Background We recently commenced a Continuing Health Care Fast Track Pilot Project which aims to enable patients with a deteriorating and life-limiting illness to remain at home by preventing avoidable admissions to hospital and facilitating early discharge from in-patient care, either hospital or hospice. We offer up to four times a day care which may include prompting or administration of medication by the staff member who are predominately health care assistants (HCAs). Recent guidance has made it clear that if HCAs have been appropriately trained and their competence is regularly assessed it is legal for them to carry out this enhanced role.

Aim To ensure the staff are competent and supported in prompting and administering medication to patients in their own home.

Method In house training undertaken by the team included the supply, storage and disposal of medicines, safe administration, accurate record keeping using the MARs sheet, accountability, confidentiality and commonly identified issues linked with errors in administration. One to one observation of healthcare assistants prompting/administering medication. Competency assessed and signed off.

Results The service can accept patients with more complex needs that may include the prompting or administration of medication. This increases patient choice and enhances the patient experience. The overall aim of meeting the patient’s preferred place of death in the patient’s home is achieved. The team are trained and supported to carry out medicine tasks in a safe and effective manner for the benefit of the people they are caring for.

Conclusion Appropriate training, a robust competency framework and ongoing support is key to safe, effective and appropriate medication administration by healthcare assistants allowing patients to die in their preferred place of care.