Electronic medicines administration records (eMAR) in adult social care

Good quality records underpin safe, effective, compassionate, high-quality care. They communicate the right information clearly, to the right people, when they need it. They are an essential part of achieving good outcomes for people.

When a CQC inspector asks to see records, we expect you to enable access in a way that meets your governance requirements. See Regulation 17: Good governance. Your system should not create a barrier or obstruction to CQC in exercising our regulatory powers and carrying out regulatory functions. This includes enabling access to the information we require in an appropriate and timely way.

See our guidance:

• What good looks like for digital records in adult social care
• Medicines administration records in adult social care

eMAR systems generally include:

• information about a person
• any support the person needs to take their medicines
• a facility to make notes
• details of personalised care plans
• management reports
• integrated ordering systems to manage medicines stock

We can view a medicines record:

• using a portable device
• using a computer desktop
• as a print-out.

Things to consider for your eMAR system

• Is the system appropriate to the service and does it meet national guidelines for record keeping?
• How will you manage the transition from paper records to digital?
• Do you have continuing access to IT and pharmaceutical support to make sure systems are updated?
• What are the arrangements if the system or internet goes down?
• Has the medicines policy been updated to reflect the electronic system?
• Does the system allow access to appropriate people?
• How do you deliver training and assess the competency of staff to use the system?
• How will you train staff to audit the system? Do you do this regularly?
• How do you manage periods when regular staff are not available and you have to use temporary staff who may be unfamiliar or untrained with the operating system?
• How will you manage purchased medicines and homely remedies?
• How do you manage mid-month changes and hospital discharges and add them to the system safely?
• Does the system have safety alerts to prevent medicines being given too close together or at the wrong time?
• Does the system meet current data governance and cyber security requirements? For example, compliance with the Data Security and Protection Toolkit (DSPT).

Other records to consider

There should be systems to make sure the following paper or other digital records used alongside eMAR records are accessible and managed safely:

• controlled drugs records
• fluid and thickening fluid charts
• insulin charts
• patch application records
• when required or PRN guidance
• topical medicines administration records (TMAR) and guidance
• warfarin anticoagulant records
• covert administration guidance
• enteral feeding and medicines administration guidance
• records of medicines administered by external healthcare professionals.