Managing medicines in a care home: what a good system looks like

Health & daily life · 3 min read · Last updated 2 November 2026

Most people who move into a care home take several medicines, and the move is a time when mistakes are most likely. A good home has a clear, written system for everything from ordering to recording. This guide uses the topics covered by NICE, the English health guidance body, as a model, and turns them into questions you can ask any home. It is general information, not medical advice.

A written medicines policy

NICE says every care home should have a written care home medicines policy. According to the NICE information for people using services, it should cover:

  • Sharing information about medicines.
  • Keeping records about medicines.
  • Dealing with mistakes when residents are given their medicines.
  • Reviewing and accurately listing each person's medicines.
  • Ordering, receiving, storing and disposing of medicines.
  • Giving medicines to people in the home's care.

NICE adds that the policy should be checked regularly to make sure it is up to date. The home should be happy to explain it to you.

What else good guidance covers

The NICE guideline lists further topics, which give a good idea of what a careful home does:

  • Supporting residents to make informed decisions about their medicines, and recording those decisions.
  • Medicines reconciliation, meaning checking that the list of medicines is accurate when someone moves in or moves between services.
  • Helping residents who want to take their own medicines.
  • The way staff give medicines, including covert administration (giving medicines without the resident knowing) and non-prescription products.
  • Safeguarding and medicine-related problems.
  • Training and competency of care home staff.

We have not reproduced the detailed recommendations here. For them, read the guideline on the NICE website.

What you can do as a family

  • Bring an up-to-date list of your relative's medicines, with doses, when they move in. Include supplements, and note any allergies.
  • Ask the home to confirm in writing who prescribes and reviews the medicines.
  • Ask for a review of the full list after a hospital stay, a fall or a change in behaviour. See preventing falls in older age.
  • If your relative can still decide, make sure their wishes about their medicines are heard and recorded.
  • If you are moving abroad, remember that brand names and availability differ by country. Ask a doctor or pharmacist for the active ingredient names, and see healthcare cover when a relative retires abroad.

Questions to ask a care home

These are our suggested questions, based on the NICE topics above:

  • Do you have a written medicines policy, and may I see it?
  • How do you check and record each resident's medicines when they arrive?
  • Who gives medicines, and how are staff trained and checked?
  • How and how often are residents' medicines reviewed, and by whom?
  • How do you store medicines safely and handle ordering and disposal?
  • What do you do when a mistake happens, and how are families told?
  • Can a resident take their own medicines if they are able and wish to?
  • What is your policy on giving medicines without a resident knowing?

If you are concerned about how a resident's medicines are being handled, see warning signs and raising concerns.

Frequently asked questions

Can a care home give medicines without telling the resident?

NICE lists covert administration, meaning giving medicines without the resident knowing, as a topic that needs clear rules. Ask any home for its policy, and ask how decisions are made and recorded.

Should medicines be reviewed regularly?

Yes. The NICE information for people using services says a care home medicines policy should cover reviewing and accurately listing each person's medicines. Ask who carries out reviews and how often.

Can my relative keep managing their own medicines?

NICE includes helping residents to take their own medicines as a topic in its guideline. Ask the home whether it supports this and how it keeps it safe.

Sources and further reading

This guide is general information only, compiled from the public sources listed above as of the date shown. It is not legal, medical, tax, financial or care advice, and we cannot guarantee that it is complete, accurate or up to date. Rules, thresholds and prices change and differ by country and region, and some sources describe other countries' rules as examples. Check details with the authorities and care homes named, and take professional advice for your own situation before you act. If you spot an error, please email [email protected] and we will correct it.