The 6 rights of medication administration

The short answer

The 6 rights of medication administration are the safety check every carer applies whenever they support a person with medicines: right person, right medication, right dose, right route, right time, right documentation. They map onto NICE NG67 — Managing medicines for adults receiving social care in the community, and they're what a CQC inspector quietly checks when reviewing your MAR records.

The six rights, one at a time

1. Right person

The first check is the person in front of you. In a domiciliary visit this is rarely ambiguous, but it's also where errors slip in — particularly where carers cover a round outside their usual area, or where partners or housemates also take medications.

Common errors: handing a partner's tablets to the person being visited; assuming "Mr Smith at number 14" when the round notes say number 4. The fix: confirm the person's full name and date of birth (or another agreed identifier) against the care plan before opening the dosette.

2. Right medication

Check the medication name on the label against the MAR chart, every time. Look-alike and sound-alike names are a known source of error — amlodipine and amitriptyline; clozapine and clonazepam. Brand changes between repeats are another: the same drug arrives in a different-coloured box and a carer hesitates.

Common errors: assuming the pack hasn't changed; not checking the strip inside a dosette against the printed label. The fix: read the label, the strength, the form (tablet, capsule, liquid). If anything looks different from last visit, stop and check.

3. Right dose

Right dose is more than the number on the label — it's the number on the label that matches today's prescription. Doses change. Warfarin schedules in particular move week to week.

Common errors: administering yesterday's dose because the dosette hasn't been re-packed; giving a whole tablet where the prescription says half; misreading "5mg" as "50mg" on liquids. The fix: calculate against the current MAR chart, not the previous one; for liquids, use the supplied measure not a household spoon.

4. Right route

Oral, topical, inhaled, sublingual, rectal, transdermal — the route is part of the prescription. A medication given by the wrong route can be ineffective or harmful.

Common errors: applying a cream meant for one area to another; not removing yesterday's transdermal patch before applying today's; giving an inhaler dose without a spacer when one is required. The fix: the care plan should state the route and the technique. Train against it; assess competence on the technique, not just the principle.

5. Right time

Right time has two parts: the prescribed time, and the window around it that the medication still works within. Some medications (like time-critical Parkinson's drugs) have a 30-minute window; others can flex by hours.

Common errors: doubling up because a previous visit was missed; running early or late on a clustered round and falling outside a drug's window without noticing. The fix: the care plan flags time-critical drugs; the rota protects their windows; missed doses are recorded with a reason and a plan, not "given" against the clock.

6. Right documentation

The right that holds the other five together. A medication that was administered correctly but not recorded looks identical, on paper, to one that was missed. CQC's reading of medication safety starts here.

Common errors: blank squares with no reason recorded; carers signing the MAR before the round to "save time"; ticks against PRN medication with no detail of what triggered it. The fix: record at the point of administration, not after; record an outcome for every entry (given, refused, withheld, missed — and why); store the record where the next carer, the manager, and an inspector can find it.

Where eMAR helps with each

The 6 rights are a human safety check — software doesn't replace the carer's eyes. But an electronic MAR changes what's possible at each step:

• Right person — the app opens with the person you're visiting; you can't accidentally record against the wrong record.
• Right medication / right dose / right route — the prescription record sits next to the administration record; changes since the last visit are visible.
• Right time — time-critical drugs surface an alert when a visit is at risk of falling outside the window.
• Right documentation — entries can't be backdated, blank entries can't be left silently, and the audit trail is created automatically.

For a deeper look at the trade-offs between paper and electronic MARs, see eMAR vs paper MAR: what CQC actually expects.

A note on the Mental Capacity Act

The 6 rights take for granted that the person consents to take the medication. They don't, always — and that's not a problem to manage around the system; it is the system. If a person with capacity refuses a medication, the right answer is to record the refusal and notify the office. If capacity for the decision is in doubt, the carer doesn't decide alone — an assessment under the Mental Capacity Act is needed, and a best-interests decision (recorded) follows.

Covert administration — hiding medication in food or drink — is only ever lawful after a documented best-interests process involving the prescriber, family and the registered manager. It is not a carer's call to make on the doorstep.

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