Medication Competency Audit

When medication errors occur, is there documented evidence of immediate competency reassessment or targeted retraining?

What we look for: Cross-reference recent medication incidents with the staff files of those involved. There should be evidence of formal reflection, supervision, or a full field reassessment before they resume full medication duties.

Evidence: Medication error logs, Incident reports, Reflective practice forms, Reassessment records

Do staff files contain documented evidence of a face-to-face practical medication competency assessment completed in the field?

What we look for: Check that competency was assessed by direct observation in a service user's home, not just via a quiz or roleplay in the office. Good looks like a detailed checklist covering preparation, administration, and recording.

Evidence: Practical competency assessment forms, Field observation notes, Assessor sign-offs

Does the competency assessment specifically evaluate staff understanding and practice regarding the safe administration of 'as required' (PRN) medicines?

What we look for: Review the standard competency template. It must include checks on whether staff check when PRN was last given, understand the gap between doses, and document the reason/outcome of administration.

Evidence: Competency assessment templates, PRN protocols, Completed assessment forms

Do spot checks on recent MAR charts confirm that staff who recently passed their competency assessment are practicing safely and accurately?

What we look for: Sample MAR charts filled in by staff who passed their competency in the last month. Look for missing signatures or incorrect coding to ensure the competency assessment accurately reflects real-world practice.

Evidence: Completed MAR charts, Audit action plans, Care worker daily notes

Are all care workers supporting with medicines documented as having completed baseline medication training and shadowing before solitary administration?

What we look for: Sample 3-5 newly recruited staff files. Ensure they did not administer medication alone until full training and shadowing were signed off. A fail would be rota evidence of solitary medication calls before training completion.

Evidence: Training certificates, Induction checklists, Shadowing sign-off forms, Rota records

Is there a clear, up-to-date medication competency matrix demonstrating that all staff have their competencies renewed at least annually?

What we look for: Review the master tracking matrix for the service. Look for any overdue annual medication competency updates. A fail would be expired competencies without immediate risk mitigation (e.g., suspension of medication duties).

Evidence: Competency tracking matrix, Expiry date alerts, Staff training database

Are knowledge-based checks included to ensure staff understand medication purposes, common side effects, and refusal protocols?

What we look for: Check if the assessment goes beyond mechanics (popping pills) to test understanding. Staff should know how to handle refusals, covert meds (if applicable), and who to contact if side effects are suspected.

Evidence: Written knowledge quizzes, Verbal Q&A records, Interview notes during assessment

Are the staff who conduct medication competency assessments (assessors) suitably qualified, experienced, and themselves assessed as competent?

What we look for: Check the credentials of the supervisors/seniors doing the assessing. They must have up-to-date advanced medication training or 'train the trainer' qualifications, and their own practice must be periodically observed.

Evidence: Train the trainer certificates, Assessor competency records, Assessor job descriptions