Medication Awareness Training
Purpose
This factsheet ensures that domiciliary care workers:
- Understand safe medication practices.
- Know their responsibilities under UK regulations.
- Recognise the appropriate Tier level of medication support.
- Are aware of their role boundaries and when to escalate.
1. Key UK Legislation and Standards
| Law / Guidance | Relevance to Medication |
|---|---|
| Health and Social Care Act 2008 (Regulated Activities) | Requires safe care and treatment, including medication management (Reg. 12). |
| CQC Fundamental Standards | Focuses on person-centred care and safety (KLOEs and medication management). |
| NICE Guideline NG67 | Medicines optimisation in community settings. |
| The Medicines Act 1968 | Controls manufacture, supply, and administration of medicines. |
| The Mental Capacity Act 2005 | Supports consent, best interest decisions, and covert administration. |
| Skills for Care Training Standards | Sets required knowledge/competency for care workers handling medication. |
2. The Three Tiers of Medication Support
The level of involvement in medication support depends on risk, complexity, and training:
Tier 1 – Prompting Only
Definition: The service user is fully responsible for taking their medication and needs only a reminder.
Examples
- Reminding someone to take their tablets.
- Handing the medication to the person.
- Confirming the medication was taken (verbal feedback).
- No physical handling or administration involved.
Key Points:
- No MAR (Medication Administration Record) required unless requested.
- No additional training beyond basic awareness.
- No storage or handling of medication.
Tier 2 – Assistance with Medication
Definition: The care worker supports with minor physical help, but the individual remains in control.
Examples
- Opening bottles or blister packs.
- Reading labels or instructions.
- Assisting with inhalers, creams, or eye drops (with guidance).
Key Points:
- A MAR chart must be in place.
- Consent and risk assessments required.
- You must be trained and deemed competent.
- You should not choose or alter medication.
- Follow 6 Rs (Right person, medicine, dose, route, time, right to refuse).
Tier 3 – Administration of Medication
Definition: The care worker takes full responsibility for administering medication as per the care plan.
Examples
- Administering tablets or liquids directly to the individual.
- Giving insulin, suppositories, or applying medicated patches.
- Measuring and administering controlled drugs.
Key Points:
- Requires full training, competency assessment, and written authorisation.
- MAR must be completed and signed after every administration.
- Follow infection control protocols.
- Monitor and report side effects.
- Controlled drugs must be securely stored and documented.
- Support must follow a clear care plan and risk assessment.
3. The 6 Rs of Safe Medication Handling
Always check:
- Right Person
- Right Medication
- Right Dose
- Right Route
- Right Time
- Right to Refuse
4. Medication Administration Record (MAR)
- Must be accurate, up-to-date, and legible
- Use the correct codes (e.g., ✓ = taken, R = refused, C = cancelled)
- Sign or initial after each administration or support
- Never pre-sign MARs
- Report any errors or omissions immediately
5. Error Reporting and Escalation
Report immediately to your manager or relevant professional if:
- A medication error occurs (wrong person, dose, or time)
- A person refuses medication
- Medication is missing or damaged
- You observe side effects (rash, dizziness, breathing issues)
Follow the incident reporting procedure in your organisation.
6. Storage and Disposal
- Store as directed (e.g., fridge, locked cabinet)
- Never leave medication unattended
- Do not dispose of medicines yourself – escalate to the office or pharmacist
- Ensure medications are not shared between service users
7. Consent and Capacity
- Always obtain informed consent
- Respect the service user's right to refuse
- If they lack capacity, act under the Mental Capacity Act
- Document any best interest decisions with the appropriate professionals
8. Boundaries and Do Not
- Do not alter dosage or timing
- Do not recommend over-the-counter meds
- Do not crush tablets unless instructed by a pharmacist
- Do not hide medication in food (covert administration) without a formal decision and documentation
9. Recognising Side Effects and Reactions
| Common Side Effects | Red Flags |
|---|---|
| Headache, nausea, dizziness | Swelling, rash, chest pain |
| Tiredness or confusion | Difficulty breathing |
| Upset stomach | Collapse or seizure |
Record all symptoms and report promptly to a health professional or supervisor.
Booking & Enquiries
To arrange Medication Awareness Training for your team:
Availability: Flexible training sessions to suit your organisation's needs.
Ready to book Medication Awareness Training for your team?