Welsh care homes face spectre of enhanced medicines policy inspection

Welsh politicians have called for enhanced scrutiny of the way care homes manage challenging behaviour in residents with dementia. In a new report, they call for Welsh care home inspectors to mark homes for their use of mandatory routine reviews and the way homes record their use of antipsychotic medicines.  

The report by the Welsh health, social care and sport committee into the use of antipsychotic medicines also makes a number of other recommendations:

  • an allied health professional dementia consultant to work with care homes
  • assessment of care home staff skills in the care of residents with dementia
  • guidance for care homes on safe and appropriate staffing levels
  • specific training for staff on challenging behaviour in dementia
  • health boards to collect and publish data on the use of antipsychotic medication in care homes. 

The AMs, in their work for the Welsh health and social care committee, believe that care could be improved by the use of a standardised checklist to help health and social care staff to identify and address/rule out possible causes of challenging behaviour, including unmet physical or emotional needs. Better access to speech and language therapy would also help. 

Dr Dai Lloyd AM, chair of the Health, Social Care and Sport Committee, said: “We are not suggesting that antipsychotics should never be prescribed for people with dementia; it is the appropriateness of their prescription that is under question.”   

Nigel Downes, Royal College of Nursing Wales associate director (professional practice), said: “Nurses have a key role in providing high quality care. Patients with dementia in a care home are likely to require greater levels of care. This can only be achieved when the workforce is properly resourced, staffing numbers are correct and staff receiving the correct level of training.”

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