Controlled drugs and accountable handling

Controlled drugs are medicines subject to misuse of drugs legislation because of risks such as dependence, misuse or diversion. They are often used in care settings for pain relief, end of life care, ADHD or for anxiety and sleep.

This course provides frontline practical guidance only. Staff must follow their local controlled drugs policy for storage, record keeping, witnessing, stock checks, disposal and reporting, because these elements are legally and professionally regulated.

Key controlled drug principles

• Storage: medicines that require safe custody must be stored securely in line with the policy.
• Access: keys and access should be limited to authorised staff as set out in the risk assessment and local procedure.
• Records: movements of Schedule 2 controlled drugs must be entered in a controlled drugs register or an approved electronic register.
• MAR: administration must also be recorded on the MAR or eMAR, with dose and time noted.
• Witnessing: CQC advises two trained, competent staff should witness key controlled drug steps where possible.
• Running balance: keeping stock balances helps identify discrepancies promptly.
• Escalation: missing stock, damaged medicines, incorrect balances, suspected diversion or unexplained discrepancies must be reported immediately.

Care homes without nursing must not hold stock for general use; they may only keep controlled drugs prescribed and dispensed for a named individual. Care homes with nursing have different arrangements and may hold some stock, subject to legal and local requirements.

Manager and senior checks

Controlled drugs require calm, precise practice. If records, stock or balances do not make sense, stop and escalate before proceeding.