Quick summary
Both, depending on training and what the care plan says. There are three recognised levels of medicines support: prompting, assisting and administering. Care workers should only provide the level that has been assessed, agreed and written into the care plan, and every dose given must be recorded.
The three levels
Level | What it means | Typical example |
|---|---|---|
Prompting | Reminding someone to take their medicine. They take it themselves | “It’s half past eight, shall I get your tablets?” |
Assisting | Practical help with a medicine the person is still directing | Popping tablets from a blister pack into a pot, opening a bottle, passing a glass of water |
Administering | The care worker gives the medicine, taking responsibility for the right medicine, dose and time | Selecting from the packaging and giving it to someone who cannot manage themselves |
NICE uses the umbrella term medicines support, defined as any support that enables a person to manage their medicines (NICE NG67). The level should be decided by assessment, not by what is convenient on the day.
The rules that govern it
Two documents do most of the work here: NICE guideline NG67 on managing medicines for adults receiving social care in the community, and the Care Quality Commission’s guidance for home care providers.
The key points:
- Medicines support must be assessed as part of the overall assessment of needs, with the outcome recorded in the care plan.
- Care workers should only provide the support agreed and documented in the care plan. Not more, even if asked on the day.
- The prescriber’s directions must be clear, specific and unambiguous. “Take as directed” is not usable.
- Every instance of support must be recorded on a medicines administration record, including the person’s name, date of birth and identifiers.
- Providers should not take over managing someone’s medicines unless the assessment shows it is needed. People should be supported to do it themselves where they can.
- Staff competence must be assessed before they manage or administer medicines, with records kept, and NICE recommends an annual review of knowledge, skills and competency (CQC).
The rule families most often ask about
Covert administration, meaning hiding medicine in food or drink, is tightly controlled.
NICE is explicit that care workers must not give, or decide to give, medicines covertly unless there is clear authorisation and instructions to do so in the care plan, in line with the Mental Capacity Act 2005. That authorisation follows a best interests process involving the prescriber and pharmacist, and it only applies where the person lacks capacity to decide about their medicines.
A family member asking a carer to “just put it in her tea” is asking them to breach that. Where hiding medicine seems to be the only way forward, the conversation belongs with the GP and pharmacist, not with the carer at the door.
What carers generally cannot do
Boundaries vary by provider, training and the care plan, and these are typically nursing tasks rather than home care ones:
- Injections, including insulin in most cases, unless specifically trained and authorised for a named person.
- Syringe drivers, which are managed by district nurses.
- Controlled drugs, where additional rules and records apply.
- Deciding whether a “when required” medicine is needed, unless there is a clear written protocol saying when to give it and what to do afterwards.
- Changing a dose, or advising on one.
- Crushing tablets or opening capsules, which alters how a medicine works and needs specific pharmacist advice.
A provider who agrees to everything without checking training and the care plan is not being flexible. They are cutting a corner that exists for a reason.
What good looks like in practice
- Medicines support is assessed at the start, with the level written down.
- The care plan names each medicine, the level of support, the timing, and anything time-critical.
- A medicines administration record is kept in the home and completed at each visit.
- There is a written protocol for “when required” medicines.
- Refusals and missed doses are recorded and reported, not quietly left.
- Staff competence is checked before they start and reviewed annually.
- The plan is reviewed after any change, particularly after a hospital stay, when medicines frequently change.
Our care plan guide sets out what else should be in the document.
Questions worth asking a provider
- What level of medicines support can your carers provide?
- What training do they have, and how is competence checked?
- How is each dose recorded, and can we see the record?
- What happens if a dose is refused or missed?
- Can you work to fixed times for time-critical medicines? For Parkinson’s this is the decisive question, as our Parkinson’s guide explains.
- Who do you contact if something looks wrong?
Frequently asked questions
Can a carer give medication?
Yes, where they are trained and competent and the care plan says so. Otherwise support is limited to prompting or assisting.
What is the difference between prompting and administering?
Prompting is reminding someone who takes the medicine themselves. Administering means the carer gives it and is responsible for the right medicine, dose and time.
Can a carer hide tablets in food?
Only where covert administration has been formally authorised in the care plan following a best interests process under the Mental Capacity Act. A carer should never agree to do it on request.
Can carers give insulin?
Generally not. Injections are usually a nursing task, with limited exceptions where a care worker has specific training and authorisation for a named person.
What happens if my mum refuses her tablets?
The carer records the refusal and reports it. An adult with capacity can refuse. Repeated refusals should go back to the GP.
Can they use a dosette box?
Yes, where one has been supplied by a pharmacy. Care workers should not fill a pill organiser themselves, because that amounts to dispensing.
About Visiting Angels Cheshire East
Visiting Angels Cheshire East provides care at home across Macclesfield, Wilmslow, Knutsford, Congleton, Alsager and the surrounding villages of East Cheshire, along with Buxton, Whaley Bridge and the Staffordshire Moorlands towns.
- Medicines support assessed and written into the care plan, at the level that is actually needed.
- Training designed and overseen by clinicians, with competence checked.
- Visits timed around doses where timing matters.
- No visit is ever shorter than an hour, so medicines are not rushed at the door.
- You see the same faces. Our carer turnover is 12 per cent, against a sector figure of 23.7 per cent (Skills for Care, 2025).
Sharon’s mother had been having visits for a fortnight when she wrote this:
“It is not something we ever thought we would need but Visiting Angels have been wonderful. They came to see us to find out exactly what we needed, even though we weren’t completely sure ourselves, but through our conversation we were able to put a package of support in place. They offered advice on other things that were available to us as well particularly financially. They put our minds at ease during what was quite a stressful time in our lives.”
Sharon Thornton, Google review
Not sure what you need yet? Start with a free assessment
Our free home care assessment is a visit at a time that suits you, with no obligation afterwards. In it we will:
- Assess what medicines support is actually needed, and set out the level in writing.
- Talk through a realistic package, and what it would cost.
- Look at the money with you, and point you towards the funding, benefits and grants you may be entitled to.
- Tell you honestly where the line is, including anything that needs a district nurse rather than us.
If medication is the reason you are looking at care, call us on 01625 720157. You can also send an enquiry, and you can see what our services cover.
Authored by Kim Blissett, Registered Manager, Visiting Angels Cheshire East.
Published 27 September 2026. Last updated 27 September 2026.
This article is general information about how medicines support works in home care, not medical or legal advice. What an individual provider’s staff can do depends on their training, policies and the agreed care plan, so check directly. Guidance from NICE and CQC changes; the position was correct at the date of publication. Visiting Angels Cheshire East provides personal care at home rather than medical or nursing care. To the fullest extent permitted by law, GB Care at Home Ltd accepts no liability for any loss or injury arising from reliance on this article.
