Training and competence for medicines optimisation in adult social care

Page last updated: 3 November 2022
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Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 deals with staffing, training, qualifications, competence and skills.

It addresses all aspects of training, experience, learning and development: from induction to continuing professional development, supervision and appraisal.

Read the regulation and guidance

Care providers should identify any other training needed by care home staff responsible for managing and administering medicines. If there is a medicines-related safety incident, you may need to review those learning and development needs.

There are no special rules about a person’s age before they can work in adult social care. But there are some general rules for under 18 year olds. You should assess carefully when a young person should be delivering personal care - including medicines support.


The care provider’s medicines policy should include training needs. It should be relevant to the type of care setting staff are working in and the tasks to be undertaken. Training should be accessible. Staff should be supported to take part.

Areas to consider are:

  • induction training for all staff at the start of their employment
  • how to identify training, learning and development needs for staff
  • how staff will be supervised during their training
  • competency assessment - who will do this and how will this be documented
  • training to understand systems and processes - examples include original packs, multi-compartment compliance aids or electronic medicines administration systems
  • ongoing training and supervision for experienced staff
  • review of training needs - for example, if processes change or in response to errors or incidents.

Care staff may need additional training to administer medicines using specialist techniques. Examples include:

  • inhalers and nebulised medicines
  • oral syringes
  • eye drops
  • rectal or vaginal preparations
  • buccal administration
  • other medical devices such as hosiery devices.

Some nursing tasks can be delegated to care staff. They will need additional training. Examples include:

  • subcutaneous injection
  • administration of medicines via feeding tubes
  • catheter care.


NICE SC1 and NG67 recommends that all staff who support people’s medicines needs have an annual review of their knowledge, skills and competencies relating to managing and administering medicines.

You should have a formal process to assess staff competence. You must not allow new staff to manage or administer medicines before assessing their competence.

The person assessing staff should be competent in medicines support tasks delivered by your service. They will assess the knowledge, understanding and skills of the staff.

You must keep records of staff competency assessments and when they are due for review.

Healthcare professionals and other registrants (for example nursing associates) working in adult social care services must maintain their professional standards as laid out by their regulator.

Learning providers

NICE guidance suggests using an 'accredited learning' provider so staff can be assessed by an external assessor. For example, you could refer to the Skills for Care endorsement framework.

Find a Skills for Care learning provider