Training & Competency for Medication and Delegated Healthcare in Homecare
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Why competency matters more than training certificates
Medication and delegated healthcare incidents often involve staff who were “trained” but not competent. In homecare, where staff work alone, competence must be observed, assessed and refreshed — not assumed.
Commissioners and inspectors increasingly test how providers assure competence in practice. For related workforce expectations, see Training and Staff Supervision & Monitoring.
What competence looks like in homecare medication support
Competence involves more than task completion.
Staff must demonstrate:
- Understanding of medication purpose and timing
- Accurate MAR recording
- Ability to recognise red flags
- Confidence to escalate concerns
Competency assessment in practice
Providers should use structured assessment methods.
Observed practice
Staff should be observed administering or supporting medication in real settings, not just simulated environments.
Scenario-based assessment
Assess how staff respond to refusals, missing medication, discrepancies or deterioration.
Task-specific sign-off
Delegated healthcare tasks require separate competency sign-off for each task.
Refreshing competence over time
Competence can drift under pressure.
Providers should refresh competence:
- At defined intervals
- Following incidents or near misses
- When guidance changes
- After extended absence
Supervision as a medication safety tool
Supervision reinforces competence.
Effective supervision includes discussion of recent medication decisions, challenges and learning.
What commissioners expect around competence
Commissioners look for evidence that:
- Training is role-specific
- Competence is assessed and recorded
- High-risk tasks receive additional oversight
- Learning feeds back into training
How to evidence competence in tenders
In tenders, describe your competency framework — training, observation, sign-off and refresh.
This demonstrates that medication and delegated healthcare are delivered safely by capable, supported staff.
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