CQC updated its guidance on ‘when required’ (PRN) medicines in September 2025. Providers must now ensure their policies and care plans reflect the following points:
- Supportive interventions first: Care plans must state what staff should try before offering a PRN medicine (e.g. comfort, distraction, fluids, repositioning).
- Clear sequence: Where more than one PRN is prescribed for the same condition, the preferred order must be documented.
- Duration and review: Care plans should set out how long PRN medicines are expected to be needed, and what to do if they are used regularly or not at all.
- Recording and effectiveness: Each administration must include the reason, exact dose, time, and the observed outcome. If the medicine is ineffective, staff must contact the prescriber promptly.
- Availability: PRN medicines must be available when needed, not limited to medicines rounds.
- Storage and stock: PRN medicines must remain in their original packaging, be in-date, and held in suitable quantities.
- Psychotropics: Continue to follow STOMP/STAMP principles, ensuring rationale, monitoring, and regular prescriber reviews.
Action for managers
- Review and update your PRN and medicines policies now.
- Ensure staff care plans reflect these requirements.
- Audit MAR charts for evidence that effectiveness and rationale are consistently recorded.
- Provide refresher training where gaps are identified.
The CQC’s guidance here:
Further info on psychotropics: I recommend the Scottish Care Inspectorate podcast on reducing inappropriate use of psychoactive medicines in care homes from 2024:
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