Understanding the inspector’s perspective helps you prepare with confidence. When CQC looks at medicines in an adult social care service, inspectors are not trying to catch you out — they are checking one thing: are people supported with their medicines safely, and can the service evidence it?

This guide explains what CQC inspectors actually look at when they review medicines, the questions they tend to ask staff, and the evidence that reassures them. For a step-by-step preparation checklist, see our guide to preparing for a CQC medicines inspection.

What inspectors are really assessing

Medicines sit within CQC’s expectations for safe care. Inspectors want to see that medicines are managed in line with good practice and that staff have the knowledge, skills and competence to support people safely. In practice they are asking:

  • Are medicines given safely, on time and as prescribed?
  • Are records clear, accurate and complete?
  • Do staff understand their responsibilities and the limits of their role?
  • Does the service notice, report and learn when something goes wrong?
  • Is there proper oversight and governance of medicines?

The specific areas inspectors look at

MAR and eMAR records

Inspectors often start with the records. They look for unexplained gaps, missing signatures, unclear handwritten entries and inconsistent use of codes. Accurate MAR and eMAR records are one of the clearest signs of a well-run service.

PRN (as-needed) medicines

Inspectors check whether every PRN medicine has a clear protocol — when and why it should be offered, the dose and the maximum in 24 hours — and whether staff record the reason each time it is given.

Storage and temperatures

They look at how medicines are stored, whether fridge and room temperatures are monitored, and whether storage is secure and appropriate.

Controlled drugs

Where a service holds stock, inspectors check the controlled drugs register, running balances, witnessing and safe disposal.

Staff competency

Inspectors want to see that staff are not just trained but assessed. They look for evidence that staff competence has been checked and is kept under review — which is why many providers pair training and an individual knowledge and understanding assessment with their own workplace competency checks.

Learning from errors

Inspectors are reassured by services that record and learn from medication errors and near misses, rather than services that appear to have none at all.

Covert administration and consent

Where medicines are given covertly, inspectors check that the Mental Capacity Act process was followed and clearly documented.

Governance and oversight

Finally, inspectors look at the bigger picture: audits, policies, staff files, and whether managers have a clear view of medicines risk across the service.

The questions inspectors often ask staff

Inspectors frequently speak directly to care staff. Common questions include:

  • What would you do if a person refused their medicine?
  • How do you record a PRN medicine that was offered but not taken?
  • What would you do if a MAR or eMAR entry looked wrong?
  • How would you escalate a missed or late dose?
  • Where would you find a person’s medicines information and level of support?

Confident, consistent answers from staff are powerful evidence that training and competency are working in practice.

Common findings and red flags

  • unexplained gaps and unsigned entries on MAR charts
  • PRN medicines with no written protocol
  • fridge and room temperatures not recorded
  • controlled drugs balances that do not match the stock held
  • thin or missing competency evidence in staff files
  • no recent medicines audit or clear oversight

How to evidence safe medicines practice

The strongest position at inspection is being able to show, not just say, that medicines are managed safely: accurate records, clear protocols, up-to-date competency evidence and a habit of reviewing your own systems. An independent pre-CQC medicines compliance audit reviews your medicines systems the way an inspector would and gives you a prioritised action plan, while Pharmacy Technician-led medication training and an individual Knowledge & Understanding Assessment build the underlying knowledge and evidence.

AJR MedSafe Academy supports adult social care providers with training, Knowledge & Understanding Assessments and independent medicines audits. Book a discovery call to talk through your medicines systems before your next inspection.

This article is for general information only. It reflects common areas of focus and does not represent CQC policy or guarantee any inspection outcome.