Safeguarding Adults

Safeguarding means protecting an adult's right to live safely, free from abuse and neglect — while respecting that adults, unlike children, generally have the right to make their own choices, including ones others dislike. Good safeguarding balances protection with the person's own view of the life they want to lead.

Abuse rarely announces itself. It looks like a pension book that is always "being looked after" by a relative, a person who flinches when a certain worker is on shift, weight quietly falling off, or someone giving up activities they loved. Care workers are often the only outsiders who see a person regularly, which is why the system depends on you noticing and speaking up.

Your job when you have a concern is small and vital: make the person safe, report it promptly, and record the facts. Deciding what happened is somebody else's job — the local authority leads enquiries, sometimes with police. Workers who quietly "keep an eye on it" instead of reporting are, with the best of intentions, giving abuse more time.

• Care Act 2014, section 42: the local authority must make enquiries (or ask others to) when the three-part test is met: an adult with care and support needs, experiencing or at risk of abuse or neglect, unable to protect themselves because of those needs.
• Care Act sections 43–45: every area must have a Safeguarding Adults Board (SAB), which conducts Safeguarding Adults Reviews when people die or are seriously harmed and lessons may exist.
• Care and Support statutory guidance (chapter 14): defines the ten categories of abuse and sets out Making Safeguarding Personal.
• Regulation 13 of the 2014 Regulations: providers must have systems to prevent abuse, and allegations trigger statutory notification to CQC.
• Mental Capacity Act 2005: governs decisions where the adult may lack capacity to decide about protection, and wilful neglect or ill-treatment of a person lacking capacity is a criminal offence (section 44).
• Criminal law applies as usual — theft, assault, fraud and sexual offences do not stop being crimes because they happen in a care setting.
• In 2026 the Casey Commission recommended, and government accepted, work towards a new national safeguarding board structure — watch GOV.UK for how this develops.

CQC expects every member of staff — including cooks, drivers and domestics — to recognise possible abuse and know exactly what to do about it, including how to escalate outside the organisation if managers do not act. Providers must show safeguarding training with real understanding behind it, safe recruitment, a current safeguarding policy naming the local authority contact route, notifications sent for allegations, and evidence that concerns led to action and learning.

Assessors often ask care workers directly: "What would you do if you thought someone was being abused?" A confident, specific answer — manager, safeguarding lead, local authority, CQC if needed, record the facts — says more than any policy document.

• When someone discloses: stay calm, listen, take it seriously. Don't promise to keep it secret. Don't ask leading questions ("Did John hit you?") — use open ones ("Can you tell me what happened?"). Write down their exact words as soon as you can.
• Immediate danger: 999 first. Medical need: treat first. Process never outranks safety.
• Preserve evidence: don't wash clothing or bedding after a possible assault, don't tidy the scene, don't handle documents more than needed.
• Report the same shift to your manager or safeguarding lead. If they are implicated or do nothing, go up a level, to the local authority directly, or to CQC — that is protected whistleblowing.
• Record facts, not theories: what you saw, when, where, who was present, exact words, injuries on a body map. "Sock-shaped bruise, left ankle, 4cm" beats "seems to have been grabbed".
• Making Safeguarding Personal: ask the person what outcome they want — an apology, new locks, a different worker, prosecution, or simply for it to stop. Their wishes lead unless others are at risk or they lack capacity to decide.
• Consent to refer: seek it where safe; you can proceed without it if others are at risk, a crime is suspected, or the person lacks capacity and referral is in their best interests. Record the reasoning.

Example 1. A home care worker notices her client, who has dementia, has almost no food in the flat again, despite a son collecting her pension weekly "for shopping". The worker doesn't confront the son or mention her suspicion to him. She reports to her coordinator before the end of shift, records dates and what she observed, and the coordinator raises a safeguarding concern with the council. A section 42 enquiry later puts appointeeship and shopping support in place — the client keeps her relationship with her son, with the money risk removed.

Example 2. A resident tells a night care assistant, "Don't tell anyone, but the tall one is rough with me." The assistant replies honestly: "Thank you for telling me. I can't keep it secret because I care about you being safe — but I will make sure the right people handle it kindly." She records the exact words at 03:10, wakes the senior, and the provider suspends the worker pending enquiry, notifies CQC and the local authority, and arranges for the resident to be supported by staff she trusts while her views on what she wants to happen are heard.