A11: Safeguarding

• Safeguarding in the health sector

  Protection of health, wellbeing and rights of individuals
• Key principles of safeguarding in the health sector

  • Empowerment
  • Prevention
  • Proportionality
  • Protection
  • Partnership
  • Accountability
• Empowerment

  The individual should be supported to make their own decisions based on best possible information
• Prevention

  Better to take action before harm occurs
• Proportionality

  Actions should be proportionate to the risk, being overprotective can disadvantage service users to be able to make their own decisions
• Protection

  Service users who are in greatest need of support and protection
• Partnership

  Working with a range of professionals, groups and communities to prevent, detect and report neglect or abuse
• Accountability

  Healthcare professionals need to be accountable for any activities in relation to safeguarding
• Safeguarding is important for protection from harm, abuse and neglect
• Mental Capacity Act (2005) plus Amendment (2019)


  Provides a framework for the implement of the principles and provisions to empower and protect individuals
• Liberty Protection Safeguards (LPS)

  Used to protect individuals who lack capacity to consent to their care arrangements
• Care Act (2014)


  • Outlines the general responsibilities of local authorities including: Safeguarding Adults Boards, Safeguarding Adult Reviews, Implements a multi-agency local adult safeguarding system, Arranges independent advocates
• Health and Care Act (2022)

  • Establishes Integrated Care Systems (ICS), Integrated Care Boards (ICB), Integrated Care Partnership (ICP), Promotes collaborative and partnership working to integrate services including social care to improve patient care and safeguard individuals
• Safeguarding Vulnerable Groups Act (2006)

  • Establishes Disclosure and Barring Service (DBS) checks to prevent individuals deemed unsuitable to work with children or vulnerable adults from gaining access to them through their work
• Mental Health Act 2007


  Sets out when someone can be detained and treated for a mental health disorder
• Equality Act 2010

  Provides legal protection for individuals from discrimination within society
• Human Rights Act 1998


  Sets out the fundamental rights and freedoms that individuals are entitled to
• Domestic Abuse Act (2021)


  Provides a framework designed to support organisations to identify and respond to domestic abuse and promote best practice
• NICE guidance and quality standards

  Defines guidance and quality standards in relation to safeguarding adults, children and young people with different conditions in a variety of settings (for example schools, care homes and support services across health and social care)
• NHS England guide

  Defines guidance in relation to safeguarding requirements to comply with legislation and regulations within health and social care services and settings
• Factors that can contribute to abuse: 

  • age 
  • individuals with health issues 
  • being physically dependent on others 
  • lack of mental capacity 
  • previous history of abuse 
  • social isolation 
  • drug/alcohol abuse 
  • finance 
  • religion 
  • Vulnerable groups: 
  • children and young people/elderly people 
  • adults receiving care in their homes 
  • individuals with physical, mental or sensory impairments 
  • individuals with learning disabilities 
  • ethnic minorities and ethnic groups 
  • socio-economically disadvantaged individuals 
• Types of abuse and harm

  • Physical
  • Modern day slavery
  • Sexual
  • Emotional
  • Coercion/control
  • Organisational/institutional
  • Financial
  • Neglect
  • Domestic
  • Professional abuse
  • Honour-based abuse
  • Violence
  • Cruelty
  • Forced marriage
  • Child sexual exploitation
  • Child criminal exploitation
• Physical abuse

  • Female genital mutilation
  • Hitting
  • Burns
• Modern day slavery

  • Exploitation of individuals for work using threats and violence
• Sexual abuse

  • Forcing someone to take part or watch sexual activities
• Emotional abuse

  • Belittling
  • Bullying
  • Verbal abuse
  • Gaslighting
• Coercion/control

  • Assaults
  • Threats and intimidation
  • Humiliation
• Organisational/institutional abuse

  • Regimented mealtimes
  • Removing personal choices
• Financial abuse

  • Withholding/taking of money
• Neglect

  • Self-neglect
  • Neglect by others
• Domestic abuse


  • Abuse that takes place in the home by a family member
• Professional abuse

  • Abuse by someone in a position of power over the victim or a position of trust
• Physical: 

  • Possible signs: 
  • bruising 
  • unexplained bleeding 

  Emotional: 

  • Possible signs: 
  • depression 
  • low self-esteem 

  Organisational: 

  • Possible signs: 
  • restricted visiting times 
  • patient complaints 

  Financial: 

  • Possible signs: 
  • lack of money and/or belongings 
  • debt 

  Sexual: 

  • Possible signs: 
  • unwanted pregnancy 
  • sexually transmitted infection 
  • sexual promiscuity 

  Neglect: 

  • Possible signs: 
  • unkempt appearance
  • malnutrition 
• What action to take if abuse is suspected or disclosed

  1. Communicate with the individual

  2. Reporting

  3. Preserving evidence
• Communicate with the individual

  • Respecting confidentiality balanced with assessing risk
  • Ensure a record of any disclosure is recorded word for word (for example using safeguarding disclosure form/safeguarding incident report form)
• Reporting

  • Knowledge of the reporting procedure and report line
  • Report instance but don't intervene unless immediate or imminent threat to safety
  • Understand the next point of escalation if suspected abuse not investigated
  • Ability to challenge authority
• Preserving evidence

  • Documentation of facts
  • Observation charts
  • Clinical photography
• A11.7 Action that can be taken by individuals and organisations to reduce the chances of abuse: 

  • Raising awareness and educating 
  • Staff training 
  • Whistleblowing procedure 
  • Effective complaints procedure 
  • Risk management procedure 
  • Risk assessment for each individual case 
  • Working with person-centred values 
  • Multi-agency working 
  • Implementing holistic approaches 
  • Accessing and promotion of advocacy
• A11.8 The meaning of patient safety and clinical effectiveness including why they’re important: 

  • Patient safety: 
  • Meaning: the avoidance of accidental or unintended injury or harm during a period of receiving healthcare. 
  • Clinical effectiveness:
  • Meaning: the application of healthcare, taking into consideration the individual’s wishes, healthcare professional’s experience, and evidence-based research in the approach.
  • Why they’re important: 
  •  raises the standard of care improving the patient’s experience and quality.
  • avoids negative outcomes for the provision of care.
• Radicalisation

  The action or process of someone to adopt or support terrorism, or radical extremist beliefs connected with terrorism or terrorist groups