Safeguarding

CARE CERTIFICATE – STANDARD 10 SAFEGUARDING ADULTS

  • 10.1 Understand the principles of Safeguarding adults
    • 10.1a Explain the term safeguarding adults
    • 10.1b Explain their own role and responsibilities in safeguarding individuals
    • 10.1c List the main types of abuse
    • 10.1d Describe what constitutes harm
    • 10.1e Explain why an individual may be vulnerable to harm or abuse
    • 10.1f Describe what constitutes restrictive practices
    • 10.1g List the possible indicators of abuse
    • 10.1h Describe the nature and scope of harm to and abuse of adults at risk
    • 10.1i List a range of factors which have featured in adult abuse and neglect
    • 10.1j Demonstrate the importance of ensuring individuals are treated with dignity and respect when providing health and care services
    • 10.1k Describe where to get information and advice about their role and responsibilities in preventing and protecting individuals from harm and abuse
  • 10.2 Reduce the likelihood of abuse
    • 10.2a Describe how care environments can promote or undermine people’s dignity and rights
    • 10.2b Explain the importance of individualised, person centred care
    • 10.2c Explain how to apply the basic principles of helping people to keep themselves safe
    • 10.2d Explain the local arrangements for the implementation of multi-agency Safeguarding Adult’s policies and procedures
    • 10.2e List ways in which the likelihood of abuse can be reduced by managing risk and focusing on prevention
    • 10.2f Explain how a clear complaints procedure reduces the likelihood of abuse
  • 10.3 Respond to suspected or disclosed abuse
    • 10.3a Explain what to do if abuse of an adult is suspected; including how to raise concerns within local whistleblowing policy procedures
  • 10.4 Protect people from harm and abuse – locally and nationally
    • 10.4a List relevant legislation, local and national policies and procedures which relate to safeguarding adults
    • 10.4b Explain the importance of sharing information with the relevant agencies
    • 10.4c Describe the actions to take if they experience barriers in alerting or referring to relevant agencies

LEVEL 2 DIPLOMA IN CARE – SAFEGUARDING AND PROTECTION IN CARE SETTINGS

  • 1 Understand principles of safeguarding adults
    • 1.1 Explain the term safeguarding
    • 1.2 Explain own role and responsibilities in safeguarding individuals
    • 1.3 Define the following terms: • Physical abuse • Domestic abuse • Sexual abuse • Emotional/psychological abuse • Financial/material abuse • Modern slavery • Discriminatory abuse • Institutional/organisational abuse • Self-neglect • Neglect by others
    • 1.4 Describe harm
    • 1.5 Describe restrictive practices
  • 2 Know how to recognise signs of abuse
    • 2.1 Identify the signs and/or symptoms associated with each of the following types of abuse: • Physical abuse • Domestic abuse • Sexual abuse • Emotional/psychological abuse • Financial/material abuse • Modern slavery • Discriminatory abuse • Institutional/organisational abuse • Self-neglect • Neglect by others
    • 2.2 Describe factors that may contribute to an individual being more vulnerable to abuse
  • 3 Know how to respond to suspected or alleged abuse
    • 3.1 Explain the actions to take if there are suspicions that an individual is being abused
    • 3.2 Explain the actions to take if an individual alleges that they are being abused
    • 3.3 Identify ways to ensure that evidence of abuse is preserved
  • 4 Understand the national and local context of safeguarding and protection from abuse
    • 4.1 Identify relevant legislation, national policies and local systems that relate to safeguarding and protection from abuse
    • 4.2 Explain the roles of different agencies in safeguarding and protecting individuals from abuse
    • 4.3 Identify factors which have featured in reports into serious cases of abuse and neglect
    • 4.4 Identify sources of information and advice about own role in safeguarding and protecting individuals from abuse, including whistle blowing
    • 4.5 Identify when to seek support in situations beyond your experience and expertise
  • 5 Understand ways to reduce the likelihood of abuse
    • 5.1 Explain how the likelihood of abuse may be reduced by: • working with person centred values • encouraging active participation • promoting choice and rights • supporting individuals with awareness of personal safety
    • 5.2 Explain the importance of an accessible complaints procedure for reducing the likelihood of abuse
    • 5.3 Outline how the likelihood of abuse can be reduced by managing risk and focusing on prevention
  • 6 Know how to recognise and report unsafe practices
    • 6.1 Describe unsafe practices that may affect the well-being of individuals
    • 6.2 Explain the actions to take if unsafe practices have been identified
    • 6.3 Describe the actions to take if suspected abuse or unsafe practices have been reported but nothing has been done in response
  • 7 Understand principles for online safety
    • 7.1 Describe the potential risks presented by: • the use of electronic communication devices • the use of the internet • the use of social networking sites • carrying out financial transactions online
    • 7.2 Explain ways of reducing the risks presented by each of these types of activity
    • 7.3 Explain the importance of balancing measures for online safety against the benefits to individuals of using electronic systems and devices

LEVEL 3 DIPLOMA IN ADULT CARE – SAFEGUARDING AND PROTECTION IN CARE SETTINGS

  • 1 Understand principles of safeguarding adults
    • 1.1 Explain the term safeguarding
    • 1.2 Explain own role and responsibilities in safeguarding individuals
    • 1.3 Define the following terms: • Physical abuse • Domestic abuse • Sexual abuse • Emotional/psychological abuse • Financial/material abuse • Modern slavery • Discriminatory abuse • Institutional/organisational abuse • Self-neglect • Neglect by others
    • 1.4 Describe harm
    • 1.5 Describe restrictive practices
  • 2 Know how to recognise signs of abuse
    • 2.1 Identify the signs and/or symptoms associated with each of the following types of abuse: • Physical abuse • Domestic abuse • Sexual abuse • Emotional/psychological abuse • Financial/material abuse • Modern slavery • Discriminatory abuse • Institutional/organisational abuse • Self-neglect • Neglect by others
    • 2.2 Describe factors that may contribute to an individual being more vulnerable to abuse
  • 3 Know how to respond to suspected or alleged abuse
    • 3.1 Explain the actions to take if there are suspicions that an individual is being abused
    • 3.2 Explain the actions to take if an individual alleges that they are being abused
    • 3.3 Identify ways to ensure that evidence of abuse is preserved
  • 4 Understand the national and local context of safeguarding and protection from abuse
    • 4.1 Identify relevant legislation, national policies and local systems that relate to safeguarding and protection from abuse
    • 4.2 Explain the roles of different agencies in safeguarding and protecting individuals from abuse
    • 4.3 Identify factors which have featured in reports into serious cases of abuse and neglect
    • 4.4 Identify sources of information and advice about own role in safeguarding and protecting individuals from abuse, including whistle blowing
    • 4.5 Identify when to seek support in situations beyond your experience and expertise
  • 5 Understand ways to reduce the likelihood of abuse
    • 5.1 Explain how the likelihood of abuse may be reduced by: • working with person centred values • encouraging active participation • promoting choice and rights • supporting individuals with awareness of personal safety
    • 5.2 Explain the importance of an accessible complaints procedure for reducing the likelihood of abuse
    • 5.3 Outline how the likelihood of abuse can be reduced by managing risk and focusing on prevention
  • 6 Know how to recognise and report unsafe practices
    • 6.1 Describe unsafe practices that may affect the well-being of individuals
    • 6.2 Explain the actions to take if unsafe practices have been identified
    • 6.3 Describe the actions to take if suspected abuse or unsafe practices have been reported but nothing has been done in response
  • 7 Understand principles for online safety
    • 7.1 Describe the potential risks presented by: • the use of electronic communication devices • the use of the internet • the use of social networking sites • carrying out financial transactions online
    • 7.2 Explain ways of reducing the risks presented by each of these types of activity
    • 7.3 Explain the importance of balancing measures for online safety against the benefits to individuals of using electronic systems and devices

Introduction

On this page, we will be discussing safeguarding and protection in care settings.

This will include local and national frameworks, legislation, restrictive practices and types of abuse and neglect. We will also explore how to respond to disclosures or allegations of abuse/neglect and how to reduce the likelihood of it occurring in the first place. Finally, in an increasingly digital world, we will examine how vulnerable individuals can be protected online.

What is safeguarding?

The Care Act Statutory Guidance describes safeguarding as:

Protecting an adult’s right to live in safety, free from abuse and neglect. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action. This must recognise that adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances.

– Care Act Statutory Guidance

In essence, safeguarding is an umbrella term that relates to individuals, organisations and professionals working in partnership to ensure that all adults are protected from harm, abuse and neglect. This includes both the prevention of harm, abuse and neglect and how to respond to it.

What constitutes harm?

Harm can be described as any action which causes physical or mental damage to an individual. This may also include damage or theft of money or possessions as well as self-harm. Therefore, abuse and neglect are examples of harm.

The national and local context of safeguarding and protection

Several local and national frameworks, policies and agencies combine to make up the context of safeguarding and protection in the UK, including:

  • Legislation
  • Regulation
  • Organisational policies and procedures
  • Local authorities

Legislation

The primary piece of legislation related to the safeguarding and protection of adults is the Care Act 2014. This act identifies the main types of abuse/neglect, sets out the responsibilities of the various agencies, and puts emphasis on the importance of prevention and the empowerment of individuals.

A good list of other legislation relating to safeguarding and protection can be found here.

Regulation

The Care Quality Commission (CQC) is responsible for the governance and inspection of health and social care organisations and agencies. They enforce several regulations as part of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 13 is specifically concerned with safeguarding and protecting individuals receiving care services.

Policies and procedures

All health and social care organisations must have a safeguarding policy and procedure which supports employees to comply with the law and best practices. This document will describe how the organisation helps protect individuals from harm, abuse and neglect and the protocols to follow if there are allegations, suspicions or concerns.

Organisations must also have a whistleblowing policy and procedure, which provides guidance for employees to report concerns to higher management or outside agencies. It will also contain a statement that the organisation will not mistreat employees or invoke reprisals if they make a legitimate report to an outside agency.

Agencies and organisations

Local authorities are charged with leading safeguarding and protection services within their area of jurisdiction.

Their responsibilities include setting up Safeguarding Adult Boards (SABs), consisting of representatives from various local agencies, including local Clinical Commissioning Groups (CCGs) and the Police. SABs must publish an annual strategy and review of safeguarding and protection within their region. They must also commission Safeguarding Adult Reviews (SARs), formerly known as Serious Case Reviews. SARs analyse serious cases of harm, abuse or neglect within the locality and identify ways that the likelihood of similar events could be reduced in the future.

Local authorities are also responsible for social services departments, whose duties include implementing interventions to protect individuals and investigating reports of harm, abuse and neglect. Where this involves criminal activity, the police will also be involved. If harm has occurred within the workplace, the Health & Safety Executive (HSE) would be involved, and if harm is caused to individuals receiving care, the Care Quality Commission (CQC) would have a role to play.

As stated earlier, all health and social care organisations must have safeguarding and whistleblowing policies and procedures. These documents will describe their responsibilities, including treating all allegations or disclosures of abuse/neglect seriously, investigating them appropriately and reporting them to outside agencies where necessary. Similarly, all health and social care professionals have a duty of care to report any concerns they have relating to the welfare of the individuals they support.

What is a care worker’s role concerning safeguarding?

This has already been explored previously. However, to recap, all care workers are responsible for reporting all concerns they have relating to the welfare of the individuals they support. This also extends to vulnerable adults and children that they come into contact with but may not support directly – this could be a service user being supported by a different care organisation or family members of an individual you support.

If unsure about what to do, you should always approach a manager for guidance. Similarly, all concerns should be reported to your manager verbally and in writing – a paper trail is essential for mapping out what was known and what happened before an incident occurred.

If a care worker feels that their concerns have not been responded to seriously or appropriately, they should escalate it to senior management or outside agencies in line with the organisation’s whistleblowing policy and procedure.

What are the different types of abuse and neglect?

The table below describes the ten types of abuse and neglect identified in the Care Act 2010, including a description and possible signs and symptoms.

TypeDescriptionSigns/symptoms
Physical abuseHitting, kicking, burning, scalding, slapping, pushing etc.Bruises, cuts, broken bones, burns etc.
Emotional abuseControlling behaviour, threats, intimidation, harassment etc.Fear, withdrawal, crying, low self-esteem
Sexual abuseNon-consensual sexual activities etc.Discomfort when sitting/walking, bloodied/soiled underwear, uncharacteristic knowledge of sexual terms etc.
Domestic abusePhysical/emotional abuse between family members/partners etc.Same as physical/emotional
Financial abuseTheft, fraud, coercion, use without permission etc.Unusual lack of money or property, poor living conditions etc.
Institutional abuseNon-person-centred care, institutional rules that go against an individual’s rights etc.All individuals eating and going to bed at the same time etc.
Modern slaveryDomestic servitude, forced labour, human trafficking etc.Fear, withdrawal and isolation, no personal possessions, unable to speak language etc.
DiscriminationMistreating an individual based on a protected characteristicUnfair policies, depression and anxiety amongst minority groups etc.
NeglectAn individual’s basic needs not being met by those charged with their carePoor living conditions, soiled clothes/skin, malnutrition, dehydration, bad smells
Self-neglectAn individual not being able to or not wanting to handle their own basic needsSame as neglect
Types of abuse/neglect and signs/symptoms

What are restrictive practices?

Restrictive practices refer to interventions whereby force is used to restrict an individual’s movement or freedom. This can include:

  • Physical restraints (e.g. straps, belts etc.)
  • Environmental restraints (e.g. locked doors, locked food cupboards etc.)
  • Chemical restraints (e.g. sedatives etc.)
  • Psychological restraints (e.g. threats, coercion etc.)

All health and social care workers must understand that restrictive practices should not be used unless absolutely necessary to protect the individual or others from harm. In addition, restrictive practices must:

  • be legally justified
  • the least restrictive option must be used
  • not be in place for longer than is necessary

Factors that can make an adult more vulnerable to abuse

Several factors can make an individual more susceptible to abuse, including:

  • Being dependent on others
  • Not understanding their rights
  • Being unable to protect themselves
  • Being institutionalised
  • Lack of support
  • Poorly trained or highly stressed carers
  • Physical, mental or cognitive disabilities

How to reduce the likelihood of abuse

There are several ways that the likelihood of abuse can be reduced, which are explored below:

Person-centred practices

Person-centred practice is a way of working that puts individuals at the centre of their care and empowers them to be involved and make their own choices. By empowering individuals to take control of their care, feel respected and valued, and have confidence and self-esteem, they are less likely to be abused and more likely to speak out if they are not happy with something.

Active participation

Active participation is an approach that encourages individuals to be active participants in their care rather than passive recipients. Again, by ensuring that individuals are empowered, they can better understand their rights, protect themselves and speak up.

Promotion of rights and choice

By promoting an individual’s rights and ensuring they can make their own decisions, they are more likely to notice if they can no longer exercise their rights and freedoms and voice their concerns.

Awareness of personal safety

Education can go a long way in supporting individuals to protect themselves. By simply understanding how they can maintain their personal safety and providing them with the resources to do so, the likelihood of them being abused can be reduced. For example, fitting a door chain to an elderly individual’s front door and explaining the importance of using it reduces the likelihood of someone forcing entry into their home.

Prevention

The Care Act 2014 emphasises proactive strategies relating to preventing harm, abuse and neglect, being preferable to reactive strategies after the fact. Prevention can include:

  • Awareness and training
  • Advocacy
  • Robust policies and procedures
  • Empoweringindividuals

Managing risk

Risk is a core component of life, and when empowering individuals to make their own decisions, there will be some inherent risk in the choices that they make. Risk assessment can be used to identify the risks and put safeguards in place to reduce the risk of harm as much as possible or even eliminate it completely. This process can also support individuals in understanding the risks and benefits of their various choices and making informed decisions.

Complaints procedures

All health and social care organisations should have an accessible, transparent and robust complaints policy and procedure. Anyone that comes into contact with the organisation should be made aware of this and encouraged to provide feedback and report any concerns.

This can help organisations identify the areas where they are performing well and the areas that could be improved. By understanding areas of practice that fall below expected standards, organisations can introduce changes that improve the quality of care and reduce the likelihood of individuals being abused.

How to respond to suspected or alleged abuse

Your organisation’s Safeguarding Policy and Procedure will describe how suspected or alleged abuse will be handled and how it should be reported.

Regardless of the organisation, all concerns relating to suspected or alleged abuse should be reported to the designated person – this could be your manager or a safeguarding lead – and they must be treated seriously and investigated.

Disclosures of abuse

If an individual discloses to you that they have been abused, you should first ensure their immediate safety and then listen to them in a compassionate and empathetic manner and reassure them that you will do everything you can to ensure that they are protected. However, you should not make promises that you cannot keep. For example, if the individual asks you to keep it a secret, you must inform them that you have a duty of care to report it to protect the individual and others. This is one of the few mitigating circumstances where confidentiality may be broken.

Preserving evidence

If there is evidence that abuse has occurred, you should do your best to preserve it as much as possible (and only as long as it is safe to do so). Ways of preserving evidence can include:

  • Taking photographs of crime scenes
  • Taking photographs of injuries
  • Requesting that the individual does not wash themselves or their clothes/bedding(in cases of sexual abuse)
  • Making copies of information, such as emails or bank statements

How to recognise and report unsafe practices

Unsafe practices are any working practices that have the potential to cause harm. Examples of unsafe practices include:

  • the use of defective equipment
  • using restrictive practices without justification
  • not following procedures correctly

All unsafe practices must be reported immediately according to organisational policies and procedures. It is also recommended to make a written record of the concern.

If concerns are not dealt with appropriately, it may be necessary to escalate it according to the organisation’s Whistleblowing Policy and Procedure.

Online Safety

There are several risks to the well-being of vulnerable adults through the use of Internet-related technologies, so it is essential to be aware of them and how they can be prevented.

Communication

Communication technologies can include SMS messaging, phone calls, video calls/conferencing and email.

These channels are often one-to-one, which means that individuals can be vulnerable to personal threats, coercion, harassment, bullying, social engineering, fraud and deception.

Users of communication technologies should be provided with information and awareness about the associated risks and what they can do if they are unsure or afraid. Maintaining bonds of mutual trust, having appropriate support networks and being open with one another can help to prevent individuals becoming victims of abuse.

Social media

Similarly, social media apps, such as Facebook, Twitter, Whatsapp and Instagram, have direct messaging capabilities. In addition, users are encouraged to publish personal information about themselves, such as their location, what they are doing and their likes/dislikes. Unscrupulous individuals may use this information to take advantage of them. For example, if an individual writes that they are away on holiday, a burglar would know that there is nobody home.

Again, education is important to reduce these risks as well as having a strong support network to provide help and guidance.

Internet access

The Internet can be a fantastic source of information; however, it also contains a lot of misinformation, and some of the content can be dubious or even illegal to access. This means that individuals may unwittingly view unlawful content, resulting in potential mental trauma or a warped understanding of what is appropriate.

Individuals should be informed of the dangers of Internet usage. To protect particularly vulnerable individuals, software or firewalls may be used to restrict access to suspect material.

Banking

Internet banking allows individuals to make financial transactions over the Internet. Whilst this can be useful and efficient, it also means additional risks relating to theft and fraud.

Individuals should be advised not to share their usernames and passwords with anyone else and log out of their banking app immediately after use.

Risks & benefits

It would not be appropriate for a care worker to tell an individual that they cannot use technology because of the potential risks – this would constitute abuse in itself as it denies them their rights and the opportunity to make their own choices. Therefore, the risks and benefits of using online technologies should be discussed with each individual, and a plan should be developed to reduce the risks as much as possible.

There may be justification for preventing individuals from using technology in some cases. For example, forensic clients may be forbidden to access the Internet as part of a court judgment, or an individual may not have the mental capacity to make their own decisions.

How to obtain further information

If you need to know more about safeguarding and protection, there are several sources of support, including:

  • Your manager/safeguarding lead
  • Safeguarding/whistleblowing policies and procedures
  • Formal/informal training
  • Coaching/mentoring
  • CQC
  • HSE
  • The local authority
  • Own research