A care home needs a written process for storing medicines at the right temperature and for checking that they stay there, and CQC expects the medicines fridge to be read, recorded and reset at least once a day. This page explains where those expectations come from, what a workable routine looks like and what to do when a reading is out of range. The one thing to remember: the manufacturer's label sets the temperature, and your records are how you show you kept to it.
Why it matters
Medicines can be damaged without looking any different
Most medicines in a care home are kept at room temperature, and a smaller number, insulin among them, need a fridge at +2 °C to +8 °C. Heat or freezing can damage a medicine without changing how it looks, which is why SPS advises that insulin should be replaced if a resident's blood glucose is unexpectedly high in case heat has damaged it (SPS heatwave guidance).
CQC's fridge guidance warns that domestic fridges do not guarantee a stable temperature, that an overfilled fridge has poor airflow and can freeze its contents, and that fridges get unplugged or switched off by accident.
What the rules say
NICE sets the duty, CQC and SPS fill in the detail
The starting point is NICE SC1. Recommendation 1.12.2 says a care home's process for storing medicines should include 'the temperatures for storing medicines and how the storage conditions should be monitored'. NICE gives no temperature range, check frequency or fridge type.
CQC, which registers and inspects care homes, gives the detail. Its fridge page asks for a dedicated medicines fridge, a daily reading of current, maximum and minimum, a reset, and a record of action taken when out of range, including asking a pharmacist whether the medicines are still safe. Its page on storing medicines in care homes says your policies must set out how staff monitor the temperature of storage areas, and suggests a storage risk assessment that includes medicines kept in residents' own rooms.
SPS supplies the technical layer: domestic fridges are not recommended, room storage would ideally sit between 15 °C and 25 °C (SPS on ambient storage), and there is a stepwise process for excursions. Where a nursing home holds vaccines, the Green Book applies, and it says domestic fridges must not be used.
What good looks like
A routine that runs every day, not just on inspection day
Each day, a trained member of staff reads the fridge at a set time, records the three figures, resets the thermometer and checks the probe cable is not stopping the door from sealing. For the medicines room, SPS treats a min/max recorder as the minimum, and care homes often adopt the daily reading set for NHS clinical areas (NHS Pharmaceutical QA Committee, 2015).
Around that, CQC asks you to check dates and rotate stock, clean and defrost the fridge with dated records, protect the plug with a switchless socket or a 'Do not unplug' label, and keep food and samples out. SPS says sensors should be calibrated each year by an accredited service (SPS on sensors); CQC itself does not specify calibration for care homes.
- Trained staff on shiftEvery day
- Read current, maximum and minimum
- Record and reset the thermometer
- Check the door seal and probe cable
- Act on any out-of-range reading and record it
- Medicines leadRegularly, to your policy
- Check expiry dates and rotate stock
- Clean and defrost, with dated records
- Check the fridge is not overfilled
- Review room temperature records
- Registered managerYearly, and on change
- Calibrate the thermometer or sensors
- Revisit the storage risk assessment as needs change
- Retrain staff when the procedure changes
Drawn from CQC and SPS guidance. SPS gives the yearly calibration; set the other frequencies in your own policy.
Worked example
Sunday morning, and the maximum reads 10.6 °C
This is an illustrative example. At 08:00 on Sunday the senior carer reads the medicines fridge: current 5.8 °C, maximum 10.6 °C, minimum 3.9 °C since Saturday's reset.
Following the SPS process, she checks the door, the plug and the probe. She labels the stock 'DO NOT USE' and leaves it in the fridge. She records the maximum and minimum; the duration is unknown, because a min/max thermometer shows how far the temperature went, not for how long. She phones the pharmacy for advice on each product and records who she spoke to, the advice and what was done, as CQC asks. If no cause can be found, SPS says to take the fridge out of use until the investigation is complete.
Where it is unclear
Points where the sources pull in different directions
CQC allows a locked box in the food fridge for small services in exceptional circumstances, while vaccine guidance rules domestic fridges out entirely (domestic fridges). UKHSA's 20-minute allowance covers a one-off short fridge excursion, but a min/max thermometer cannot show duration (UKHSA's 20-minute allowance). Rooms above 25 °C in hot weather are treated differently by UKHSA and SPS (room temperature in heatwaves), and weekend checks vary by setting (weekends and closed periods).
In summary
The short version
- Your medicines policy states storage temperatures and how they are monitored (NICE SC1 1.12.2).
- Use a dedicated medicines fridge, not a domestic one, and check it actually holds +2 °C to +8 °C.
- Read, record and reset the fridge thermometer at least once a day, every day.
- Monitor the medicines room and residents' rooms through your storage risk assessment.
- Clean, defrost and protect the plug, with dated records.
- On any out-of-range reading: quarantine, seek pharmacist advice, record what you did.
- Where sources differ, decide, record your reasoning and train staff on it.