facilitate
the checking in process.
Collection of empty files
On a monthly basis, Boots will arrange with each home a
mutually convenient time to collect the empty files. This would
usually happen a few days after the start of the new cycle,
giving the home time to complete the audit trail for the previous
28 day cycle.
Returns and disposal of medicines will be made available for
Care Homes to return to the Pharmacy (Residential Homes only)
or Pharmaceutical Waste Carrier for Homes with Nursing.
Mid Cycle Prescriptions
Any prescriptions for interim medication should be faxed to
Boots by an agreed cut-off time, for delivery the same day.
The original prescription must be handed over upon receipt of
the medication, so that the faxed copy can be checked against
the hard copy, to ensure that the item/s are correct. A separate
MARR sheet for the new item/s will be issued, for ease of
record keeping.
distribution of the MDS system
8
104628 MDS BOOKLET 1/20/06 9:30 AM Page 9
9
Boots will undertake an initial
assessment of the storage
available in the home.
If the home has a suitable trolley that could be adapted to hold
the MDS system, Boots may be able to provide the equipment for
doing this. The home would need to carry out the fitting of the
adapting panel.
In the event of a home having no storage of their own, Boots may
be able to provide a trolley/s on loan to accommodate the MDS
system whilst the home continues to receive their medication
supply from us.
An equipment agreement would need to be signed at this time
by the home, and it would remain the responsibility of the home
to ensure that any medication trolleys on loan from Boots were
maintained and fit for their purpose.
storage of the MDS system
104628 MDS BOOKLET 1/20/06 9:30 AM Page 10
10
Boots is able to offer a unique
6–tier training system to homes
using our MDS service.
Tier 1 – Initial set-up system training
Training will be provided to all relevant home staff prior to starting
the Monitored Dosage System.
This training covers all aspects of operating the system accurately
within the home and in accordance with current legislation.
The trainer, usually the Dispensing Services Advisor, will provide
a certificate of attendance for each member of staff who has
participated in the session.
The session normally takes about 1 hour to complete and
comprises of safe administration of medication and accurate
and meaningful record keeping. Audit trails, including receipt
and the returning of medicines are also covered.
There will be time to discuss the comprehensive service that
you will receive from the supplying MDS store and details of
the Key Contact and support staff will be given at the session.
We usually train all staff involved with medication administration
at the same time, at a time to suit the home, to minimise
disruption.
A Systems Training Package encompassing the above will be
left at the home for the use of the Home for any staff unable
to attend the initial training session.
Tier 2 – On-going training
For the purpose of refresher training or new members of staff, the
training package provides comprehensive instructions on how to
use the MDS system effectively. In addition, Boots can provide
each home with a copy of our training video.
There is a workbook to complete after viewing the video,
consisting of a question and answer type document. There is
also a competency assessment sheet for homes to use.
As further back up each home will each receive a manual to use
as an on-going source of reference, and a quick reference guide
inserted into the front of the MARR sheet folder, which acts as
a prompt when adjusting to using the MDS system.
training requirements
104628 MDS BOOKLET 1/20/06 9:30 AM Page 11
Tier 3 – Further training
Each home that uses Boots MDS automatically receives a copy
of our ‘Care to Train’ folder and related inserts. The Care to Train
folder consists of six single modules:
Pain and its management
Depression
Dementia
Heart Disease
Continence
Sleep
This is a topical, relevant information pack used for the
continuation of education within the care home environment.
The package can be used for self-study and there is an
assessment to complete at the end of each module.
Tiers 4, 5 and 6 – Care of Medicines Training
We can also offer our homes additional training packages for both
nurses and care staff.
These packages are called ‘Care of Medicines’ and include
foundation courses aimed at care staff and advanced for nurses
or senior carers.
The courses last half a day and are run by a suitably trained
pharmacist. There is also a workbook and certificate provided
following the assessment.
The courses are usually chargeable but for large numbers of
delegates or for group homes, we may be able to negotiate
a preferential rate.
The Care of Medicines Foundation Module is accredited to
National Care Standards by ASET (an affiliated body to the
National Curriculum Authority and partners with The Learning
Skills Council).
safe handling of medicine
answer book
monitored
dosage system
Carer name
Home name
safe handling of medicine
work book
monitored
dosage system
medication handling
system training
Trust us to help you handle medicines safely
104628 MDS BOOKLET 1/20/06 9:30 AM Page 12
12
Boots The Chemists will provide
access to pharmacist advice for
all group homes. This would be
carried out regularly, in either
a visit to the home or during a
telephone conversation.
It is routine practice for the advising pharmacist to give feedback
on all procedures associated with medication management within
the home.
They make recommendations in order to assist homes with
preparation for visits from the National Care Standards
Commission, ensuring that homes comply with all legal and
good practice aspects of storage, handling and administration
of medicines.
All visits would be documented and a copy sent to the home.
In addition Boots can provide a pharmacist to deliver
topic–specific training.
pharmacist advice
104628 MDS BOOKLET 1/20/06 9:30 AM Page 13
13
In addition to our store
pharmacists, a number of key
personnel will be available to
all homes during provision of
our services.
Each home will be allocated a Key Contact whose role is to
ensure the smooth running of the system on a day–to–day basis.
The Key Contact will be the main person dealing with the
everyday issues involved with the medication management of
a home, and will be an expert in operating the system.
At a regional level a Dispensing Services Advisor (DSA), will be
responsible for the initial contact and implementation of the
system. The role of the DSA is to ensure
a smooth transition of service and continued maintenance
throughout. The DSA can also be contacted should there be any
concerns relating to the service provision.
In the unlikely event of the home not being satisfied with the
service they receive from our store team, the DSA will intervene
to reach a solution.
communication and support
104628 MDS BOOKLET 1/20/06 9:30 AM Page 14
14
Regular reviews will be held with
both parties at either a national
or regional level to ensure the
continued success of these
arrangements.
The DSAs are available at all times should any issues arise
outside these meetings.
agreement review process
104628 MDS BOOKLET 1/20/06 9:30 AM Page 15
Boots may be able to advise
homes when developing a
medication policy across the chain.
This would include advice on all current legislation and guidance,
ensuring compliance with the National Minimum Care Standards.
The above forms the core of service that care homes
can expect from Boots The Chemists in the provision of the
MDS service.
Should you like any further information please
contact me at the address below:
Lisa Hallam
National Accounts Manager
The Boots Company PLC
Dispensing Operations
D90 West F17
Nottingham NG90 1BS
Tel: 07734 056 710
Fax: 01691 670 322
Email: [email protected]
policies and
procedures
104628 MDS BOOKLET 1/20/06 9:30 AM Page 16