More than half the care homes in England fail to meet minimum standards for the handling of drugs and medicines, putting more than 200,000 older people and children at risk, government inspectors warned last night.
The National Care Standards Commission said it was "a matter of grave concern" that so many homes were exposing residents to life threatening consequences.
After an analysis of its inspections at 16,700 care homes in 2002-03, it found more than one in seven "completely failed" to meet standards for safe storage of medicines, proper record keeping and careful arrangements for making sure residents took the right dose. A further 43% of homes for older people and 48% of those for children fell below the minimum standard, but without glaring defects.
Those owned by doctors were no better than average and those run by private firms and local authorities were worse than the voluntary sector.
Typical examples of poor practice included the wrong medication being given to residents, insecure storage at the wrong temperature, and inappropriate handling of medicines by untrained staff.
The best homes gave staff regular medication training, had monthly drugs audits and good relationships with local health staff. The commission estimated there were about 50,000 older people and children in homes that were completely defective in medication management and about 185,000 in those that were less seriously below standard.
The problem was serious because such a high proportion of older people in care homes were on medication. About 82% have a longstanding illness and 48% have two or more chronic conditions.
Anne Parker, the commission's chairwoman, said: "Mistakes in handling drugs and medicines can have life threatening consequences. One in seven homes not meeting the standard presents an unacceptable risk to the adults and children living in them."
The commission called on the government to develop accredited training in the handling of medicines for all care home staff. It said primary care trusts should review prescribing practices.
The charity Help the Aged said the report provided "shocking evidence of the mismanagement of medication across the care home sector for adults and children alike.
"The aim of a care home is to provide residents with a secure environment in which to live with the management and administration of medication playing a vital part."
Paul Burstow, the Liberal Democrat health spokesman, said: "This report is shocking. It is unacceptable that poor practice on medication is putting the lives of older people and children at risk.
"Drugs are being prescribed by GPs when they are unlicensed for the treatment of older people for dementia. There needs to be better monitoring of whether these drugs are being used for the benefit of patients or for the ease of staff."
