What are carers’ responsibilities in supporting medication safely?

Carers play a vital role in ensuring medication is given safely and correctly. Every carer must follow their training, workplace medicines policy, and current NICE guidance. This includes understanding whether their duty involves assisting or administering and giving medication safely.

What Is the Difference Between Assisting and Administering when Giving Medication Safely?

Carers need to know exactly what their role involves.

• Assisting means helping a person to take their own medication, for example by prompting or opening packaging.

• Administering means giving the medicine to the person on their behalf, following a prescriber’s instructions.

In care homes, practice should reflect NICE SC1: Managing medicines in care homes – covering prescribing, handling, administering, and monitoring.
In home or community settings, carers should follow NICE NG67: Managing medicines support in the community, which explains how to assess support needs and decide who provides medication support.

What Should Carers Do Before Giving Any Medicine?

Before any medicine is given or supported:

• Confirm consent and, if capacity may be lacking, follow the Mental Capacity Act process.

• Check the Medication Administration Record (MAR) for the right person, medicine, dose, route, and time.

• Record immediately after support, including refusals or omissions. The CQC expects a clear and accurate MAR entry for every instance of medication support.

Carers must always follow the Five Rights:
Right person, right medicine, right dose, right route, right time, and correct documentation using an approved MAR format.

How Should Carers Administer and Record Medicines?

Medicines must be given exactly as prescribed. Carers should never change the form of a medicine, such as crushing tablets, unless authorised by a prescriber or pharmacist and clearly recorded in the MAR or care plan.

Record whether the medicine was taken, refused, or delayed, and include any reason or advice sought. The MAR is a legal document and must be completed accurately every time.

How Should Carers Support “When Required” (PRN) Medicines?

PRN medicines should only be given when:

• The reason for use is clear in the care plan.

• The dose and maximum in 24 hours are defined.

• Guidance explains when to give and when to seek advice.

Carers must record why the PRN medicine was given and what effect it had.
Both NICE SC1 and NICE NG67 stress that clear PRN directions and monitoring are essential for safe care.

What Are the Rules for Controlled Drugs in Care Settings?

When individuals are prescribed controlled drugs (CDs), carers must follow organisational procedures for secure storage, restricted access, witnessing (where required), balance checks, and detailed record-keeping.

These processes must comply with NICE NG46: Controlled drugs – safe use and management.

When Can Medicines Be Given Covertly?

Covert administration, meaning giving medicine without the person’s knowledge, should only happen when:

• It is in the person’s best interests.

• A formal capacity assessment has been completed.

• A multidisciplinary agreement has been reached involving the prescriber and pharmacist.

 Every decision must be clearly documented and reviewed regularly in line with NICE medicines guidance and your organisation’s policy.

How Can Carers Support Self-Administration Safely?

Some individuals may be able to manage their own medicines with limited support. Carers should assess whether the person can self-administer safely and identify the right level of assistance, such as prompting, supervision, or help opening packaging.

 All medicines must be stored securely, whether managed by staff or by the individual. Refer to NICE SC1 and NG67 for detailed best practice.

What Should Carers Do If a Medication Error Happens?

If a medication error or near miss occurs, carers must:

1. Report it immediately to a senior staff member.

2. Seek clinical advice if required.

3. Record the details accurately.

4. Take part in reflective learning to help prevent similar incidents.

 Under CQC Regulation 12, providers must have systems in place to prevent avoidable harm and ensure that only trained, competent staff handle medicines.

Where Can Carers Find Official Guidance on Medicines Support?

• NICE SC1: Managing medicines in care homes

• NICE NG67: Medicines support in the community

• NICE NG46: Controlled drugs – safe use and management

• CQC: Regulation 12 – Safe care and treatment

Why Is Ongoing Training Important for Carers Supporting Medication?

Carers must continually update their knowledge and skills to ensure they are giving medication safely and providing effective support. Medicines, guidance, and best practices evolve regularly, so attending refresher courses, reviewing organisational policies, and engaging with new NICE guidance is essential. Reflective practice, such as reviewing incidents or near misses, helps carers identify improvements in their practice and enhances the safety and wellbeing of the people they support. By committing to ongoing professional development, carers not only maintain compliance with CQC standards but also build confidence and competence in their role, ultimately improving outcomes for those in their care.

How Can I Learn More About Medication Training? 

Our Medication Awareness in the Care Home eLearning course helps learners understand the essentials of medicine management, their responsibilities, and how to support safe and effective care.

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