A service’s safeguarding strategy should be comprehensive based on a zero-tolerance approach to all forms of abuse. Chris Payne explains how it can be shaped by taking the following steps, using the stated resources.
Promote the idea that safeguarding is everyone’s responsibility
Everyone from birth onwards has a basic need to be safe and secure from harm to grow as a person and to develop a sense of wellbeing in later life. This self-evident truth is well recognised in the laws and regulations that protect people from coming to harm. They are all based on the idea that safeguarding is everyone’s responsibility. (See Safeguarding Service Users from Abuse or Harm: The Policy Context topic.)
Understand the laws on safeguarding
The Care Act 2014 requires local authorities to have structures and strategies to keep all vulnerable people who fall within their sphere of responsibility safe from harm. Registered care providers must then comply with the safeguarding provisions of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which also require them to implement their respective local authority safeguarding policies and strategies and to work in partnership with them. There are similar laws and regulations for other UK countries.
Study the relevant regulations
The key regulation is 13, “Safeguarding Service Users from Abuse”. This makes clear that care providers must take a zero-tolerance approach to all forms of abuse, which includes neglect and “acts of omission”, degrading treatment, disproportionate restraint and the unauthorised deprivation of a person’s liberty. The regulation recognises that people who lack mental capacity are particularly vulnerable and might require specific measures to protect their rights; issues that are addressed in the Mental Capacity and Human Rights and Deprivation of Liberty topics.
Understand how inspectors assess on how well you are keeping people safe
Inspectors can be expected to give high priority to a care service’s safeguarding practices. To assess how well a service is keeping its users safe from harm they search for evidence against a set of questions included under the KLOE key question “Is it Safe”? (S1.1–S1.4). You can use the self-audit tool for Regulation 13, “Safe 1: Safeguarding People Who Use Services from Abuse and Avoidable Harm” to check that your service users are well protected from any form of abuse, and that you will be meeting inspection requirements.
Develop your safeguarding policies and procedures
Regulation 13 requires care providers to “have robust procedures and processes” to keep people safe from any form of abuse. Abuse takes many forms with each requiring consideration in terms of policy and procedures. Linked to the Safeguarding: Developing Sound Practice topic is a library with over 40 model policies on safeguarding issues, some of which reflect the different policy contexts of England, Wales and Scotland. There is a key overarching Safeguarding Service Users from Abuse or Harm Policy for care homes and domiciliary services respectively with others covering specific forms of abuse such as: financial abuse (care homes), financial abuse (domiciliary care), emotional and social abuse, use of restraint (care homes), use of restraint (domiciliary care), particularly in situations of challenging behaviour, missing persons, the safeguarding of “high risk” service users, and the safeguarding of children in care homes, or in domiciliary care situations, in the delivery of adult care.
Ensure that your staff understand and can implement your safeguarding policies and procedures through training and supervision
Regulation 13 also requires care providers to make staff familiar with all safeguarding policies and procedures, and to implement them as necessary. Staff training in safeguarding is clearly important from induction onwards. You could use, for example, the Safeguarding Vulnerable Adults Training Presentation as an introduction for all staff. You will also need to make training provision in line with your local safeguarding board requirements and recommendations (as will be found on the respective websites). You will further need to ensure that all training is backed up through staff supervision so that you can check that your staff understand and can put into practice what they have covered in any safeguarding training.
Act promptly when people are being harmed or at risk of being harmed
Anyone involved in a care situation might allege that they as a service user or another has been abused. Care staff have a special responsibility to identify, promptly report and record suspected, alleged or evident acts of abuse. They might refer to the Checklist on Safeguarding Practice to show that their actions are in line with the procedures. Managers must act on every report from any source by promptly addressing and assessing the situation, and deciding on an appropriate course of action. They might refer to the Safeguarding: Manager’s Suspected Abuse Action Plan in this process.
Alert your local safeguarding team
Where there is evidence of potential or actual abuse, managers should promptly alert their local adults’ safeguarding authority, following the procedures that will be described on its website.
Reports of abuse must also be notified to the Care Quality Commission under its notification procedures; a model policy provides guidance on this. It is important than to work in partnership with the local safeguarding team in terms of further investigation and the implementation of any agreed protection plans.
Promote a transparent and open safeguarding culture
An “outstanding” service is more likely to have leaders that are committed to zero tolerance of abuse by freeing up people to discuss openly any concerns so that acts of abuse are never driven under the carpet. The service’s “Whistleblowing” Policy, will then act as a backstop, enabling staff to report in confidence and without fear of negative comeback incidents that they genuinely consider they cannot report by more open means. There needs to be continuous monitoring and reviewing of all safeguarding issues, where users can be made of the Safeguarding: Managers’ Audit Checklist. The leadership style that is required for an open and transparent culture is discussed in the Leadership and Management and the Care Service as a Learning Organisation topics.
Ensure that your staff are also well protected
Staff must also feel safe and secure to provide good care confidently and competently. Their needs for protection are addressed in a separate topic Violence and Aggression Towards Staff, which includes model policies on keeping staff safe and lone working.
Close attention to all these aspects should result in a service in which safeguarding becomes everyone’s responsibility to keep everyone safe.