A MAR chart audit is a structured review of Medication Administration Records to check whether medicines support has been recorded accurately, whether gaps have been followed up, and whether managers can evidence safe medicines governance.

A MAR chart audit helps care providers check whether medicines have been recorded clearly, consistently and safely. MAR stands for Medication Administration Record. It is one of the most important medicines records in adult social care because it shows what support has been provided, what has not been provided, what was refused, and what action staff took.

When MAR records are unclear, incomplete or inconsistent, managers may struggle to evidence safe medicines practice. A MAR chart audit can help identify gaps before they become recurring problems or inspection concerns.

AJR MedSafe Academy has created practical guidance on how to audit MAR and eMAR records and provides Pharmacy Technician-led medicines audit support for care providers.

Why MAR chart audits matter

Medicines records are not just paperwork. They are part of safe care and treatment. They help staff, managers, health professionals and inspectors understand whether a person has received the right medicines support at the right time.

A MAR chart audit can help answer questions such as:

  • Were medicines administered as prescribed?
  • Were missed doses recorded and escalated?
  • Were refusals recorded clearly?
  • Were PRN medicines supported by clear instructions?
  • Were topical medicines, patches or variable doses recorded properly?
  • Were handwritten changes authorised and clear?
  • Did staff use the correct codes and notes?
  • Were patterns of errors or omissions followed up?

For managers, regular MAR audits also help demonstrate governance. CQC guidance on medicines administration records says adult social care providers must keep secure, accurate and up-to-date medicines records. A MAR chart audit is one way to check whether that is happening in practice.

What to include in a MAR chart audit

A useful MAR chart audit should look beyond whether boxes are signed. It should review the quality of the record and whether it tells a clear story.

Key areas to check include:

  • person details are correct and match the care plan
  • medicine names, strengths and directions are clear
  • allergies and sensitivities are recorded where required
  • start dates, stop dates and changes are clear
  • administration entries are completed consistently
  • non-administration codes are explained
  • refusals are recorded and escalated where appropriate
  • PRN medicines include outcome notes where needed
  • time-critical medicines are administered and recorded at the right time
  • topical medicines and patches are recorded clearly
  • handwritten entries are signed, dated and authorised
  • discontinued medicines are clear
  • recurring gaps have action notes or manager review

If your audit finds repeated issues, it may indicate a wider need for medicines management training for care staff or a more detailed medicines governance review.

Common MAR chart audit findings

Many care providers find the same issues appearing across different services. Common MAR audit findings include:

  • missed signatures with no explanation
  • unclear refusal records
  • PRN medicines given without enough detail
  • no note of whether PRN medicine was effective
  • medicine changes not clearly reflected on the record
  • handwritten entries that are not double-checked
  • topical medicines not recorded consistently
  • patch sites not rotated or documented clearly
  • stock discrepancies not followed up
  • late or missed medicines not escalated

These issues do not always mean unsafe care has occurred, but they do show areas that need attention. Good audit practice is about learning, improving and preventing repeat issues.

MAR audits and CQC evidence

A MAR chart audit can support CQC readiness because it shows that managers are reviewing medicines records and taking action where concerns are found. However, an audit is only useful if the findings lead to improvement.

Managers should be able to evidence:

  • what was audited
  • what gaps were found
  • what action was taken
  • who was responsible
  • whether the issue was followed up
  • whether learning was shared with staff
  • whether training or competency assessment was needed

If your service is preparing for inspection or has identified medicines concerns, AJR MedSafe can provide a Pre-CQC medicines compliance audit covering MAR/eMAR records, governance, staff evidence, storage, PRN, errors and action planning.

How often should MAR charts be audited?

The right frequency depends on your service, risks, medicines complexity, staffing arrangements and previous findings. Some providers review samples weekly or monthly, while others complete more detailed audits at set intervals.

A more frequent MAR chart audit may be needed if:

  • there has been a medication error
  • staff are new or inexperienced
  • eMAR or paper systems have changed
  • there are repeated refusals or missed medicines
  • the service is preparing for CQC inspection
  • a manager has concerns about recording quality

The key is consistency. Audits should not only happen when an inspection is expected. Regular review helps managers identify risks early.

MAR chart audit checklist

| Area to check | What managers should look for |
|—|—|
| Person details | Name, allergies, support needs and care plan information are correct |
| Medicine instructions | Medicine name, dose, route, time and directions are clear |
| Administration records | Entries show what was given, when and by whom |
| Non-administration | Missed, refused or unavailable medicines are coded and explained |
| PRN medicines | Reason, dose, time, outcome and escalation are recorded where needed |
| Time-critical medicines | Late or missed doses are identified and escalated |
| Topical medicines and patches | Application, site rotation and removal are recorded clearly |
| Changes and handwritten entries | Any changes are authorised, dated and easy to follow |
| Manager oversight | Gaps have documented review, action and follow-up |

Expert insight from Amelia Raby

Amelia often finds that a MAR chart audit is most useful when it asks “what happened next?” A missed signature, refusal or PRN entry should not sit on the record without context. Managers need to know whether staff escalated the concern, whether the person was safe, and whether learning or follow-up action was needed.

How AJR MedSafe Academy can help

AJR MedSafe Academy is led by Amelia Raby, a GPhC-registered Pharmacy Technician with extensive medicines management experience. Amelia supports care providers with practical, evidence-focused review of medicines systems, including MAR and eMAR records.

Support can include:

  • MAR chart audit support
  • eMAR record review
  • Pre-CQC medicines compliance audits
  • medication error review and support
  • medicines management training
  • Knowledge & Understanding Assessments for care staff
  • action planning and governance recommendations

If your MAR records are inconsistent or you want external support before inspection, you can request a Pre-CQC medicines compliance audit or book a discovery call.

Frequently asked questions

How often should MAR charts be audited?

The frequency depends on the service, medicines risk and previous findings. Many providers review samples regularly and complete deeper audits at set intervals. More frequent review may be needed after errors, new staff, system changes or repeated recording concerns.

What is the difference between a MAR chart audit and an eMAR audit?

A MAR chart audit reviews paper Medication Administration Records. An eMAR audit reviews electronic records and system reports. The principles are similar: both should check accuracy, gaps, escalation, PRN recording and manager follow-up.

Should a MAR audit include PRN medicines?

Yes. PRN medicines should be reviewed carefully because staff need clear instructions, reason for use, dose, timing, outcome notes and escalation where required.

Can AJR MedSafe audit MAR and eMAR records?

Yes. AJR MedSafe Academy can review MAR and eMAR records as part of a wider Pre-CQC medicines compliance audit or medicines governance review.

Useful guidance for care providers

This article is for general information only. A MAR chart audit can help identify gaps and strengthen governance, but it cannot guarantee CQC compliance, a rating or an inspection outcome.