This is what I would do: 1. In the first instance of refusal, encourage gently one time, and then inform them you will come back to offer again shortly, then leave the flat/room. 2. Come back 10-15 minutes later and offer medication again. If still not accepted, talk to the person about their reasons and complete a two-step capacity form. 3. If still refused after capacity form, document on the MAR sheet and in their care plan, insert the two-step capacity form into their notes, and inform a senior or manager on shift, or if required, on-call for night staff. Follow any instructions they give. Would you do anything different?