Safeguarding vulnerable adults is a priority for anyone working in a care home, day centre, or home care.
As a care provider, you have a responsibility to make sure that your clients are well cared for, working towards their goals, and safe from harm.
If you’re a supervisor or manager, you also have a responsibility to make sure that your staff team understand this, and know what to do if they suspect abuse.
In this article, we’ll look at what safeguarding is, some tips for safeguarding care home and domiciliary care clients, and some examples of safeguarding vulnerable adults.
Table of Contents
What is safeguarding?
Safeguarding in health and social care is all about protecting your clients from abuse or neglect, and making sure that they can live safely and free from harm.
Whether you support older people, younger adults with complex health needs, or children, safeguarding is vitally important. These groups are at a higher risk of abuse and harm than the general population, and, as a carer, you may be in a position to notice and intervene.
However, safeguarding isn’t always simple. Identifying issues can be difficult, and good safeguarding practices may mean that you need to strike a fine balance between preventing harm and allowing your clients to make their own decisions.
What are the six principles of safeguarding?
Safeguarding vulnerable adults or younger people can be summed up in six main principles. The six principles of safeguarding are:
- Empowerment: Your clients should be empowered to make their own decisions. This means that they have control over their lives, and safeguarding plans should accommodate this.
- Prevention: You should try and prevent harm before it occurs. This might include training staff, raising awareness of abuse among service users, and having a clear roadmap of how people can report a problem.
- Proportionality: You should try to have a proportional response to situations. Respect your clients’ wishes where possible, and think about what is best for them.
- Protection: Your staff team should know what to do to identify abuse and protect service users. They should know your organisation’s policies and procedures for reporting concerns, and should know what support to offer clients.
- Partnership: Also known as co-production, your organisation should work with other healthcare providers, local authorities, and other organisations to prevent, identify, and report abuse. You should only share information about clients when necessary.
- Accountability: Everyone is responsible for safeguarding, and your staff team should know what their roles and responsibilities are.
What is abuse?
When we talk about safeguarding in health and social care, we talk about protecting people from abuse.
As a care provider, you need to be aware of the different types of abuse. It’s not always just physical violence. Your clients might not be aware that they are victims of abuse – or even that they themselves are abusing a partner, family member, care worker, or friend.
Types of abuse may include:
- Physical abuse: This may include hitting, kicking, punching, or biting. It can also include inappropriate use of restraints, withholding food or force feeding, or over-medicating someone to sedate them.
- Domestic abuse: This is often from a partner, but may also be from a parent, child, sibling, or someone else who lives with the client.
- Sexual abuse: This may include rape or other sexual assault, unwanted touching, indecent exposure, inappropriate comments, or other sexual activity without consent. In some cases, clients may not be able to consent to any sexual activities, meaning that any sexual activity is abuse.
- Emotional or psychological abuse: This may include verbal abuse, such as name calling, threats or intimidation. Enforcing isolation or encouraging someone to isolate themselves from friends and family is also emotional abuse.
- Financial abuse: This may include stealing money or items, fraud, or preventing someone from accessing their own money or possessions. It could also include pressuring someone to sign over money or property, encouraging someone to change a will, or misusing a power of attorney. Refusing to pay rent, or trying to charge overpriced amounts for repairs can also be classed as financial abuse.
- Discrimination: This is where someone is treated differently based on a certain characteristic, such as their race, age, disability, gender, sexual orientation, religion, marriage, or parental status. It might include verbal abuse or unpleasant comments, physical violence, or harassment.
- Organisational or institutional abuse: This type of abuse typically happens within a care setting, when service users receive poor care that affects their quality of life. It might include a very one-size-fits-all approach, rather than personalised care. Clients may be restrained unnecessarily, prevented from having visitors, or denied privacy during personal care. Staff may fail to respond to questions or complaints, and low staff numbers may mean that clients are denied proper care.
- Neglect: This may include failing to give someone enough nutrition, not helping them to access medical care, not providing necessary personal care, or failing to give them the medication they need. It may also include keeping them from using necessary equipment, such as glasses, dentures, or hearing aids, not allowing them to have visitors, or ignoring them. Neglect might be deliberate or may happen unintentionally if a family carer struggles to cope.
- Self-neglect: Sometimes a client is unable to look after themselves, and neglects their health, personal hygiene, and environment. Self-neglect can also include self-harm, and the inability to access key services such as medical care.
- Modern slavery: This may include forced labour, human trafficking, forcing someone to work to pay off unrealistic debts, or forcing someone into sex work.
What are the signs of abuse?
If you’re safeguarding home care clients or people living in care homes, you should make sure that you and your staff team know how to identify abuse.
There might not always be clear indications – and an abused client might not realise that they are a victim.
But there are signs you can look for:
- Frequent bruising or other injuries, with no clear explanation
- New continence needs, without a medical explanation
- Unexplained weight loss or pressure sores
- Unexplained damage to their home or property
- Missing possessions or money
- Isolating themselves from friends, family, or other people
- Changes in behaviour, such as becoming more withdrawn, angry or anxious
- Reluctance to accept personal care, particularly changing clothes or bathing
- Reluctance or refusal to be around certain people
- Self-harming
If you’re concerned about institutional abuse, look for issues such as:
- Poor standards of care
- Few or no visitors to a care facility
- Poor or no record-keeping
- Low staffing levels or high staff turnover
- Service users being denied choices and independence
- Service users being unnecessarily exposed during personal care
- Staff members discussing service users in public
How can we improve safeguarding in our organisation?
If you’re a care provider, you want to make sure that your clients are protected from harm. We’ve put together some examples of safeguarding vulnerable adults that can help to keep your clients safe from abuse.
Examples of safeguarding vulnerable adults:
- Making sure that your staff team have comprehensive safeguarding training. Safeguarding training should be mandatory training for carers, whether they support clients in their own homes or a care facility. This training should also be extended to admin staff and anyone else who spends time with service users.
- Educating your staff team about the signs of abuse. If they understand how to identify abuse, they can speak up if they have concerns.
- Conducting regular risk assessments. Conducting regular risk assessments is easier when using care planning software, which helps ensure assessments stay current and are visible to your whole team.
- Empowering your staff team to speak up if they see problems. Have an easily-accessible whistleblowing policy, so that colleagues know what to do if they suspect abuse.
- Encouraging clients and their family members to speak up about concerns. If service users or their relatives are worried about abuse and harm, make sure that they know how to contact the care team or management. Consider using care management software like openPASS to facilitate communication between caregivers and family members.
- Recruiting a caring and compassionate staff team. While we can never prevent all abuse, you can reduce the risk of abuse from care workers with a robust recruitment process. Make sure you get good references from previous employers, and ensure that the people you employ understand the code of conduct for healthcare support workers.
- Supporting clients to report abuse. If a client discloses abuse to you or a member of your staff team, listen to them and, where possible, listen to their wishes about taking action.
Safeguarding home care clients
When thinking about safeguarding domiciliary care clients, you should consider:
- Domestic abuse: If your client lives with a partner or family member, do they pose any threat to them?
- Neglect: If your client lives with a family carer, do they provide the support the client needs, or are they refusing or unable to provide for their basic needs?
- Self-neglect: Is your client able to live safely in their own home with the support of a carer, or do they need additional support?
- Financial abuse: Is the client the one who makes the decisions about their own money, and are family, friends and tradespeople treating them fairly?
- Any type of abuse from other care workers towards your client: Are other carers violent or verbally abusive towards the client?
If you work for a care agency, using home care software can help standardise procedures for reporting abuse and logging concerns.
However, as a home care worker, you may not have a manager or supervisor to discuss these issues with.
If you’re concerned about harm or abuse involving a client and their caregiver, you can contact the CQC or your local authority to report your concerns. Alternatively, if you’re worried about self-neglect, talk to family members or ask for a needs assessment from the local authority.
And finally, if you’re worried about financial abuse, violence, or other harm, you can always contact the police.
In an emergency, always call 999 to contact the police.
Safeguarding care home clients
If you support clients in a care home, you should be particularly aware of:
- Institutional abuse: Are service users treated fairly, and is the organisation well-run?
- Modern slavery: Is every member of the staff team employed legally?
- Any type of abuse from other care workers towards clients: Are members of the staff team violent, verbally abusive, or neglectful to service users?
- Any type of abuse among clients: Are clients violent towards each other, or do they discriminate against other service users?
- Any type of abuse towards care workers: Are some carers treated badly by colleagues, clients, or managers because of protected characteristics, or are they victims of violence?
If you suspect abuse or harm in a care home, you may be able to follow your organisation’s policies and raise the issue with your supervisor or a manager. If you don’t feel safe to do this, you could contact the CQC or your local authority and share your concerns. You can also call the police to report abuse or harm.
In an emergency, call 999 to contact the police.
Conclusion: safeguarding in health and social care
Safeguarding home care clients and people living in care homes is a vital part of working for a care provider. Whether you’re a carer, work in activities, or provide admin support, you should know how to spot abuse, and the procedures for reporting any concerns.
Remember that abuse comes in many forms, and doesn’t always involve physical violence. If you suspect abuse, take action as soon as possible, to help keep your clients safe.
