Safeguarding in Care & Support Services

Understanding Safety, Rights, Quality of Care and Protection from Abuse Everyone receiving care or support has the right to be treated with dignity, respect, compassion and fairness. Care services should promote wellbeing, independence, choice, safety and human rights. Safeguarding in care and support services helps protect people from: Abuse. Neglect. Exploitation. Harm. Discrimination. Poor care. Unsafe treatment. This guide explains abuse in care settings, abuse by carers, institutional abuse, care standards, safeguarding responsibilities, reporting concerns and legal protections across England. This information is intended for general guidance only and does not constitute legal advice.

What is Safeguarding?

Protecting Adults and Children

Safeguarding means protecting people's:

• Safety.
• Wellbeing.
• Rights.
• Dignity.
• Independence.

Safeguarding applies to:

• Care homes.
• Hospitals.
• Supported living.
• Home care services.
• Residential schools.
• Day services.
• Community support services.

Care Act 2014

Care Act 2014

Abuse in Care Homes

Understanding Care Home Abuse

Care home residents should receive safe, compassionate and person-centred care.

Abuse may include:

• Physical abuse.
• Emotional abuse.
• Financial abuse.
• Neglect.
• Sexual abuse.
• Discriminatory abuse.
• Organisational abuse.

Warning signs may include:

• Unexplained injuries.
• Poor hygiene.
• Weight loss.
• Fearfulness.
• Lack of medical attention.
• Restricted freedoms.

Abuse in Hospitals

Patient Rights and Safety

Hospital patients should receive care that is:

• Safe.
• Respectful.
• Dignified.
• Lawful.
• Evidence-based.

Concerns may involve:

• Neglect.
• Poor treatment.
• Unsafe care.
• Abuse.
• Failure to meet needs.

NHS Complaints Information

NHS Complaints Procedure

Abuse in Supported Living

Protecting Independence and Safety

Supported living services should promote:

• Independence.
• Choice.
• Safety.
• Inclusion.

Abuse may occur through:

• Financial exploitation.
• Coercive control.
• Neglect.
• Emotional abuse.
• Restricting freedoms.

People living in supported accommodation retain the same legal rights as anyone else.

Abuse by Carers

Understanding Carer Abuse

Most carers provide valuable support.

However, abuse can occur in some situations.

Examples may include:

• Physical abuse.
• Emotional abuse.
• Financial abuse.
• Neglect.
• Coercive behaviour.
• Restricting contact with others.

Abuse can be intentional or arise from unmet support needs, stress or inadequate services.

Safeguarding concerns should always be assessed seriously.

Institutional Abuse

Organisational Failures

Institutional abuse occurs when systems, practices or cultures within organisations cause harm.

Examples may include:

• Poor care standards.
• Excessive restrictions.
• Ignoring complaints.
• Lack of dignity.
• Unsafe practices.
• Failure to respect rights.

Institutional abuse can affect:

• Care homes.
• Hospitals.
• Residential services.
• Educational settings.
• Secure settings.

Neglect in Care Settings

Failure to Meet Needs

Neglect may involve:

• Inadequate food or hydration.
• Poor hygiene support.
• Failure to provide medication.
• Lack of healthcare access.
• Unsafe living conditions.

Neglect can have serious physical and emotional consequences.

Physical Abuse

Unlawful Harm

Physical abuse may include:

• Hitting.
• Pushing.
• Rough handling.
• Misuse of restraint.
• Inappropriate force.

Physical abuse may constitute a criminal offence.

Emotional & Psychological Abuse

Protecting Dignity

Emotional abuse may involve:

• Humiliation.
• Threats.
• Intimidation.
• Isolation.
• Bullying.
• Coercive behaviour.

Everyone has the right to be treated with dignity and respect.

Financial Abuse

Protecting Assets and Money

Financial abuse may include:

• Theft.
• Fraud.
• Misuse of benefits.
• Coercion relating to money.
• Pressure regarding wills or property.

Age UK

Age UK

Sexual Abuse

Protection from Sexual Harm

Sexual abuse includes any sexual activity that is unwanted, non-consensual or exploitative.

Concerns should be reported immediately.

Rape Crisis

Rape Crisis England & Wales

Restrictive Practices

Balancing Safety and Rights

Restrictive practices may include:

• Physical restraint.
• Seclusion.
• Restrictions on movement.
• Restrictions on communication.

Any restrictions should be:

• Lawful.
• Necessary.
• Proportionate.
• In the person's best interests where applicable.

Mental Capacity & Decision-Making

Supporting Choice

Adults should be assumed capable of making decisions unless assessed otherwise.

The Mental Capacity Act 2005 provides safeguards where people may struggle to make certain decisions.

Key principles include:

• Supporting decision-making.
• Respecting autonomy.
• Least restrictive options.

Mental Capacity Act

Mental Capacity Act 2005

Deprivation of Liberty Safeguards (DoLS)

Protecting Rights

DoLS help protect people who may need restrictions for their safety and care.

Restrictions must be:

• Lawful.
• Authorised.
• Necessary.
• Proportionate.

NHS DoLS Information

Deprivation of Liberty Safeguards Information

Care Quality Commission (CQC)

Independent Care Regulator

The Care Quality Commission regulates health and adult social care services in England.

The CQC:

• Inspects services.
• Monitors standards.
• Investigates concerns.
• Publishes inspection reports.

Care Quality Commission

Care Quality Commission (CQC)

Checking Care Quality

Before Choosing a Service

People can review:

• Inspection reports.
• Ratings.
• Enforcement actions.
• Provider information.

Find Care Services

Find and Compare Care Services

Reporting Concerns About Care

Speaking Up About Concerns

Concerns can often be raised with:

• Care providers.
• Managers.
• Safeguarding teams.
• Local authorities.
• Healthcare organisations.

Complaints should be investigated fairly and appropriately.

Adult Safeguarding Referrals

Reporting Abuse or Neglect

Safeguarding concerns may be reported to:

• Local authority adult safeguarding teams.
• Social services.
• Police.
• Healthcare providers.

Find Local Council

Find Your Local Council

Advocacy Support

Independent Support

Advocates may help people:

• Understand their rights.
• Express their wishes.
• Participate in decisions.
• Challenge poor treatment.

VoiceAbility

VoiceAbility Advocacy Services

Complaints About Care Services

Raising Formal Complaints

Individuals can complain about:

• Poor care.
• Unsafe treatment.
• Staff behaviour.
• Service failures.

Local Government & Social Care Ombudsman

Local Government and Social Care Ombudsman

Parliamentary and Health Service Ombudsman

Parliamentary and Health Service Ombudsman

Whistleblowing in Care Services

Protecting People Who Speak Up

Staff should be able to raise concerns about:

• Abuse.
• Neglect.
• Unsafe care.
• Poor practice.

Whistleblowers may have legal protections.

Protect (Whistleblowing Advice)

Protect Whistleblowing Advice

Additional Safeguarding in Care & Support Services Topics

Care Home Safeguarding

Care homes should provide safe, compassionate, person-centred care that respects dignity, independence and wellbeing.

Safeguarding responsibilities include:

• Preventing abuse and neglect.
• Protecting residents from harm.
• Promoting dignity and choice.
• Supporting human rights.
• Responding appropriately to concerns.

Care Quality Commission (CQC)

https://www.cqc.org.uk

Neglect in Care Homes

Recognising Neglect

Neglect may involve:

• Failure to provide food or drink.
• Poor hygiene support.
• Failure to provide medication.
• Inadequate healthcare access.
• Unsafe living conditions.
• Lack of supervision where required.

Warning signs may include:

• Weight loss.
• Pressure sores.
• Poor personal hygiene.
• Deteriorating health.
• Emotional distress.

Medication Errors

Safe Medication Management

Medication errors may include:

• Wrong medication.
• Incorrect dosage.
• Missed medication.
• Delayed medication.
• Poor record keeping.

Care providers should have systems to ensure safe medication administration.

NHS Patient Safety

https://www.england.nhs.uk/patient-safety

Malnutrition & Dehydration

Protecting Health and Wellbeing

People receiving care should have access to:

• Nutritious food.
• Adequate fluids.
• Dietary support.
• Specialist nutritional care where needed.

Particular attention may be needed for:

• Older people.
• People with dementia.
• People with disabilities.
• People with swallowing difficulties.

NHS Nutrition Information

https://www.nhs.uk/live-well/eat-well

Falls Prevention

Reducing Injury Risks

Falls may have serious consequences for vulnerable adults.

Prevention measures may include:

• Mobility assessments.
• Environmental safety checks.
• Appropriate equipment.
• Medication reviews.

NHS Falls Prevention

https://www.nhs.uk/conditions/falls

Infection Control

Preventing Illness

Care providers should maintain effective infection prevention measures.

This may include:

• Hygiene procedures.
• Handwashing.
• Vaccination programmes.
• Safe food preparation.
• Cleaning standards.

UK Health Security Agency

https://www.gov.uk/government/organisations/uk-health-security-agency

End-of-Life Care Standards

Compassionate Care

People nearing the end of life should receive:

• Dignity.
• Respect.
• Pain management.
• Emotional support.
• Family involvement where appropriate.

NHS End of Life Care

https://www.nhs.uk/conditions/end-of-life-care

Marie Curie

https://www.mariecurie.org.uk

Hospital Safeguarding

Protecting Patients

Hospitals should maintain safeguarding systems that protect:

• Children.
• Vulnerable adults.
• Mental health patients.
• People with disabilities.

NHS Safeguarding

https://www.england.nhs.uk/safeguarding

Patient Safety Incidents

Learning from Harm

Patient safety incidents may involve:

• Medication errors.
• Falls.
• Treatment delays.
• Misdiagnosis.
• Equipment failures.

Healthcare providers should investigate incidents and learn from them.

NHS Patient Safety

https://www.england.nhs.uk/patient-safety

Duty of Candour

Being Open and Honest

Health and care providers have responsibilities to be open and honest when things go wrong.

This includes:

• Informing affected individuals.
• Providing explanations.
• Offering apologies where appropriate.
• Learning from mistakes.

CQC Duty of Candour

https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-20-duty-candour

Mental Health Hospital Safeguarding

Protecting Patients

Mental health services should provide:

• Safe treatment.
• Respectful care.
• Human rights protections.
• Appropriate safeguarding procedures.

Care Quality Commission

https://www.cqc.org.uk

Maternity Safety

Protecting Parents and Babies

Maternity services should promote:

• Safe pregnancy care.
• Safe childbirth.
• Postnatal support.
• Respectful care.

NHS Maternity Services

https://www.nhs.uk/pregnancy

Learning from Serious Incidents

Improving Care

When serious incidents occur, organisations should:

• Investigate appropriately.
• Identify lessons learned.
• Improve systems and procedures.
• Reduce future risks.

Supported Living Safeguarding

Safe Independent Living

Supported living services should balance:

• Independence.
• Choice.
• Safety.
• Dignity.
• Inclusion.

People should be involved in decisions affecting their lives wherever possible.

Direct Payments & Personal Budgets

Choice and Control

Direct payments and personal budgets allow some individuals greater control over their care arrangements.

Support should remain:

• Safe.
• Transparent.
• Person-centred.

NHS Personal Health Budgets

https://www.england.nhs.uk/personal-health-budgets

Personal Assistants & Care Workers

Safe Care Provision

People employing personal assistants should receive information about:

• Safe recruitment.
• DBS checks.
• Employment responsibilities.
• Safeguarding.

Community Support Services

Supporting Independent Living

Community support may include:

• Day services.
• Outreach support.
• Social activities.
• Healthcare support.
• Advocacy services.

Mate Crime

Exploitation Disguised as Friendship

Mate crime occurs when someone exploits or abuses a vulnerable person whilst pretending to be their friend.

This often affects:

• Disabled people.
• People with learning disabilities.
• Socially isolated individuals.

Ann Craft Trust

https://www.anncrafttrust.org

Cuckooing

Criminal Exploitation of Homes

Cuckooing occurs when criminals take over the home of a vulnerable person for criminal purposes.

Victims often require safeguarding support.

Crimestoppers

https://crimestoppers-uk.org

Financial Exploitation

Protecting Assets

Financial exploitation may include:

• Theft.
• Fraud.
• Pressure regarding finances.
• Misuse of benefits.
• Coercive control.

Age UK

https://www.ageuk.org.uk

Disability Hate Crime

Protection from Targeted Abuse

Disabled people have the right to live free from:

• Harassment.
• Intimidation.
• Violence.
• Hate crime.

Stop Hate UK

https://www.stophateuk.org

Online Abuse of Vulnerable Adults

Digital Safeguarding

Online abuse may include:

• Fraud.
• Grooming.
• Harassment.
• Financial exploitation.
• Coercive control.

National Cyber Security Centre

https://www.ncsc.gov.uk

Sexual Exploitation of Vulnerable Adults

Safeguarding Adults

Adults may be vulnerable due to:

• Disability.
• Mental health difficulties.
• Dependency.
• Social isolation.

Concerns should be reported through safeguarding procedures.

Rape Crisis

https://rapecrisis.org.uk

Best Interests Decisions

Mental Capacity Act Principles

Where someone lacks capacity for a specific decision, decisions should be made in their best interests.

This should include:

• Their wishes.
• Their values.
• Family input where appropriate.
• Least restrictive options.

Mental Capacity Act 2005

https://www.legislation.gov.uk/ukpga/2005/9/contents

Lasting Powers of Attorney

Planning for the Future

A Lasting Power of Attorney (LPA) allows a person to appoint someone they trust to make decisions if they lose capacity.

Office of the Public Guardian

https://www.gov.uk/power-of-attorney

Court of Protection

Protecting Vulnerable Adults

The Court of Protection makes decisions relating to:

• Mental capacity.
• Welfare decisions.
• Financial matters.

Court of Protection Information

https://www.gov.uk/courts-tribunals/court-of-protection

Liberty Protection Safeguards (LPS)

Protecting Liberty Rights

LPS are intended to replace Deprivation of Liberty Safeguards and provide legal protection where restrictions are necessary and lawful.

NHS Information

https://www.nhs.uk

Advance Decisions

Future Healthcare Choices

Advance decisions allow individuals to record certain treatment wishes in advance.

NHS Advance Decisions

https://www.nhs.uk/conditions/end-of-life-care/planning-ahead/advance-decision-to-refuse-treatment

Carers' Rights

Support for Carers

Carers may have rights relating to:

• Assessments.
• Support services.
• Employment protections.
• Financial assistance.

Carers UK

https://www.carersuk.org

Young Carers

Protecting Young People

Young carers may require:

• Educational support.
• Emotional support.
• Safeguarding.
• Practical assistance.

The Children's Society

https://www.childrenssociety.org.uk

Carer Assessments

Understanding Support Needs

Local authorities may assess carers' needs and identify available support.

Carers Assessments

https://www.gov.uk/carers-assessment

Respite Care

Taking Breaks from Caring

Respite services can provide temporary support and help carers maintain their wellbeing.

Carers Trust

https://carers.org

Safeguarding Adults Reviews (SARs)

Learning from Serious Cases

SARs examine serious safeguarding cases to identify lessons and improve future practice.

Local Safeguarding Adults Boards

https://www.local.gov.uk

Professional Standards

Accountability

Care professionals should maintain:

• Competence.
• Integrity.
• Respect.
• Professional boundaries.

Professional Standards Authority

https://www.professionalstandards.org.uk

DBS Checks

Safer Recruitment

Disclosure and Barring Service (DBS) checks help organisations make safer recruitment decisions.

DBS

https://www.gov.uk/government/organisations/disclosure-and-barring-service

Fitness to Practise Concerns

Professional Regulation

Concerns about professional conduct may be reported to relevant regulators.

Examples include:

• Nursing and Midwifery Council.
• General Medical Council.
• Social Work England.

Professional Standards Authority

https://www.professionalstandards.org.uk

Disability Rights in Care

Equality and Inclusion

Disabled people should receive:

• Equal access.
• Reasonable adjustments.
• Accessible services.
• Respectful treatment.

Disability Rights UK

https://www.disabilityrightsuk.org

Autism & Care Services

Autism-Inclusive Care

Care services should understand:

• Communication needs.
• Sensory needs.
• Routine and predictability.
• Individual preferences.

National Autistic Society

https://www.autism.org.uk

Learning Disabilities & Care

Person-Centred Support

People with learning disabilities should receive support that promotes:

• Independence.
• Choice.
• Inclusion.
• Dignity.

Mencap

https://www.mencap.org.uk

Accessible Communication

Making Information Understandable

Accessible communication may include:

• Easy Read.
• Large print.
• Braille.
• British Sign Language.
• Alternative formats.

Accessible Information Standard

https://www.england.nhs.uk/accessibleinfo

Equality Act Rights

Legal Protections

The Equality Act 2010 protects people from unlawful discrimination.

Equality Act 2010

https://www.legislation.gov.uk/ukpga/2010/15/contents

Right to Dignity

Every person receiving care has the right to:

• Respect.
• Privacy.
• Compassion.
• Person-centred support.

Right to Family Life

People should be supported to maintain important family and social relationships where appropriate.

Human Rights Act 1998

https://www.legislation.gov.uk/ukpga/1998/42/contents

Right to Liberty

Restrictions should only occur where lawful, necessary and proportionate.

Right to Privacy

People should have their privacy respected regarding:

• Personal information.
• Healthcare.
• Relationships.
• Daily life.

Freedom from Inhuman or Degrading Treatment

Nobody should experience:

• Abuse.
• Neglect.
• Humiliation.
• Cruel treatment.

This is a fundamental human right protected by law.

Equality and Human Rights Commission

https://www.equalityhumanrights.com

Key Message

Safeguarding in care and support services is about protecting people from abuse, neglect and exploitation while promoting dignity, independence, wellbeing, equality and human rights. Everyone receiving care should be listened to, respected, involved in decisions and supported to live as safely and independently as possible. Public bodies, care providers, families, carers and communities all play a role in ensuring safe, accountable and compassionate care.