Medication Competency Assessment MC002

Staff Medication Administration
Competency Assessment
Care Homes Practice Support
Medicines Management Department
NHS Coventry & Warwickshire CCG
Parkside House,
Quinton Road
Coventry,
CV1 2NJ
Contents of Competency Assessment
Page 1 Contents of Competency Assessment
Page 2 to Page 8 Observation Assessment
Page 9 to Page 17 Underpinning Knowledge Assessment – Questions
Page 18 to Page 19 Suggested ‘Indicators for Skill Performance Criteria’
Page 20 to Page 22 A – Competency Assessment for External Topical Application (Additional Competencies)
Page 23 to Page 25 B – Competency Assessment for Eye Drops and Eye Ointment (Additional Competencies)
Page 26 to Page 28 C – Competency Assessment for Ear Drops (Additional Competencies)
Page 29 to Page 31 D – Competency Assessment for Nose Drops and Nasal Sprays (Additional Competencies)
Page 32 to Page 34 E – Competency Assessment for Inhalers (Additional Competencies)
Page 35 to Page 37 F – Competency Assessment for Controlled Drugs (Additional Competencies)
Page 38 to Page 40 G – Competency Assessment for PEG (Additional Competencies)
Page 41 to Page 45 H – Competency Assessment for Medication Pathways (Additional Competencies)
Page 46 to Page 47 I – Competency Assessment for Administration of Homely Remedies (Additional Competencies)
Prepared by CRCCG Medicines Management Care Homes Team Prepared: Dec 2014
Version: MC002
With thanks to Voyage and Sovereign House who kindly allowed us to use their competency frameworks for the purpose of best practice
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Staff Medication Administration Competency Assessment
This document should be used to assess and document individual levels of competence associated with the management and administration of
medication.
All staff administering medication must be assessed as competent at least once every 12 months
 The observation assessment is to be satisfactorily completed for staff prior to their involvement in the administration of
medication, for re-assessment and yearly competency assessments.
 To be assessed after completion of an accredited training Course. Assessment must be completed on 3 separate occasions,
in order for competency to be signed off.
 Staff should only administer medications they have been assessed as competent to administer.
 Competency assessment should be recorded on this form. If registered nurses are administering medication they must
comply with the most recent guidance published by the
Observation Assessment Nursing and Midwifery Council (NMC)
Name of staff member Name of service
Designation of staff Date E Learning

member completed
Designation of
Name of staff assessing
staff assessing
competence
competence
1st Assessment
Date and time of 2nd Assessment Reason for
assessments assessment
3rd Assessment
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3 ASSESSMENT OCCASIONS REQUIRED FINAL SIGN OFF
Date / Observed By / Assessment Method (Direct Observation (D) or After 3rd
Questioning (Q)) Assessment
CRITERIA 1st Assessment 2nd Assessment 3rd Assessment Date & Signature
of assessor plus
any comments
Date By Method Date By Method Date By Method
Preparation prior to Administration

1) Prepare
Safe environment
Preparation of all equipment
Knowledge of individuals
Clean and tidy work area
Correct records (MAR charts,
Protocols, Stock control)
Check communication
book/diary/support plan for
changes/relevant instructions
Washes hands
Wears a ‘do not disturb’ tabard
2) Check MAR Charts
Identity/name
Consent to treatment (MCA)
Signatures, legible, written correctly
Dates/times
Route of administration
Names of medicines to be administered
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CRITERIA Questioning (Q)) Assessment
1st Assessment 2nd Assessment 3rd Assessment Date & Signature
Date By Method Date By Method Date By Method of assessor plus
Special precautions
3) Prepare medicine pots/spoons or
other equipment as required
Prepare their choice of drink as written
in their support plan
Disposable gallipots used or a clean
pot/spoon for each resident is used
Clean and used equipment is clearly
segregated
Administering the Medication

1) Select designated area
One individual at a time
2) Greet the individual by name and offer

medication
3) Select the individual’s MAR Chart and

medicines
Check that the chart and medication
corresponds with the individuals name
4) Check week commencing dates on the

administration system
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Right day/right time?
Check each medication matches the
description
Check you have correct quantity of
tablets
Ensures medication trolley is locked at
all times between each administrations
and keys are with them at all times
5) Before administering makes a check

Right resident?
Right medication?
Right route?
Right dose?
Right time?
Right to refuse?
Check the dose on the MAR chart
matches the dose on the pharmacy
label, the external manufacturers
packaging and the manufacturers
blister pack
Is medication being offered at
appropriate times? (e.g. Alendronic
acid 30mins before breakfast, aspirin
with or after food)
6) Offer the individual their medication,
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checking consent offering them a fresh
drink of water or alternative method as
identified in their support plan
7) Signing the MAR Chart
Sign the MAR sheet for each
medication administered when you
believe that it has been swallowed
Sign for any external applications
8) If any medication is not
administered
For any reason complete the MAR
chart using the correct code as stated
on the bottom of the chart
Fully document the reasons for this
Inform the staff member in charge of
the shift
Inform next staff on handover
Observe the individual for any ill effects
for refusal of medication and fully
document
Follow procedure for spoilt/refused
medication
9) Giving PRN medication
Do not administer without appropriate
guidance
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The use of PRN medication should be
clearly outlined in the individual/s
support plan
Follow guidance/protocols set up in the
support plan
Fully document that PRN medication
has been given and record quantity
given
Sign the MAR chart and the PRN
Chart, counting stock level and
recording appropriately
10) House keeping
Tidy medicine cupboard and ensure
area is clean
Check that medicine cupboard is
locked, stocked and secured
Wash and dry and equipment used
Check all MAR Charts are complete,
correct and that you have signed
appropriately
1st ASSESSMENT 2nd ASSESSMENT 3rd ASSESSMENT

I have supervised I have supervised I have supervised
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They have successfully administered They have successfully administered They have successfully administered
medication to the individuals (minimum of 1 medication to the individuals (minimum of 1 medication to the individuals (minimum of 1
individual) covering all of the criteria in the individual) covering all of the criteria in the individual) covering all of the criteria in the
competency tool on this occasion. competency tool on this occasion. competency tool on this occasion.
Signed Assessor: Signed Assessor: Signed Assessor:
Full name / designation: Full name / designation: Full name / designation:
Date: Date: Date:
Signed Trainee: Signed Trainee: Signed Trainee:
Full name / designation: Full name / designation: Full name / designation:
Date: Date: Date:
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Underpinning Knowledge Assessment - Questions
 The underpinning knowledge assessment should be used to assist in pertaining the candidates underpinning knowledge of
medicines management within the care home
 The assessment is to be satisfactorily completed for staff prior to their involvement with the administration of medication.
This should be completed via a one to one session with the assessor asking the questions and documenting the answers.
This allows for an informal discussion to surround the questions being asked and any further training needs to be identified.
 To be assessed after completion of an accredited training Course. All questions must be satisfactorily answered in order for
competency to be signed off.
 Staff should never administer medication they have not been assessed as competent to administer.
 Answers given should be documented and recorded on this form
SUGGESTED QUESTIONS TO ASSIST IN

‘STANDARD OF EVIDENCE REQUIRED FOR KNOWLEDGE PERFORMANCE CRITERIA’
Show understanding of Care Homes Medicines Policy and Royal Pharmaceutical Society Guidance, NMC guidelines and NICE
guidance
 Where can you find the NMC Code of Professional Conduct; standards for conduct, performance and ethics, and guidelines for the
administration of medicines? (Nurses only).
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
 What might you use them for? Request the candidate to bring one to you. (Nurses only)
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
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 Where can you find your care homes medication Policy?
___________________________________________________________________________________________________________
 What might you use this for and in what circumstances?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
 Where can you find the Royal Pharmaceutical Society’s Guidelines?
___________________________________________________________________________________________________________
 What are they and what might you use these for?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
 Where can you find the NICE guidance for managing medicines in care homes (SC1)?
_______________________________________________________________________________________________________________
Show understanding of own accountability / responsibility in Management of Medicines

 What are your responsibilities in regard to medication management using the Pharmacy MAR system? (should include ordering,
administration, disposal, medical devices, storage including CDs, and evidencing same)
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
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 All medicines are known by two names, what are these?
1) __________________________________ 2)_________________________________
 What is a FP10?
_______________________________________________________________________________________________________________
 Once the home receives the monthly prescriptions or EPS token from the GP surgery, explain the procedure to be followed before
sending the FP10 or confirming the token is ready to be dispensed by the pharmacy?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
 When medication is received into the home what actions must be carried out before the medication can be administered to the resident?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
 When a controlled drug is received into the home what actions must be taken before the medication can be administered to the resident?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
 Describe the process the home must follow for disposing of medication?
___________________________________________________________________________________________________________
__________________________________________________________________________________________________________
 How long must you keep medication following the death of a resident?
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___________________________________________________________________________________________________________
 How often should the refrigerator and room temperature be checked?
___________________________________________________________________________________________________________
 Where these should be documented?
_______________________________________________________________________________________________________________
 What temperatures should be documented?
_______________________________________________________________________________________________________________
 What are the minimum and maximum temperature ranges for the refrigerator and room temperature?
__________________________________________________________________________________________________________
 By what routes should medication be given if the instructions on the prescription state the following
a) Oral..............................................................................................................................
b) Buccal..........................................................................................................................
c) Subingual.....................................................................................................................
d) Intra-Occular................................................................................................................
e) Rectal..........................................................................................................................
f) Trans dermal................................................................................................................
g) Topical.........................................................................................................................
h) Subcutaneous..............................................................................................................
i) Intramuscular............................................................................................................
Understanding of individual’s medical conditions in relation to their medications

 Review six administration records (two of which should contain the administration of a Topical Preparation) via MAR sheets and ask for
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individual’s current medical conditions and why they are on their particular medications (basics for residential staff, but greater
knowledge for RNs).Consider resources that can be used e.g. BNF, patient information leaflets etc. and document your thoughts on the
response and any further training needs identified.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Understanding the effects and side effects of medications given (minimum of six medications at random)
 Look at 6 medicines and ask for basic knowledge on how they work and any possible side effects of the medicine. Ensure evidence of
what was asked and their responses are included with this assessment (basics for residential staff, but greater knowledge for RNs).
1) _______________________________________________________________________________________________________
2) _______________________________________________________________________________________________________
3) _______________________________________________________________________________________________________
4) _______________________________________________________________________________________________________
5) _______________________________________________________________________________________________________
6) _______________________________________________________________________________________________________
Understanding of responsibilities in verbal requests

 What is your accountability/responsibility in dealing with verbal requests? (Should mention issues such as last resort, use of fax or
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email). Refer to Policy.
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
 What is your responsibility in relation to managing medication which is running low?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Management of errors / near misses

 What procedure should be followed for medication errors / near misses?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
 Give an example of a medication discrepancy.
__________________________________________________________________________________________________________
 Give an example of a medication error.
______________________________________________________________________________________________________________
 Give an example of a medication near-miss.
__________________________________________________________________________________________________________
 What is reportable to the NMC in regard to a medication error? (Nurses Only)
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
 What is reportable to safeguarding in relation to medication errors?

___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
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Management of adverse effects of medications

 How would you recognise an adverse effect of a medication?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
 How would you recognise an adverse effect of a Topical Preparation?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
 To whom and how would you report this adverse effect? (understanding of the role of MHRA for nurses / awareness for others)
__________________________________________________________________________________________________________
 You have received a Drug Alert, What would you do?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Calculations – Allow the candidate to look at the calculation section and answer the questions. Allow them 5 minutes to complete
this task.
How many micrograms are there in 1 milligram?
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100 1000 10 (please circle)
How many milligrams are there in 1 gram?
100 1000 10 (please circle)
What are the recognised abbreviations for:
Gram Milligram
Microgram Millilitre
Drug Calculations
You have 2.5mg tablets and the patient is prescribed 10mg.

How many tablets would you give?
A medicine bottle says the syrup is 20mg/ml.

What does that mean?
Your patient is prescribed 120mg of the above medicine.

How much would you give?
If you are unsure about a dose you were about to administer, what would you do?
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SUGGESTED ‘INDICATORS FOR SKILL PERFORMANCE CRITERIA’
Preparation prior to commencing drug administration
 Washing of hands
 Collecting of drug keys and trolley including any medicines from the drug fridge
 Collecting clean and dry medicine pots (should be disposable)
 Collecting PPE if required
 Making available sufficient glasses, spoons and jugs of drinking water/juice
 Ensure you have a black pen and a current BNF / BMA New Guide to Medicines and Drugs available or you know how to access
medicine information via the patient information leaflet.
Effective communication with individuals during procedure

 Introducing themselves
 Explaining as required what they are doing and answering any questions they have about their medicines/topical preparations as per
CQC Regulations.
 Giving the appearance of not being rushed
 Answering at the time any additional queries the individual may have even if it is not related to medicines, or explaining that they will
have to come back to discuss this with them, ensuring they do so.
Ordering of medications for the Home

 Have previously undertaken this task to the required standard with minimal input from the person assessing
 Able to explain the method of ordering medications for monthly, interim or same day requirements.
Receipt of medications into the Home

 Have previously undertaken this task to the required standard with minimal input from the person assessing
 Able to explain the method of receiving medications and checking in at the Home or what to do in an emergency if no new MAR sheets
are provided by the pharmacy provider.
Storage of medicines in the Home

 Able to clearly demonstrate where topical medicines should be kept both on the trolley and in the medication room
 Able to demonstrate where tablets/capsules, liquids, injections, CDs etc. should be kept in the medication room and how to store these
even if in use daily
 Asking why we record medication room and drug fridge temperatures, how frequently we do this, what the normal limits are and what
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SUGGESTED ‘INDICATORS FOR SKILL PERFORMANCE CRITERIA’
we do if not within these.
Administration of medicines
 Capable of conducting administration of medicines according to Medication Policy and NMC guidance (nurses)
 Recording of medicine administration to previously mentioned standards including what to do if an individual refuses (MAR sheets, Care
Plan and information all others involved)
 How to monitor an individual who self-medicates and confirm capability and what to do if concerns arise
 Able to demonstrate clearly how to administer CDs, that they have undertaken this task with date, time and assessor’s name in the
evidence section as this may have been done prior to observation of a medication round; or if no-one on a CD, then to clearly state the
procedure
 Clearly able to state Medication Policy and NMC (nurses) policy on Covert Administration of Medicines, what are the options available
 How to dispose of refused / not taken tablets including Controlled Drugs and topical preparations safely and in accordance with policy
and legislation.
Responsibility for the appointment of the Competency Assessor who must be someone who is capable of meeting all the above and has
recognised competency (skill and knowledge) in this area of practice lies with the Home Manager.
Any additional and appropriate documented evidence to confirm competency should be attached to the competency assessment
document.
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A – COMPETENCY ASSESSMENT FOR EXTERNAL TOPICAL
APPLICATION (additional competencies)
Designation of staff Date Learning

member completed
Designation of
Name of Assessor
Assessor
Date and time of
assessments
PURPOSE
Competent
CRITERIA Staff member’s explanation of purpose to be
signed
documented below as evidence of their understanding
Preparation prior to administration
1) Explain and discuss the procedure with the person
Ask the individual in which private area they wish to
have the application administered e.g.
bedroom/bathroom
2) Safe environment
Correct records (MAR charts, Protocols, Stock
control)
Check communication book/diary/support plan for
Prepare PPE
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PURPOSE
Competent
signed
Check MAR Charts
3) Identity/name
Signatures, legible, written correctly dates/times
Special precautions
Check the instructions of how to apply
Check expiry date and always date any new
applications opened, record new expiry date
Wash hands
Administration
4) Assist the person into the required position
5) Close room door and curtains
6) Assess the condition of the skin and use an aseptic
technique if the skin is broken
7) Put on PPE
If applying moisturiser, apply to dry skin, applying
cream down the limb in the direction of hair growth
using gentle sweeping motion.
For fragile skin on limbs use a cupping action with
both hands
If applying a barrier cream, apply as per directions
8) When applying a steroid cream, medicated cream
administer a small amount using fingertip apply thinly
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PURPOSE
Competent
signed
Post administration
9) Assist the person to redress and assist the person to
return to their chosen area and activity
10) Wash hands clean the area used and dispose of
waste products
11) Record the administration
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B – COMPETENCY ASSESSMENT FOR EYE DROPS & EYE
OINTMENT (additional competencies)

member completed
Designation of
Name of Assessor
Assessor
Date and time of
assessments
PURPOSE
Competent
signed
Ask the individual in which private area they wish
to have the application administered e.g. bedroom
2) Safe environment
control)
Prepare PPE
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PURPOSE
Competent
signed
Check MAR Charts
3) Identity/name
Signatures, legible, written correctly dates/times
Special precautions
Ensure you know which eye or both is to be treated
Check label and MAR for directions indicating which
eye or both eyes (NB. Antibiotic eye drops may be
prescribed a separate bottle per eye)
Wash hands and put on gloves
Administration
4) Close room door and curtains
Ask the person to sit back with neck slightly
hyperextended or to lie down
6) If there is any discharge clean the eye using a
gauze swab or wipe with warm water, wipe away
from the nose, use a clean swab each time to clean
until discharge removed
7) Take the top of the bottle and put it down
somewhere clean
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PURPOSE
Competent
signed
With combined prescriptions of drops and ointment
put drops in first
Ask the person to look to the ceiling and carefully
pull the skin below the affected eye using a swab to
expose the conjunctiva sac
Either
8) Administer the prescribed number of drops holding
the eye dropper 1-2cm above the eye. If the person
blinks or closes their eye before installation, repeat
the procedure.
Or
Apply a thin stream of ointment along the inner
conjunctiva from the nose outwards. If there is
excess medication on the eyelid gently wipe it from
the inner to outer part of the eye.
9) Ask the person to close their eyes for 1-2 minutes
Explain the person may have blurred vision for a few
minutes after application
Wipe away and liquid from the person’s cheek with
a clean tissue
Post administration
10) Assist the person to return to their chosen area and
activity
11) Wash hands, clean the area used and dispose of
waste products
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C – COMPETENCY ASSESSMENT FOR EAR DROPS
(additional competencies)

member completed
Designation of
Name of Assessor
Assessor
Date and time of
assessments
PURPOSE
Competent
signed
have the application administered e.g. bedroom
2) Safe environment
control)
Prepare PPE
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PURPOSE
Competent
signed
Check MAR Charts
3) Identity/name
Signatures, legible, written correctly, dates/times
Special precautions
Ensure you know which ear or both is to be treated
Ideally it is more suitable if the person can lie on
their side with the ear to be treated uppermost.
Ask the person to sit back with neck tilted to the side
with the ear to be treated uppermost.
5) Warm the drops to body temperature

Take the top of the bottle and put it down
somewhere clean
6) Hold the middle of the external earlobe (Pinna) and
gently pull outwards and upwards
If wax or fluid blocks the outer portion of the canal,
wipe out gently with gauze
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PURPOSE
Competent
signed
7) Hold the bottle/dropper to allow the drops to fall in
the direction of the canal, squeezing the
bottle/dropper if necessary
8) Keep the head tilted for a couple of minutes, it may
be necessary to temporarily place a gauze swab
over the ear canal
Repeat in the other ear if prescribed
Wipe away any excess liquid with swab or wipe
Post administration
activity
10) Wash hands clean the area used and dispose of
waste products
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D – COMPETENCY ASSESSMENT FOR NOSE DROPS & NASAL
SPRAYS (additional competencies)

member completed
Designation of
Name of Assessor
Assessor
Date and time of
assessments
PURPOSE
Competent
signed
2) Safe environment
control)
Prepare PPE
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PURPOSE
Competent
signed
Check MAR Charts
3) Identity/name
Special precautions
4) Ask the person to blow their nose to clear the nasal
passages if this is possible
Ideally it is more suitable if the person can lie on their
back or ask the person to sit back with neck
hyperextended, unless this is clinically
contraindicated (Physical condition can determine
position)
6) Take the top of the bottle and put it down somewhere
clean
With the non-dominant hand, gently push upwards
on the end of the person’s nose
7) Avoid touching the sides of the nostrils with the
bottle/dropper and instill the drops just inside the
nostril of the affected side
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PURPOSE
Competent
signed
8) Ask the person to sniff back any liquid into to the

back of the nose or maintain their position for 2-3
minutes
Administration of nasal spray

9) Ask the person to tilt their head slightly forward
10) Close one nostril by gently pressing against the side
of the nose
11) Insert the tip of the nasal spray into the other nostril
and ask the person to start to breathe in slowly
through their nose. Whilst they are still breathing in
squirt one spray into the nostril keeping the bottle
upright
12) Remove the spray from the nostril and ask the
person to breathe out through their mouth
13) Ask the person to tilt their head backwards to allow
the spray to drain into the back of the nose
14) Repeat steps above if a dose is required in the other
nostril or a second dose in the same nostril
Post administration
activity
waste products
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E – COMPETENCY ASSESSMENT FOR INHALERS

member completed
Designation of
Name of Assessor
Assessor
Date and time of
assessments
PURPOSE
Competent
signed
2) Safe environment
control)
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PURPOSE
Competent
signed
Prepare PPE
Check MAR Charts

3) Identity/name
Special precautions
Wash hands
4) Assist the person to sit in an upright position
5) Remove the mouthpiece cover from the inhaler and
shake the inhaler well for 2-5 seconds
6) Without a spacer device:
Ask the person to take a deep breath and exhale
completely, open the lips and place inhaler opening
1-2cm from the mouth but not touching the lips
With a spacer device:
Ask the person to exhale and grasp the spacer
mouthpiece with teeth and lips while holding the
inhaler
7) Ask the person to tip the head back slightly inhale
slowly and deeply through the mouth whilst
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PURPOSE
Competent
signed
depressing the canister
8) Encourage the person to breathe in slowly for 2-3
seconds and hold their breath for approximately 10
seconds then exhale slowly through pursed lips
9) Ask the person to wait 2-5minutes between puffs
and if more than one type of inhaled medication is
prescribed, to wait 5-10 minutes between inhalations
10) If steroid medication is administered ask the person
to rinse their mouth after the procedure
Post administration
activity
waste products
Wash and rinse spacer and leave to dry naturally
NB: There are many different inhaler devices; techniques for inhalation will vary depending on the type
of inhaler device prescribed. Ensure the patient information leaflet is always referred to illustrate how
the device should be correctly used in order to achieve the optimal therapeutic response from the drug
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F – COMPETENCY ASSESSMENT FOR CONTROLLED DRUGS

member completed
Designation of
Name of Assessor
Assessor
Date and time of
assessments
PURPOSE
Competent
signed
Follow steps 1,2 & 3 in the Competency Assessment
Pre-administration
1) With a second appropriately trained person, take the
keys and open the controlled drug cupboard. Take
the controlled drug book and turn to the page with
the person’s name, name and strength of the
controlled drug.
2) With the second trained person, select the correct
drug from the controlled drug cupboard.
3) With the second trained person, check the stock

level against the last entry in the controlled drug
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PURPOSE
Competent
signed
book.
4) With the second trained person, check the
appropriate dose and concentration/strength and
formulation against the MAR chart, the pharmacy
label, the external manufacturers packaging and the
manufacturer’s blister pack. Remove the dose from
the box/bottle and place into an appropriate container
e.g. medicine pot or syringe.
5) Return the remaining stock to the cupboard and lock
the cupboard.
6) Enter the person’s name, name of drug, date, dose
and new stock level in the controlled drug book.
It may require entries into other pages of the
controlled drug book if the dose is made up from
different strengths.
Administration
7) With the second trained person, take the prepared
dose, the MAR chart and controlled drug book to the
person and check the person’s identity by the person’s
preferred method of communication and check against
the person’s picture and support plan.
8) Administer the drug after checking the prescription
chart again. If given orally wait until the person has
swallowed the medication.
Post administration
9) Once the medication has been administered, the
MAR chart is signed by the trained person
responsible for administering the medication.
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PURPOSE
Competent
signed
The trained person responsible for administering the
medication and the trained person who witnessed
the administration signs the controlled drug book.
10) The trained person responsible for administering the
medication should check the person after
administration to check for effectiveness and/or
toxicity.
11) For qualified nurses only if the drug is given via a
syringe driver/pump the nurse should return to
check the infusion and site and document in the
appropriate records.
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G – COMPETENCY ASSESSMENT FOR PEG

member completed
Designation of
Name of Assessor
Assessor
Date and time of
assessments
PURPOSE
Competent
signed
have medication administered e.g. bedroom.
2) Safe environment
50ml & 10ml syringes
Giving set (if required)
control)
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PURPOSE
Competent
signed

Prepare PPE
Check MAR Charts
3) Identity/name
Special precautions
4) You may need to stop the nutrition for 1-2 hours
before and 2 hours after administration or allow for
this time period if supplement administered by bolus
if there is a contraindication for medicine with
supplement.
5) Consult with the pharmacist which medicines should
never be crushed.
6) Prepare each medication to be given separately,
volumes greater than 10ml may be drawn up in a
50ml syringe.
Soluble tablets: dissolve in 10-15ml of water
Version: MC002
39
PURPOSE
Competent
signed
Liquids shake well, for thick liquids mix with an equal
volume of water
Tablets: crush and mix with 10-15ml of water
7) Never add medication directly to the nutrition.
8) Prior to administering medication flush the tube with
at least 30ml of water using an enteral syringe.
9) Administer the medication via a syringe, rinse pill
crusher and pot with 10ml water put through the
tube.
10) If more than one medicine is to be administered,
flush between medications with at least 10ml of
water to ensure that the drug is cleared from the
tube.
11) Flush the tube with at least 30ml of water after the
administration of the last drug
12) Ensure the water for flushes is part of the prescribed
daily amount of fluid. Any concerns check with the
persons Dietician
Post administration
activity
waste products
Wash and rinse spacer and leaves to dry naturally
15) Record the administration and flushes
Version: MC002
40
H – COMPETENCY ASSESSMENT FOR MEDICATION
PATHWAYS (additional competencies)

member completed
Designation of
Name of Assessor
Assessor
Date and time of
assessments
PURPOSE
Competent
signed
Ordering Prescriptions
1) Uses the right hand side (RHS) of the prescriptions
to order repeat medication and/or MAR chart sheet
and/or orders medication online and selects the
amount of days medication required; ordering only
items that are required and still prescribed.
2) Keeps a record copy of the medication ordered.
Checking Prescriptions
3) Prescriptions and/or EPS tokens issued by the GP
are checked against this order record copy before
being sent to the pharmacy for dispensing to ensure
that all medicines ordered have been prescribed
Version: MC002
41
PURPOSE
Competent
signed
correctly; any discrepancies are reported to the GP
practice, a record of this should be documented.
4) All prescriptions are photocopied before being sent

to the pharmacy and/or EPS tokens are kept.
5) Prescriptions should be forwarded to the supplying

pharmacy for dispensing once all prescriptions are
complete and accurate. For prescriptions sent via
EPS the home should check the EPS token and call
the pharmacy to confirm they are complete and
correct.
(NB. Not all items can be sent via EPS so homes using EPS
may receive Tokens and Paper FP10 (green) prescriptions to
check.)
Receiving Medication
6) Medicines delivered from the pharmacy are
checked against the order record and also the
photocopy of prescription/prescription token to
make sure that all medicines ordered have been
supplied correctly. Any discrepancies are reported
to the pharmacy; a record of this should be
documented.
7) MAR Records must include the following:
date of receipt
name and strength of medication
quantity received plus any carried over from the
previous cycle
Version: MC002
42
PURPOSE
Competent
signed
residents for whom the medicine has been
prescribed
Signature of the staff member who received the
medication
Documentation on MAR Charts

8) All drugs received are accounted for; stock levels
are recorded on the MAR chart in the boxes
provided.
The date and the initials of the person responsible

are entered.
9) When medication is carried forward the following

checks of the label on the dispensed medication is
made;
The resident’s name
Name of the medication
Directions and dose to make sure it is the same as
the new MAR chart.
A Check the medication is still in date
A physical count of the quantity which is entered
onto the MAR chart in the box provided
10) When handwriting onto a MAR chart;

ensuring a countersignature is present
or countersigning another entry checking for
accuracy
11) Safe practice and procedures are followed if making

an amendment to a MAR. The original entry is
cancelled and the new entry is made and rewritten
Version: MC002
43
PURPOSE
Competent
signed
in full. Documentation is clear on the cancelled
entry that there is a new entry below.
Entries must include the following;
The name of drug
The strength of the drug
The form of the drug
The doses of the medication
The route of administration
When they must be given
Any special Information, such as giving the
medicines with food
A date and Signature of the person making the
record.
A countersignature – There must be a system to
check that the details are correct
The quantity received and/or quantity carried
forward
Storage of medication
1) Medicines should be stored in a suitable locked
cabinet, ideally within a clinical area or medicines
room; Medicines requiring refrigeration
are stored in a lockable drug fridge
2) The temperature of the medication room/clinical

area and refrigerator is monitored daily and
recorded room temperatures are documented on a
daily log
3) Knows how to report any temperature deviation
following procedure; actions and documents
outcome as detailed in procedure.
4) Understands the storage and documentation
requirements for controlled drugs.
Version: MC002
44
PURPOSE
Competent
signed
Returning/Disposing Medication
1) Details are recorded as soon as practically possible
in a waste medicines disposal book
2) Record include;
The date
Residents Name
Medicine name
Medicine strength
Medicine Form e.g. Tablet/Capsule
Quantity
Staff Initials
The reason for disposal
Medication is only disposed if it is expired or no
longer prescribed for the resident. Medication
should be carried forward and used when possible.
3) After a resident passes away all medication
remaining, should not be disposed of for 7 days in
case a post mortem is needed. All the medication
and the current MAR sheet is to be put into a
sealed envelope, signed by the manager and
witnessed by another member of staff, and stored in
a lockable cupboard until it can be disposed of.
Version: MC002
45
I – COMPETENCY ASSESSMENT FOR ADMINISTRATION OF
HOMELY REMEDIES (additional competencies)

member completed
Designation of
Name of Assessor
Assessor
Date and time of
assessments
PURPOSE
Competent
signed
Outline for administration

1) The decision to administer a homely remedy can
only be made by the care home staff in charge,
whom must ensure there are no contra-indications
before giving the medicine.
2) There must be a signed homely policy agreement in
place to state which remedies the resident is
authorized to have
3) Staff should sign to confirm that they are competent
to administer homely remedies and accountable for
their actions (In the care home homely remedy
policy).
Administration
Version: MC002
46
PURPOSE
Competent
signed
4) Any medication administered must be clearly
entered on the clients MAR chart and notes
detailing;
The drug
Dose/Quantity given
Reason for use
Time given
Signature of the Care home staff administering the
medication.
5) The handwritten Homely remedy on the MAR chart
should be double signed
The entry must be clearly marked ‘homely remedy’
6) A running balance of all homely remedies should be
kept on a balance sheet; this should include the
date purchased, copy of receipt, Batch number and
expiry date.
7) If symptoms persist or the patient does not respond
to treatment the Doctor must be
contacted.Administration of these remedies
should be limited to a period of 48 hours.
Audit
8) Homely Remedy stock should be regularly checked
to ensure there is;
Enough stock left for residents who may require
them
The stock is in date
Version: MC002
47

Medication Competency Assessment MC002

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Medication Competency Assessment MC002

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Staff Medication Administration

Page 1 Contents of Competency Assessment

Page 2 to Page 8 Observation Assessment

Page 9 to Page 17 Underpinning Knowledge Assessment – Questions

Page 18 to Page 19 Suggested ‘Indicators for Skill Performance Criteria’

Page 26 to Page 28 C – Competency Assessment for Ear Drops (Additional Competencies)

Page 32 to Page 34 E – Competency Assessment for Inhalers (Additional Competencies)

Page 35 to Page 37 F – Competency Assessment for Controlled Drugs (Additional Competencies)

Page 38 to Page 40 G – Competency Assessment for PEG (Additional Competencies)

Page 41 to Page 45 H – Competency Assessment for Medication Pathways (Additional Competencies)

Name of staff member Name of service

Designation of staff Date E Learning

Preparation prior to Administration

Administering the Medication

2) Greet the individual by name and offer

3) Select the individual’s MAR Chart and

4) Check week commencing dates on the

5) Before administering makes a check

1st ASSESSMENT 2nd ASSESSMENT 3rd ASSESSMENT

Signed Assessor: Signed Assessor: Signed Assessor:

Full name / designation: Full name / designation: Full name / designation:

Date: Date: Date:

Signed Trainee: Signed Trainee: Signed Trainee:

Full name / designation: Full name / designation: Full name / designation:

Date: Date: Date:

SUGGESTED QUESTIONS TO ASSIST IN

Show understanding of own accountability / responsibility in Management of Medicines

Understanding of individual’s medical conditions in relation to their medications

Understanding of responsibilities in verbal requests

Management of errors / near misses

 What is reportable to safeguarding in relation to medication errors?

Management of adverse effects of medications

How many micrograms are there in 1 milligram?

How many milligrams are there in 1 gram?

100 1000 10 (please circle)

What are the recognised abbreviations for:

You have 2.5mg tablets and the patient is prescribed 10mg.

A medicine bottle says the syrup is 20mg/ml.

Your patient is prescribed 120mg of the above medicine.

Effective communication with individuals during procedure

Ordering of medications for the Home

Receipt of medications into the Home

Storage of medicines in the Home

Name of staff member Name of service

Designation of staff Date Learning

Name of staff member Name of service

Designation of staff Date E Learning

Name of staff member Name of service

Designation of staff Date E Learning

5) Warm the drops to body temperature

Name of staff member Name of service

Designation of staff Date E Learning

8) Ask the person to sniff back any liquid into to the

Administration of nasal spray

Name of staff member Name of service

Designation of staff Date E Learning

Check MAR Charts

Name of staff member Name of service

Designation of staff Date E Learning

3) With the second trained person, check the stock

Name of staff member Name of service

Designation of staff Date E Learning

Check communication book/diary/support plan for