Disguising medicines in food or drink

Disguising medication in food or drinks without the knowledge or consent of the service users is referred to as 'covert medication.' The support and administration of covert medicines is a complex issue and staff should not support with or administer medicines to a service user without their knowledge or consent. Exceptions to this are covered in the last paragraph.

If an individual has swallowing difficulty or dislikes the taste of a medication, and consents or requests their medications are crushed, in liquid form or mixed with drink or food, then this is different and is not covert administration. See Kirklees Good Practice Medication Guidelines for crushing medication for further support and guidance.

A competent adult has the legal right to refuse treatment, even if a refusal will adversely affect his or her health or shorten his or her life.

However, in extreme cases, and when a service user lacks the capacity to be able to consent, covert medication may need to be considered. If this is the case, a Mental Capacity Assessment and 'best interest' meeting with people who know and understand the service user should take place beforehand to decide whether covert support is in the best interest of the service user. All information and agreements must be documented and signed by all parties on the care/support plan and risk assessment.

Further guidance

Safeguarding adults information for professionals

Mental Capacity Act Code of Practice | GOV.UK

Managing medicines for adults receiving social care in the community | Guidance | NICE