CQC Medicines Management: What Inspectors Check in Care Homes and Home Care, the Policy You Need and an Audit Checklist (2026)
What the regulations and quality statement require, what inspectors look at on the day, what your medicines policy should cover, how to audit, and how medication reviews and errors fit in.
CQC assesses medicines management mainly under Regulation 12 (safe care and treatment), through its “medicines optimisation” quality statement under the Safe key question, and under Regulation 17 (good governance). Regulation 12 requires the proper and safe management of medicines. CQC’s guidance says policies should cover supply and ordering, storage, dispensing and preparation, administration, disposal and recording, staff must be trained and competent, medicines must be given as prescribed and at suitable times, and covert administration must follow the Mental Capacity Act. Inspectors check records, stock, staff competence, reviews and how you learn from errors.
This guide is for registered managers, deputies and medicines leads in care homes and home care agencies in England. It sets out what CQC says about medicines, what inspectors usually check, what a medicines policy should cover and how to audit. It uses CQC’s own guidance, linked in the sources section. Where we give checks or frequencies, they are our suggestions, not CQC requirements. This is not clinical advice: follow your pharmacist, prescriber and national guidance for individual decisions.
Key takeaways
- Regulation 12(2)(g) requires “the proper and safe management of medicines”. CQC’s guidance lists the policy areas it expects you to cover.
- The medicines optimisation quality statement adds involvement of the person, current best practice, accurate information at transfers, no inappropriate behaviour control through medicines and safe controlled drugs arrangements.
- Inspectors look at records, stock and storage, staff competence, reviews and learning from errors, not just the policy.
- A medication error is not notifiable to CQC on its own, but it must be recorded, investigated and learned from.
- Medication reviews must align with the person’s care plan and be repeated when medicines change.
In this guide
- What does CQC say about medicines management?
- The old KLOE questions still show what inspectors ask
- What inspectors check on the day
- Care homes and home care: what differs
- The medicines management policy: what to include
- How to audit medicines management
- Medication reviews
- Medication errors and reporting
- Sources and how this was checked
- Frequently asked questions
What does CQC say about medicines management?
Regulation 12: safe care and treatment
CQC’s guidance on Regulation 12 sets out, for medicines:
- Staff responsible for managing and administering medicines must be suitably trained and competent, and this should be kept under review.
- Staff must follow policies and procedures on medicines, which should be in line with current legislation and guidance and address supply and ordering, storage, dispensing and preparation, administration, disposal and recording.
- Medicines must be administered accurately, in accordance with the prescriber’s instructions and at suitable times, so people are not placed at risk.
- People’s medicines must be available in the necessary quantities at all times, including when people manage their own medicines, and be available when people transfer between services.
- When agreed to be in a person’s best interests, covert administration must follow the Mental Capacity Act 2005.
- Medication reviews must be part of, and align with, care and treatment plans, and be reviewed regularly and when medication changes.
- Providers must comply with relevant patient safety alerts, recalls and rapid response reports from the MHRA and the Central Alerting System.
- Incidents must be reported internally and to the relevant external bodies, investigated, monitored and learned from.
The medicines optimisation quality statement
Under the Safe key question, CQC’s “medicines optimisation” quality statement expects providers to make sure medicines and treatments are safe and meet people’s needs, capacities and preferences, by enabling people to be involved in planning, including when changes happen. It covers: involvement in decisions; assessments and reviews of the support people need, documented in the care plan; current best practice; appropriate prescribing, supply and administration in line with the law and the Mental Capacity Act; accurate information when people move between settings; people’s behaviour not being inappropriately controlled by medicines; and safe arrangements for controlled drugs. Subtopics include roles and delegation, self-medication, storage and disposal, antimicrobial stewardship and STOMP and STAMP. Related regulations are 9 and 12, and 11 on consent.
The old KLOE questions still show what inspectors ask
CQC’s historic adult social care medicines key line of enquiry (S4) (page dated 12 May 2022) asked “how does the provider ensure the proper and safe use of medicines?” through eight prompts. CQC replaced KLOEs with quality statements, but the questions remain a useful checklist (our paraphrase):
| Prompt | What it asked | Evidence to have |
|---|---|---|
| S4.1 | Is the service’s role in medicines defined in policies, procedures and training, following current professional guidance? | Medicines policy, training records |
| S4.2 | How do you make sure people get prescribed and non-prescribed medicines, including controlled drugs and “as required” medicines, as intended and recorded? | MAR or eMAR, PRN protocols, controlled drugs register |
| S4.3 | How are medicines ordered, transported, stored and disposed of safely and securely? | Ordering and receipt records, storage checks, disposal records |
| S4.4 | Are there clear procedures for giving medicines covertly, in line with the Mental Capacity Act? | Capacity assessments, best interests decisions, pharmacist advice |
| S4.5 | How do you make sure behaviour is not controlled by excessive or inappropriate use of medicines? | Reviews of sedating or psychotropic medicines, positive behaviour support |
| S4.6 | How do staff assess the level of support a person needs to take medicines safely, including self-administration? | Support assessments, risk assessments, care plans |
| S4.7 | How do you work with healthcare professionals on reviews of medicines at appropriate intervals? | Medication review records, GP and pharmacist contacts |
| S4.8 | How do staff make sure accurate, up-to-date medicines information is available when people move between settings, and medicines stay available? | Transfer records, discharge information, reconciliation |
What inspectors check on the day
| Area | What inspectors look at (our summary) | What to have ready |
|---|---|---|
| Policy and training | Whether staff know and follow the policy, and are trained and competence-checked | Medicines policy, training matrix, competency assessments |
| Records | MAR or eMAR accuracy: gaps, codes, refusals, allergies, handwritten entries signed and checked | Recent MAR charts and audit results |
| Stock and storage | Locked storage, temperatures for fridges and rooms, stock counts, out-of-date items, disposal | Temperature logs, stock check records, disposal log |
| Controlled drugs | Safe storage, register entries, witnessed entries and regular checks | Controlled drugs register and checks |
| “As required” (PRN) medicines | Clear protocols for when to give, how much, and recording of reasons and effect | PRN protocols and records |
| Topical products and patches | Instructions, body maps and application records | Body maps, application charts |
| Covert administration and capacity | Capacity assessment, best interests decision, pharmacist input, review | Decision records |
| Reviews | Regular medication reviews with prescriber or pharmacist, aligned with the care plan | Review dates and outcomes |
| Errors and incidents | How errors are recorded, investigated and learned from, and Duty of candour where it applies | Error log, investigation notes, lessons learned |
| Transfers | Accurate medicines information when people go to or return from hospital | Transfer sheets, reconciliation checks |
| Alerts | Action on MHRA patient safety alerts and recalls | Alert log with actions |
See what a MAR chart must contain and controlled drugs in care homes.
Care homes and home care: what differs
The regulations are the same, but the national guidance differs. NICE has separate guidelines: SC1 on managing medicines in care homes (2014) and NG67 on managing medicines for adults receiving social care in the community (2017). The NG67 topics include assessing the support people need, who should provide it, governance, joint working, covert administration, staff training and record keeping, and commissioning arrangements should be agreed and recorded before a provider gives medicines support. SC1 covers medicines policies, informed decisions, record keeping, reconciliation, reviews and self-administration. Check NICE for the current versions.
| Care home | Home care | |
|---|---|---|
| Storage | Medicines held and secured by the home, with a medicines room or trolley | Usually the person’s own supply in their own home, so storage and access risks are assessed |
| Who administers | Trained and competent care staff or nurses, as the home decides | Care workers prompt, assist or administer depending on the assessed need and agreed plan |
| Records | MAR or eMAR in the home | MAR or eMAR in the home or via the app, with office oversight of exceptions |
| Key risks | Stock control, PRN, controlled drugs, covert, shift handover | Missed visits meaning missed doses, access, lone working, communication with family and pharmacy |
The medicines management policy: what to include
CQC asks new providers to send a medicines management and prescribing policy with their registration application (see CQC policies and procedures). Using CQC’s list, cover supply and ordering, storage, dispensing and preparation, administration, disposal and recording. Our suggestions for what else to include:
- Who may administer, with training and competence requirements and how they are reviewed.
- Levels of support (prompt, assist, administer) and how they are assessed with the person.
- “As required” (PRN) medicines, topical products, patches and variable doses.
- Controlled drugs.
- Covert administration and the Mental Capacity Act process.
- Self-administration and how risk is assessed.
- Medication reviews, transfers and reconciliation.
- Errors, near misses, incident reporting, duty of candour and what is notifiable.
- Responding to MHRA alerts and recalls.
Make it specific to your service. A generic template is easy for inspectors to spot. See the medication error log template.
How to audit medicines management
CQC sets no audit frequency. Many services audit medicines monthly, and check high-risk items, such as controlled drugs, more often. Our free audit pack includes a medication audit with scoring and an action log. A basic monthly audit (our suggestion):
- Sample MAR charts for gaps, codes and signatures, and check against stock.
- Check storage, temperatures, expiry dates and disposal.
- Check controlled drugs records against stock.
- Review PRN use and reasons.
- Check staff competence assessments and training are current.
- Review errors and near misses, and whether actions were closed.
- Check medication reviews are in date.
Medication reviews
CQC’s Regulation 12 guidance says medication reviews must be part of, and align with, people’s care and treatment assessments and plans, and be completed and reviewed regularly and when medication changes. The quality statement expects people to be involved in assessments and reviews of the support they need, documented in the care plan, and that behaviour is not inappropriately controlled by medicines. In practice, record when each person’s medicines were last reviewed, by whom, what changed and when the next review is due. CQC sets no fixed interval. See care plans and the care plan template.
Medication errors and reporting
CQC’s guidance says there is no requirement to notify CQC about a medicines error on its own. You only notify if the error caused a death, a serious injury, abuse or an allegation of abuse, or an incident reported to or investigated by the police. You must still record, investigate and learn from every error and near miss. See what to do after a medication error and CQC notifications.
Sources and how this was checked
- CQC: Regulation 12, Safe care and treatment (guidance on 12(2)(g) and related paragraphs).
- CQC: Medicines optimisation quality statement.
- CQC: Medicines management (historic KLOE S4) (page last updated 12 May 2022).
- NICE: SC1 Managing medicines in care homes; NG67 Managing medicines for adults receiving social care in the community.
Read 25 October 2026. The inspector checks table, audit list and policy additions are our summaries, not CQC requirements. This is not clinical advice.
Keep medicines audits and actions on schedule
CQCLogic schedules audits, tracks actions to closure and keeps training and policy review dates alongside them. It does not manage MAR charts or give clinical advice. See a sample improvement plan, view pricing or get started free.
Frequently Asked Questions
What does CQC look for in medicines management?
That medicines are managed properly and safely under Regulation 12: trained and competent staff, a policy covering supply, storage, administration, disposal and recording, accurate records, medicines given as prescribed and at suitable times, reviews, safe controlled drugs and learning from errors.
Which CQC regulation covers medicines?
Regulation 12 (safe care and treatment) covers “the proper and safe management of medicines”. Regulation 17 (good governance) covers the audits and records, and Regulation 11 covers consent, including covert administration decisions.
Do I need a medicines management policy for CQC?
Yes. CQC asks new providers to send a medicines management and prescribing policy with their application, and Regulation 12 expects staff to follow policies covering supply, storage, administration, disposal and recording.
Do medication errors need reporting to CQC?
Not on their own. CQC says to notify only if the error caused a death, injury, abuse or allegation of abuse, or an incident reported to or investigated by the police. All errors must still be recorded, investigated and learned from.
What are the 5 principles of medication management?
CQC does not publish five principles. A commonly taught set is the “five rights” of administration: right person, right medicine, right time, right dose and right route. They are a useful check, not a CQC standard.
How often should medicines be audited?
CQC sets no frequency. Many services audit monthly and check controlled drugs more often. Our free audit pack includes a medication audit.
What is a medication review?
A review of a person’s medicines with a prescriber or pharmacist, aligned with their care plan. CQC says reviews should be regular and happen when medication changes, and the person should be involved.
Can staff give medicines covertly?
Only when agreed to be in the person’s best interests, in line with the Mental Capacity Act 2005, with the right assessments, decisions and professional advice recorded.
What are the 5 key areas CQC considers when inspecting a service?
CQC asks five key questions: is the service safe, effective, caring, responsive and well-led. Medicines management sits mainly under Safe, with governance of medicines under Well-led.
What NICE guidance applies to medicines in care homes and home care?
NICE SC1 covers managing medicines in care homes (2014) and NG67 covers managing medicines for adults receiving social care in the community (2017). Check NICE for the current versions.