Practice No.
127
Reference: 10/06
Version 3
Page 1 of 5
HCC AS 06/09
CSCI: Quality
HCC AS 10/06 125 Performance and
HCC AS 10/06 126 Methods Directorate :
The Safe
Management of
Controlled Drugs in
Care Homes (Jan 07)
The Royal Marsden
Hospital Manual of
Clinical Nursing
Procedures
Last up-dated
January 2010
NMC Code of Professional
Conduct
NMC Standards for
Medication Management Aug
2008
GSCC Code of practice for
social care workers and
employers
SAFE STORAGE AND DISPOSAL OF MEDICATION AND MEDICAL
EQUIPMENT
This defines the arrangements for the storage of medications, disposable and nondisposable medical equipment in Residential, Respite or Day Care Units, to ensure
compliance with manufacturers’ storage instructions and appropriate legislation. This
guideline deletes Practice No. 421 ‘Specific procedure for disposing of unwanted
drugs and medicines’ :
1.
Residential Care
Storage of medication

Medication must be stored in a locked cupboard which is only
used for the storage of medication. The temperature must not
exceed 25o C

External medication must be stored separately from oral medication

Medication may be stored in a locked medication trolley, but this
must be secured to the wall when not in use

All controlled medication must be stored in a specified Controlled
Drugs cupboard, which is of metal construction with a lock which
must comply with the safe custody regulations in the Misuse of
Medication Act 1971. The cupboard must be fixed to a wall of solid
construction by means of rag or rawl bolts

Medication which must be stored between 2-8oC must be stored in
a locked refrigerator designated for the purpose. The temperature
must be recorded daily, and if it exceeds the limits, the pharmacist
must be contacted to see if the medication is suitable for use

Homely remedies must be stored in a separate area to prescribed
medication, which is labelled as such

Medication no longer needed, must be stored separately in a
clearly labelled container whilst awaiting disposal.
Security of Storage Areas

The registered manager must ensure that the keys to all cupboards
in which medications are stored, are kept securely and are only
accessible to nominated staff

An individual home policy must detail the arrangements for key
security and staff responsibility for maintaining key security

All nominated staff must ensure that the keys are available to the
succeeding designated person at the end of each shift.
Disposal of medication

This applies to:
- Medication remaining after a resident has died
- Medication that has been discontinued
- Dispensed refused doses
- Medication that is past the expiry date.

All medication from residential units must be returned to a pharmacy,
preferably the dispensing pharmacy, for disposal

Medication from Nursing units, must be disposed of according to the
arrangements for the collection of waste medication with a licensed
waste disposal contractor

Controlled drugs must be denatured before disposal.

A record of the medication for disposal must be kept by the home,
and must include:
- The date
- The name of the resident
- The name, form (e.g. tablets), strength and quantity of the
medication

The pharmacist, designated pharmacy representative, or licensed
waste disposal company representative must sign as having received
the medication, and the book must be returned to the home.
2.
Day Care
.
Storage of medication

All medication received with service users must have an audit trail
from receipt to disposal. Practice No 126 applies

A risk assessment must be carried out and recorded in the care plan,
to asses the way in which the service user manages their medication.
The assessment must specify if the service user wishes, and is
capable of retaining medication in their possession whilst in the centre

The assessment must also include an assessment of risk to others, of
a service user keeping their own medication and the availability of any
special storage facility e.g. lockable refrigerator

Medication not kept in a service user’s possession must be stored in
a locked cupboard. The manager is responsible for ensuring there are
designated key holders

All medication must be in original containers provided by the
pharmacy. This may be in the form of individual containers or as a
daily dosage box system, with sufficient medication to cover the
length of the day service session.

Medication which must be stored between 2-8oC must be stored in a
locked refrigerator kept for the purpose. The temperature must be
recorded daily, and if it exceeds the limits, the pharmacist must be
contacted to see if the medication is suitable for use

External medication must be stored separately from oral medication
Security of Storage Areas

The registered manager must ensure that the keys to all cupboards in
which medications are stored, are kept securely and are only
accessible to nominated staff

An individual unit policy must detail the arrangements for key security
and staff responsibility for maintaining the security

All nominated staff must ensure that the keys are available to the
succeeding designated person at the end of each shift.
Return and Disposal of medication

Where a service user is not independent and the day service has
been responsible for holding their medication during the day, when a
service user ends their session at the centre, any medication must be
returned to them, or the person collecting them. They, or the person
collecting them must be asked to sign for the receipt of the medication

The details in the record must be the same as those recorded when
receiving the medication into the day care centre

A separate sheet for each service user must be used and the details
recorded in black ink

When a dose has been contaminated, or not taken, it must be placed
in the medication disposal box, prior to return to the pharmacy for
disposal

3.
All day centres must have a medication disposal (green) box.
Storage of Medical Equipment

This will apply to the storage of disposable equipment such as sterile
and non-sterile medical devices (hypodermic syringes and needles,
cannulae, catheters, drainage bags), and non-disposable items such
as thermometers, sphygmomanometers and glucometers

Care must be taken to ensure that all items are stored in accordance
with any special manufacturers’ instructions for storage e.g. fragile,
this way up

All medical equipment must be stored in a designated room which
must be locked when not in use. The keys to this room must be kept
by the authorised person

Hypodermic syringes and needles must be kept in a separate
locked cupboard in the designated room. The keys to this cupboard
must also be kept by the authorised person

Products stored in single, sterile packaging only, must not be stored
directly on the floor of the designated room

Where possible, all items must be stored on shelves for ease of
identification and access

Products must not be stored near sinks or where there is a
danger of them getting wet or damp and thus compromising the
integrity of the clean or sterile packaging

Products kept stored in outer cartons must not be stacked close to
electric lighting, or other heat sources which may represent a fire
hazard

All items must be stored in accordance with safe moving and
handling methods
4.
Disposal of Medical Equipment

Some medical equipment, such as pressure relieving mattresses,
must be returned to the supplier and should be disposed of in
accordance with the agreed returns procedure

A record must be kept of the date and method of return and the
collecting agent must sign for receipt of the returned item

Until the used equipment is collected it must be stored in a safe place,
preferably a locked cupboard

All ‘sharps’ must be disposed of according to Practice no. 140

All contaminated waste must be disposed of in accordance with
Practice no. 420, which will include human tissue or blood;
microbiological cultures and containers for collection of body fluids.
5.
Storage and Disposal of Oxygen

Storage
Pure oxygen, at high pressure, such as from a cylinder, can react
violently with common materials such as oil and grease. Even a small
increase in the oxygen level in the air to 24%, can create a dangerous
situation. An oxygen enriched atmosphere is difficult to detect as the
gas is colourless, odourless and tasteless

Before storing oxygen cylinders a risk assessment of the storage area
must be undertaken

The storage area must be well ventilated, away from combustible
materials and separated from cylinders of flammable gas

There must be a fire extinguisher, in good condition and ready for use
close to the oxygen storage area

The storage area must be clearly marked, identifying the contents and
clearly prohibiting naked flames and smoking in the area

A purpose built trolley must be used to move the cylinders

Cylinders in storage must be kept chained or clamped to prevent them
falling over

Empty cylinders must be clearly marked as such and stored
separately from full cylinders.
Disposal

All empty, partially empty or unused cylinders must to returned to the
supplying agent as agreed.