CQC and Buccal Midazolam Training: What Care Providers Need to Know

CQC and Buccal Midazolam Training: What Care Providers Need to Know

If you run a residential care home, supported living service, or domiciliary care agency supporting adults with a learning disability, making sure your team can respond safely to a seizure emergency is essential.

For many people, buccal midazolam is a prescribed rescue medication that can stop a prolonged seizure and prevent serious harm. But this isn’t just about clinical care — it’s also something the Care Quality Commission (CQC) will expect you to get right.

In this blog, we’ll walk through what CQC looks for in practice, what good training involves, and how to make sure your service is inspection-ready.

Why this matters

Epilepsy is significantly more common in people with a learning disability than in the general population — often affecting around 20–30%, and higher in those with more complex needs.

That means many adult social care services are supporting people who may require emergency medication. Ensuring staff feel confident and competent to act quickly and safely is one of the most important steps you can take to protect the people you support.

Where this fits with CQC

CQC assesses services against five key questions: Safe, Effective, Caring, Responsive, and Well-led. Training around buccal midazolam sits mainly within Safe and Effective.

Under Safe, inspectors look at how medicines are managed. This includes whether staff administering medication are trained, competent, and appropriately supported. Where medicines require a specific technique — such as buccal administration — additional training is expected.

Under Effective, CQC considers whether staff have the right skills and up-to-date knowledge to meet people’s needs. For services supporting people with epilepsy, this means training should go beyond basic awareness and include how to administer prescribed rescue medication safely.

What’s changed under the new CQC framework

With the introduction of the Single Assessment Framework, CQC now gathers evidence on an ongoing basis rather than relying solely on scheduled inspections.

This means services need to be ready at any time. Training records, competency assessments, and care documentation should always be up to date — not just when an inspection is expected.

If an incident occurs, such as a prolonged seizure or medication error, one of the key things CQC is likely to review is whether staff were appropriately trained and assessed as competent.

What inspectors typically look for

When reviewing epilepsy care and the use of buccal midazolam, inspectors often look for clear, consistent evidence such as:

Up-to-date training records for staff who may need to administer the medication
Evidence of competency assessments completed in the workplace
Person-centred seizure management plans with clear instructions
Accurate and complete MAR chart documentation
Records of incidents and any learning or improvements made
Evidence that training is refreshed regularly (commonly every two years)
Appropriate clinical guidance or delegation where required

Gaps don’t automatically lead to enforcement, but they can raise concerns — especially if they are part of a wider pattern or linked to an incident.

What good training looks like

Best practice guidance from organisations such as the Epilepsy Specialist Nurses Association (ESNA) highlights what effective training should include.

In practice, this means:

Covering both epilepsy awareness and the use of buccal midazolam
Including a live demonstration of the administration technique
Giving staff the opportunity to ask questions and work through real-life scenarios
Assessing understanding during the session
Following up with workplace-based competency sign-off

Training can be delivered face-to-face or virtually, as long as it remains interactive and allows the trainer to assess each participant’s understanding.

Importantly, training alone isn’t enough — employers are responsible for ensuring staff are competent in practice.

Common gaps to avoid

Across many services, a few common issues tend to come up:

Training that hasn’t been refreshed within the recommended timeframe
Reliance on e-learning alone without practical demonstration or assessment
Lack of documented competency sign-off
Staff unfamiliar with individual seizure care plans
New staff working before completing training

These are usually easy to fix with the right systems in place — and addressing them early can make a big difference during assessment.

A simple check for your service

It can be helpful to ask yourself:

Are all relevant staff trained and up to date?
Have they been assessed as competent in practice?
Are care plans clear, current, and person-specific?
Is there a system to track renewals and prevent gaps?

If the answer is yes, you’re likely in a strong position.

How Teach Health can support you

At Teach Health, we provide practical, clinically informed epilepsy awareness and buccal midazolam training designed specifically for adult social care staff.

Our sessions are delivered live by experienced Registered Nurses with backgrounds in epilepsy and learning disability care. We focus on building real confidence — not just knowledge — through demonstration, discussion, and interaction.

We offer:

Group training at your service or delivered virtually face to face
Small, interactive sessions to support individual learning
Flexible scheduling, including evenings and weekends
Clear guidance on competency sign-off and ongoing compliance

Whether you’re refreshing existing staff or training a new team, we aim to make the process straightforward, relevant, and aligned with what CQC expects in practice.

If you’d like to find out more or book a session, you can contact us at info@teachhealth.co.uk or call 020 8720 6635.

About the author

This article was written by the clinical team at Teach Health, specialists in epilepsy and health training for adult social care and education settings across the UK.

While every effort has been made to ensure the accuracy of the information in this article, the author does not accept liability for any inaccuracies or for actions taken based on this information.