Medication Administration and Competency training that gets your team CQC-ready

Covert medication means giving medicine to someone without their consent by disguising it in food, drink, or through a feeding tube. This is only ever done when someone lacks the mental capacity to consent to the medication and the medication is essential for their health and wellbeing. It is a serious step that requires proper legal processes and safeguards. Medication should only be given covertly if there is written authorisation from the prescribing doctor and a best interests decision has been properly made.

If someone lacks capacity to consent to medication, any decision to give it must be made in their best interests. This is not just what staff think is best. It requires a formal process involving the person as much as possible, their family or representatives, anyone with power of attorney for health and welfare, advocates, the GP, pharmacist, and care staff. You must consider the benefits and risks of giving the medication, whether there are less restrictive alternatives, and what the person would have wanted. Only essential medications should be considered for covert administration.

All covert medication must be recorded carefully. The care plan must include the capacity assessment, best interests decision, GP authorisation, and pharmacy advice. Every time you give medication covertly, you record it on the MAR chart just like any other medication. A designated nurse or manager checks these records regularly to ensure the care plan is being followed correctly. The whole arrangement must be reviewed monthly with everyone involved in the decision making. If the person's condition changes or they start to accept medication normally, covert administration must stop immediately.

A medication error is any mistake in prescribing, dispensing, giving or recording a medicine, such as a missed dose, the wrong resident, or a signature gap on the MAR chart. A near miss is a mistake caught before it reached the resident, and you report those too, because they show where systems need fixing. If an error happens, make the resident safe first, tell the nurse in charge, and be honest with the resident and their family under the duty of candour. Nobody should be punished for reporting honestly. Controlled drugs, like morphine, have extra rules: they live in a separate locked cupboard, are counted in a register, and two trained staff must witness administration and sign.