Introduction

This policy outlines the information required, and the expectations of a Hireup Support Worker when administering Schedule 8 (S8) medications to people and of the Client when S8 medication administration is required on shift.  

This policy aims to ensure the standard of service delivery remains safe and high quality and to proactively reduce the number of medication associated adverse events. It aims to provide guidance to Support Workers, outlining what duties are acceptable for them to complete and what duties are outside of the scope of a Support Worker.

All S8 medications administered by a Support Worker will be accompanied by a Medication Authority Form (MAF). A MAF is to be completed by an appropriate, registered health professional, such as a treating doctor and should be reviewed every 12 months or as otherwise stated by the treating health professional. The MAF will detail the appropriate route of administration. Common routes of S8 medication administration include oral and transdermal. 

This policy should be used in conjunction with the Administration of Medication Policy. 

Hireup Values 

Hireup’s values provide us with the direction in which we engage with our community and develop policy and process across the business. 

We recognise that S8 medication administration support is only a part of a person’s overall support needs. By upholding the value of ‘the person is the point’ we take an individualised approach to medication management.  

Hireup acknowledges Clients and their families are experts in their individual medication management. Central to this understanding is the principle of ‘championing choice’ and control for Clients to make informed decisions about their S8 medication administration support. Whilst Hireup is not responsible for the assessment or development of a Client’s medication authority form, we support Clients to engage with suitable health professionals and to be involved in the planning and management of their S8 medication administration, as well as any individual training arrangements. 

Definitions 

Support Worker: a person that provides support to the Client, typically in a paid capacity.

Schedule 8 (S8) Medications: prescription medications that have a recognised therapeutic need but also a higher risk of misuse, abuse and dependence (sometimes referred to as drugs of dependence). Examples of these include opioids.

Schedule 8 Register: a register of all S8 medications that keeps stock of all relevant medications and is used to document when S8 medications have been restocked and used.

Medication authority form: a document that outlines for service users:

• Name of each medication
• Purpose of each medication
• Dosage amount and frequency
• Route of administration
• Preparation instructions
• Storage instructions
• Potential side effects of the medication

Oral medication: medications that can be taken orally, such as tablets and liquids. This can also refer to medications that would be ordinarily administered orally that are prescribed to be given via a tube, such as a percutaneous endoscopic gastrostomy (PEG). This will be accompanied by a tube feeding care plan. The safest route of administration will be included on the person’s MAF. If the person has mealtime management needs, their mealtime management plan will outline any modifications that need to be made to the medication and the safest way to administer. 

Transdermal medication: medications that are delivered through a patch on the skin. The patch delivers medication slowly over a number of hours or days. 

Percutaneous Endoscopic Gastrostomy (PEG): a flexible tube that is placed through the abdominal wall into the stomach, bypassing the mouth and the oesophagus.

Polypharmacy: the use of five or more medications, or two or more psychotropic medications, at the same time to treat or multiple concurrent conditions. It includes the use of all prescription medicines, over-the-counter medicines, and complementary medicines. Polypharmacy is associated with an increased risk of medication-related adverse effects and poorer health outcomes.

Polypharmacy review: a review of all medications by a medical practitioner and/or pharmacist to assess interactions between medications to reduce or manage potential adverse effects.  

Guidelines

Service Provider

As a service provider, Hireup will:

• Work with the Client (or their Account Manager where applicable) to determine the support they require from Hireup, and determine what documentation is required.
• Support the Client (or their Account Manager where applicable) to complete a polypharmacy review where required.
• Determine areas of S8 medication administration that are within the scope of practice for a Support Worker to provide.
• Regularly review the medication authority form to ensure the information provided is the most up to date and appropriate.
• Work with the Client (or their Account Manager where applicable) to ensure medications are stored appropriately.
• Ensure appropriate record keeping practices are maintained by the Client (or their Account Manager where applicable)) and Support Workers responsible for the administration of S8 medications.
• Provide Support Workers with written procedures for the provision of S8 Medication Administration, in conjunction with the Client (or their Account Manager where applicable) and their treating Health Professional.
• Ensure Support Workers have access to plans and ensure these plans are only updated by a registered and relevant health professional.
• Identify areas of education and training for Support Workers.
• Provide Support Workers with appropriate training and assessment to ensure the safe provision of S8 medication administration, including regular supervision.

Support Worker

A Support Worker MAY:

• Perform any task that is listed on the plan, apart from those that must be completed by a health professional. If concerned or unsure, talk to the Client (or their Account Manager where applicable), and contact the Hireup support office for support.
• Access supervision outside of scheduled supervision timeframes by contacting Hireup directly.

A Support Worker MUST: 

• Complete online training modules provided by Hireup within the allocated time frame unless otherwise specified by Hireup.
• Complete regular training in the administration of oral medications (including being informed and aware of risks associated with altering the dose of a medication) in each Client’s individual medication administration support needs.
• Complete other relevant online training modules provided by Hireup prior to administering medications, unless otherwise specified by Hireup.
• Follow the support plan as provided and raise any concerns with the Client (or their Account Manager where applicable) immediately, as well as notify Hireup.
• Be aware that they must ensure the proper use of medication.
• Report when medication is refused, missed or vomited up.
• NOT give any medications to a Client that has not been ordered for that Client.
• NOT give any medications that are expired.
• NOT administer any medications that are not labelled appropriately or have been taken out of their packaging and are not identifiable.
• NOT change any part of the plan or deviate from the plan provided.
• Document the administration of medication as per the Client’s record keeping and Hireup, including on the S8 register.
• Report any or variations in the Client’s health and wellbeing (such as abnormal drowsiness, changes in breathing patterns, change in level of alertness), and/or medication orders to the Client, (or their Account Manager where applicable) and/or their health professional where necessary, followed by an incident report to Hireup once safe to do so.
• Report any concerns or issues associated with administration of S8 medications to the Client (or their Account Manager where applicable) and Hireup for further advice.

• Identify any gaps in knowledge and report these to Hireup for further advice.

Clients

A Client MUST:

• Provide Hireup with an honest and accurate account of their support needs.
• Provide a support plan to Hireup that outlines their specific medication administration support requirements, completed by an appropriate, registered health professional.
• Have the plan reviewed by an appropriate, registered health professional when changes occur. At a minimum, the plan should be reviewed every 12 months unless otherwise indicated on the plan.
• Keep a register that records all S8 medications. The register must meet the following standards:
  • The registers used are to be bound with serially numbered pages, corrections must be crossed out and initialled - white out and pencil are not to be used.
  • A separate page is allocated to each particular form of medication for each individual.
  • All medications received for individuals must be recorded at the time of receipt and all medications administered must be recorded at the time of administration. This is a separate activity to the Medication Administration Record. The register entries must be signed by the person placing the medication into the enclosure or removing the medication from the enclosure for the individual to take their dose. Where possible, two people should be involved in the recording of S8 medications.
  • The balance of S8 medications held at any particular time must be the same as the balance that is recorded in the register. If there is a discrepancy this should be discussed with Hireup as soon as practicable. A register balance must be checked at the handover of shifts and signed by the persons involved in the handover.
• Advise Hireup of any changes to support needs, requirements or the medication authority form.
• Report any concerns regarding Support Worker’s capability in providing medication administration support to Hireup for further advice.