Medication Administration Practical Competency Assessment (HR-F022) MEDICATION ADMINISTRATION COMPETENCY SIGN-OFF (HR-F022) Notify MEDICATION ADMINISTRATION COMPETENCY SIGN-OFF Medication Administration Practical Competency Assessment (HR-F022)SECTION 1: ASSESSMENT BASELINE & CONTEXTTitle- Select -MrMrsMissMsMxOtherStaff Member NameStaff_IDJob TitleCare Worker / Support WorkerComplex Care WorkerSenior Care Worker / MentorField SupervisorCare Coordinator / Rota SchedulerClinical LeadQuality Assurance / Compliance OfficerHR / Recruitment AdministratorImplementation ResearcherDeputy Care ManagerRegistered Care ManagerOperating Local Authority- Select -HaringeyIslingtonBarnetWaltham ForestCamdenHackneyBrentHarrowRedbridgeNewhamCity of LondonWestminsterTower HamletsBarking and DagenhamHaveringKensington and ChelseaHammersmith and FulhamEalingHillingdonHounslowSouthwarkLambethLewishamGreenwichWandsworthRichmond upon ThamesMertonKingston upon ThamesSuttonBexleyBromleyCroydonOtherDate of ObservationAssessor NameAssessment Type- Select -Initial Competency (Observation 1 of 3)Initial Competency (Final Sign-Off)Annual Competency ReviewPost-Incident Re-Assessment / Return to PracticeName of Service UserLevel of Support Assessed TodayLevel 1 (Prompting/Assisting only)Level 2 (Administration from original packaging / blister pack / MDS)Level 3 (Specialist Technique - e.g., Buccal Midazolam, PEG, Insulin)SECTION 2: PRE-ADMINISTRATION & THEORETICAL KNOWLEDGE (Safe: QS4) The Assessor must verbally quiz the staff member on these critical protocols prior to opening the medication cabinet.Time-Critical Medication: "Identify a time-critical medication (e.g., for Parkinson's or Diabetes) and explain the consequence of a 30-minute delay." Assessor Check: Did they understand the narrow window for administration and the immediate escalation required if delayed?- Select -Yes - CompetentNo - InadequateN/APRN (As Required) Protocol: "Explain the procedure for administering a PRN medication." Assessor Check: Did they check the exact time of the last dose, assess pain/need, and record the specific rationale and outcome on the MAR/eMAR?- Select -Yes - CompetentNo - InadequateN/ARefusals & Covert Administration (MCA): "What do you do if a service user with dementia repeatedly refuses vital medication? Can you hide it in their food?" Assessor Check: Did they state they would respect the refusal, code it correctly, and escalate? Did they explicitly state covert administration is ILLEGAL without a formal, documented Best Interests decision and pharmacy guidance?- Select -Yes - CompetentNo - InadequateN/ATranscribing & Alterations: "A family member tells you the GP changed the dose this morning. What do you do?" Assessor Check: Did they state they must NEVER alter a MAR/eMAR or take verbal instructions, and must contact the office to verify with the pharmacy/GP?- Select -Yes - CompetentNo - InadequateN/ADigital Contingency (eMAR Failure): "If your mobile app crashes or has no signal in the home, how do you safely administer and record the medication?" Assessor Check: Did they explain the paper-MAR backup procedure or the protocol for calling the office for live verification?- Select -Yes - CompetentNo - InadequateN/ASECTION 3: PRACTICAL OBSERVATION - THE 6 Rs (Safe: QS4) Silently observe the staff member. Do not intervene unless there is an immediate risk. ANY 'Fail' in this section terminates the assessment instantlyInfection Prevention & Control (IPC): Washed hands thoroughly and applied appropriate PPE (non-touch technique for tablets; gloves for creams) prior to handling?- Select -PassFailN/ARight Person: Verified identity and gained explicit verbal consent before proceeding?- Select -PassFailN/ARight Medicine & Expiry: Checked the pharmacy label against the MAR/eMAR, and visually checked the expiry/discard date of liquids, creams, or drops?- Select -PassFailN/ARight Dose: Selected the exact dosage as printed on the MAR/eMAR (not relying on memory or family instruction)?- Select -PassFailN/ARight Route & Right Time: Administered via the correct route and within the safe time window?- Select -PassFailN/ARight Documentation (The Golden Rule): Recorded the administration (signed MAR / updated eMAR) IMMEDIATELY after the service user swallowed the medication, and never before?- Select -PassFailN/ASECTION 4: DOMICILIARY SPECIFICS & COMPLEX ADMINISTRATION Specialist Administration EvaluatedInhaler: Checked technique, spacer use, required rinsing.- Select -PassFailN/AEye/Ear Drops: Checked 'date opened', correct positioning, hygiene.- Select -PassFailN/ATopical Creams: Used gloves, referenced body map, applied thinly/correctly.- Select -PassFailN/AControlled Drugs (CD): Checked balance, recorded in CD register (if applicable to agency policy).- Select -PassFailN/ASafe Storage: Returned medication to the designated secure lockbox/cupboard and ensured it was locked before leaving?- Select -PassFailN/AHomely Remedies / OTC: Navigated family requests for non-prescribed remedies safely according to policy?- Select -PassFailN/ASECTION 5: ASSESSOR FEEDBACK & FINAL GRADINGCommunication & Dignity (Caring: QS1)- Select -Outstanding (4)Good (3)Adequate (2)Inadequate (1)Areas for Improvement / Minor Corrections- Select -None - Exemplary Practice Demonstrated.CommunicationEfficiencyPreparationIPC FocusDocumentation SpeedCritical FailureFinal Competency Grading- Select -Competent (Pass)Requires Further Shadowing (Pending)Inadequate (Fail)Assessor Declaration- Select -I confirm I have physically observed this staff member. They have demonstrated the required knowledge and practical skill to safely administer medication in a domiciliary setting under NICE NG67.Staff Member Declaration- Select -I understand the feedback. I am personally accountable for every medication I administer. I must report any errors, near misses, or omissions immediately.Rostering System Integration: "Does this Pass complete the required competency framework to unlock the 'Medication Administration' tag for this employee on the scheduling software?- Select -YesNoUpdate Staff Member Profile- Select -Profile updated, allowing dispatchers to assign medication-critical callsAssessor NameDateNext Review Date:SUBMIT FORM