Physical Abuse
Physical abuse includes hitting, slapping, pushing, restraining, misuse of medication, and any use of physical force that causes pain, injury, or distress
Safeguarding in Care: Protecting Adults at Risk
Every person who receives care deserves to live free from abuse, neglect, and exploitation. Safeguarding in care is the term used to describe the actions taken by care providers, local authorities, and partner agencies to prevent harm, protect adults at risk, and respond to concerns when they arise.
For domiciliary care and supported living providers registered with the Care Quality Commission, safeguarding is not optional. It sits at the heart of every regulated activity and forms a central part of how the CQC assesses whether a service is safe.
At Care Sync Experts, we help care providers across England build safeguarding frameworks that meet CQC requirements, protect the people they support, and stand up to inspection.
hello@caresyncexperts.co.ukWhat Is Safeguarding in Health and Social Care
Safeguarding adults means protecting a person's right to live in safety, free from abuse and neglect.
The Care Act 2014 established the legal framework for adult safeguarding in England and placed a duty on local authorities to make enquiries, or cause others to make enquiries, where an adult with care and support needs is experiencing or is at risk of abuse or neglect.
This duty applies regardless of whether the local authority is meeting those care and support needs directly or whether the adult is receiving care from a registered provider.
Safeguarding in health and social care extends beyond responding to incidents after they happen. It includes the prevention of harm, the promotion of wellbeing, and the creation of environments where abuse is less likely to occur. For care providers.
This means having clear policies, trained staff, effective reporting pathways, and a culture where concerns are raised without fear of reprisal.
Why Is Safeguarding Important in Health and Social Care
Adults who receive domiciliary care or live in supported living settings can be more vulnerable to abuse because of their dependency on others for personal care, daily living support, or decision-making assistance.
Without effective safeguarding arrangements, adults at risk face increased exposure to physical harm, financial exploitation, psychological abuse, and neglect.
Providers who fail to safeguard the people they support face enforcement action from the CQC, including warning notices, conditions on registration, and in the most serious cases, cancellation of registration.
Safeguarding matters because it ensures that the people who provide that support do so in a way that respects dignity, promotes independence, and prevents harm.
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A Section 42 enquiry is triggered when three conditions are met:
- The adult has needs for care and support, whether or not those needs are currently being met.
- The adult is experiencing, or is at risk of, abuse or neglect.
- As a result of those care and support needs, the adult is unable to protect themselves from either the risk of, or the experience of, abuse or neglect.
Care Act 2014 and Section 42 Safeguarding Duties
The Care Act 2014 is the primary legislation governing adult safeguarding in England. Section 42 of the Act sets out the circumstances under which a local authority must carry out a safeguarding enquiry.
Care providers have a duty to cooperate with Section 42 enquiries and to refer safeguarding concerns to the relevant local authority safeguarding adults team.
The Section 42 framework does not require the adult to lack mental capacity for a safeguarding enquiry to proceed. An adult may have full mental capacity and still be unable to protect themselves from abuse because of the nature of the situation, the power dynamics involved, or the complexity of the relationship with the person causing harm.
Where Do Care Agency Clients Come From?
Several pieces of legislation work alongside the Care Act 2014 to form the legal basis for adult safeguarding.
Act 2005
Mental Capacity
The Mental Capacity Act 2005 establishes that every adult has the right to make their own decisions and that a person must be assumed to have capacity unless it is established otherwise.
Act 1998
Human Rights
The Human Rights Act 1998 enshrines the right to life, the right to freedom from torture and inhuman treatment, and the right to liberty and security.
Act 2010
Equality
The Equality Act 2010 protects adults from discriminatory abuse by making it unlawful to discriminate on the basis of protected characteristics including age, disability, race, religion, sex, and sexual orientation.
Act 1983 (as amended 2007)
Mental Health
A second consultant reviews every response for compliance with the tender requirements, accuracy, clarity, and alignment with the scoring criteria.
For domiciliary care and supported living providers, these pieces of legislation are not abstract. They shape how care plans are written, how risk assessments are conducted, how consent is obtained, and how decisions are made when an adult lacks the mental capacity to make a specific decision at a specific time.
Duty of Candour in Health and Social Care
Duty of candour is a legal requirement under Regulation 20. Our guide explains what counts as a notifiable safety incident, the steps you must follow, and what happens if you fail to comply.
The 10 Categories of Abuse Under the Care Act 2014
The Care Act 2014 and its accompanying statutory guidance identify 10 categories of abuse that safeguarding arrangements must address. Recognising these categories is the first step in identifying and responding to safeguarding concerns.
Sexual Abuse
Sexual abuse covers any sexual activity that the adult has not consented to or could not consent to, including rape, indecent exposure, sexual harassment, and inappropriate looking or touching
Psychological Abuse
Psychological abuse includes threats, intimidation, humiliation, verbal abuse, isolation, and any behaviour that causes emotional harm or distress.
Financial or Material Abuse
Financial or material abuse involves theft, fraud, exploitation, pressure in connection with wills or property, misuse of a person's money or possessions, and scams targeting adults at risk.
Organisational Abuse
Organisational abuse occurs when the culture, practices, or systems within a care setting cause harm, including poor care standards, rigid routines that ignore individual needs, and insufficient staffing that places people at risk.
Domestic Abuse
Domestic abuse includes psychological, physical, sexual, financial, and emotional abuse by a partner, family member, or someone in a close relationship with the adult.
Discriminatory Abuse
Discriminatory abuse is motivated by prejudice based on a person's age, disability, gender, race, religion, sexual orientation, or any other protected characteristic.
Modern Slavery
Modern slavery encompasses human trafficking, forced labour, domestic servitude, and any situation where a person is exploited and controlled by another.
Self-Neglect
Self-neglect describes a situation where an adult neglects their own health, personal hygiene, or living environment to the extent that their wellbeing is at risk. This category can include hoarding behaviours.
Neglect and Acts of Omission
Neglect and acts of omission involve the failure to provide adequate care, including ignoring medical or physical care needs, withholding food or medication, and failing to provide access to appropriate health, social care, or educational services.
Examples of Safeguarding Adults in Practice
Safeguarding concerns can present in many different ways during the delivery of domiciliary care. A care worker visiting an adult in their own home may notice unexplained bruising, a sudden change in behaviour, or signs that money is being removed from the person's account without their knowledge.
A supported living provider may identify that a tenant is being targeted by individuals who use their property for criminal activity, a form of exploitation known as cuckooing.
A team leader conducting a medication audit may discover that controlled drugs are unaccounted for, raising concerns about either theft or medication errors. In each of these situations, the provider has a duty to raise the concern through the appropriate safeguarding pathway, document the concern accurately, and cooperate with any enquiry that follows.
Six Safeguarding Principles Every Provider Must Follow
The Care Act 2014 statutory guidance sets out six principles that underpin all adult safeguarding work. These principles apply to every care provider, every local authority safeguarding team, and every partner agency involved in protecting adults at risk.
Prevention means that it is better to take action before harm occurs. Care providers should have proactive systems in place to identify and reduce risks rather than responding only after an incident has happened.
Empowerment means that adults are supported and encouraged to make their own decisions and give informed consent. The presumption is that the adult is best placed to decide what happens in their life, and safeguarding responses should reflect this.
Protection means that support and representation must be available to those who need it most. Adults who are unable to protect themselves should be offered advocacy, and their voices should be central to any safeguarding response.
Proportionality means that the response to a safeguarding concern should be the least intrusive response appropriate to the level of risk. Not every concern requires a full safeguarding enquiry, and the response should be proportionate to the nature and seriousness of the risk.
Partnership means that safeguarding is a shared responsibility. Local solutions are achieved through services working together with their communities, and care providers play a central role in this partnership.
Making Safeguarding Personal in Domiciliary Care
Making Safeguarding Personal is a sector-led initiative that moves adult safeguarding away from process-driven responses and towards a person-led, outcome-focused approach.
What is Making Safeguarding Personal?
The principle behind Making Safeguarding Personal is that safeguarding responses should be shaped by what the adult wants to happen, not by what professionals believe should happen. This means asking the adult at the start of the process what outcomes they want and then working towards those outcomes throughout the enquiry.
For domiciliary care providers, Making Safeguarding Personal has practical implications. When a safeguarding concern is raised, the provider should ensure that the adult is asked what they want to happen and that their wishes are recorded and communicated to the local authority safeguarding team.
The adult may not want a formal investigation. They may want the abuse to stop without involving the police. They may want to maintain the relationship with the person causing harm but with additional safeguards in place.
Making Safeguarding Personal recognises that the adult has the right to make these choices, provided they have the mental capacity to do so and provided that other people are not also at risk of harm.
Providers of supported living services must ensure that their safeguarding arrangements reflect the specific needs and vulnerabilities of the people they support.
Safeguarding Vulnerable Adults in Supported Living
Supported living services support adults who may have learning disabilities, autism, mental health conditions, or physical disabilities to live in their own homes with varying levels of care and support. The CQC's Right Support, Right Care, Right Culture framework sets out the expectations for services supporting people with a learning disability and autistic people, and safeguarding is central to this framework.
In supported living, safeguarding concerns can arise from the way support is delivered. Overly restrictive practices, blanket rules that apply to all tenants regardless of individual need, and environments that limit personal freedom can all constitute organisational abuse. The use of physical restraint, the locking of doors without lawful authority, and the removal of personal items as a form of behaviour management are all safeguarding concerns that must be reported and addressed.
This includes having policies that address the Deprivation of Liberty Safeguards (DoLS) and the forthcoming Liberty Protection Safeguards, ensuring that staff are trained to recognise the signs of abuse in people who may not be able to communicate their experiences verbally, and maintaining robust systems for monitoring and reviewing the quality of care.
The Designated Safeguarding Lead in Domiciliary Care
The DSL acts as the main point of contact for safeguarding concerns, ensures that all staff know how to report concerns, oversees safeguarding training, and maintains the organisation's safeguarding records.
Every domiciliary care and supported living provider should have a Designated Safeguarding Lead (DSL) who takes responsibility for the management of safeguarding within the organisation.
The DSL does not need to be a specific job title, but the role must be clearly allocated to a named individual who has the authority, training, and support to carry it out effectively. In many domiciliary care agencies, the Registered Manager takes on the DSL role, although the responsibilities can be delegated to another senior member of staff provided that clear lines of accountability are maintained.
The DSL should have completed safeguarding training at a level appropriate to their role and should update this training at regular intervals. They should attend local Safeguarding Adults Board meetings or training events where possible and should maintain relationships with the local authority safeguarding team so that referrals can be made quickly and efficiently when concerns arise.
Mental Capacity Act 2005 and Safeguarding
The Mental Capacity Act 2005 is directly relevant to safeguarding because many adults at risk have conditions that may affect their ability to make specific decisions at specific times.. The Act establishes five key principles that must be followed whenever a decision is being made on behalf of, or in relation to, a person who may lack capacity.
A person must be assumed to have capacity unless it is established that they lack capacity.
A person is not to be treated as unable to make a decision merely because they make an unwise decision.
Before any act is done or decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action.
A person is not to be treated as unable to make a decision unless all practicable steps to help them do so have been taken without success.
Any act done or decision made on behalf of a person who lacks capacity must be done in their best interests.
For safeguarding purposes, capacity is decision-specific and time-specific. An adult may have the capacity to decide what to eat for lunch but lack the capacity to understand the risks involved in a complex financial arrangement.
Care providers must carry out capacity assessments when there is reason to believe that an adult may not be able to make a specific safeguarding-related decision, and these assessments must be recorded.
Consent, Confidentiality, and Information Sharing
Safeguarding requires care providers to share information with other agencies, including the local authority, the police, and the CQC. The principle of consent is central to this process, but consent is not always required before information can be shared
When Information Can Be Shared Without Consent
Information can be shared without consent when there is a risk to the life of the adult or another person, when sharing is necessary to prevent a crime, when the adult lacks the mental capacity to consent to the sharing and it is in their best interests, or when there is an overriding public interest in sharing the information.
The Seven Golden Rules of Information Sharing
The seven golden rules of information sharing, as set out in government guidance, provide a framework for making these decisions. Information should be shared on a need-to-know basis, should be proportionate to the level of risk, and should be recorded so that there is a clear audit trail of what was shared, with whom, and why.
Phase 1
Confidentiality vs Secrecy
Care providers should ensure that their staff understand the difference between confidentiality and secrecy. Confidentiality means that personal information is protected and shared only when there is a lawful basis for doing so. Secrecy means that information is withheld even when sharing it could prevent harm. Safeguarding must never be compromised by a misplaced sense of confidentiality.
CQC Regulation 13 and the SAFE Domain
The CQC assesses safeguarding under the SAFE key question and through Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 13 requires that service users are protected from abuse and improper treatment, including neglect, degrading treatment, unnecessary or disproportionate restraint, and deprivation of liberty without lawful authority.
A provider that fails to meet the requirements of Regulation 13 will receive a rating of Requires Improvement or Inadequate under the SAFE key question.
How CQC Inspectors Assess Safeguarding
during an inspection, CQC inspectors assess whether the provider has effective safeguarding systems in place by examining the provider's safeguarding policy, speaking to staff about their understanding of safeguarding procedures, reviewing safeguarding training records, looking at how safeguarding concerns have been handled, and checking whether appropriate notifications have been submitted.
Related Regulations
Regulation 12 (safe care and treatment) and Regulation 19 (fit and proper persons employed) also relate to safeguarding.
Regulation 12 requires providers to assess and mitigate risks to the health and safety of service users, while Regulation 19 requires that staff are recruited through safe recruitment processes that include DBS checks, reference checks, and verification of qualifications and identity.
Procurement Act 2023 for Care Providers
The Procurement Act 2023 changes how local authorities buy care services. Our guide explains the new rules, transparency requirements, and what care providers need to do differently when bidding for contracts.
Safeguarding Policies and Procedures for Care Providers
A safeguarding policy should not be a generic document downloaded from the internet. It should be tailored to the service, reflect the specific needs of the people the provider supports, and be reviewed at least annually or whenever there is a change in legislation, guidance, or local safeguarding arrangements.
Every CQC-registered provider must have a written safeguarding policy that sets out how the organisation prevents, identifies, and responds to safeguarding concerns.
What a Safeguarding Policy Should Include
A safeguarding policy for a domiciliary care or supported living provider should include a clear definition of safeguarding and the categories of abuse, the name and contact details of the Designated Safeguarding Lead, the procedure for reporting safeguarding concerns internally and externally, guidance on preserving evidence, information about local authority safeguarding contacts, the procedure for making CQC statutory notifications, and guidance on whistleblowing and raising concerns. The policy should be accessible to all staff, service users, families, and other stakeholders.
Safeguarding Policy Support
At Care Sync Experts, we write safeguarding policies that meet CQC requirements, reflect the Care Act 2014 statutory guidance, and are tailored to the specific service type and the people it supports.
Our policies are used by domiciliary care and supported living providers across England as part of their CQC registration applications and ongoing compliance management.
Our CQC Inspection support
If you need a safeguarding policy that will stand up to CQC inspection, contact us on
How Care Sync Experts Support Safeguarding Compliance
Care Sync Experts provides specialist safeguarding support to domiciliary care and supported living providers at every stage of their CQC journey.
Whether you are preparing for CQC registration and need a complete set of safeguarding policies, preparing for a CQC mock inspection and want to test your safeguarding arrangements, or responding to a safeguarding concern and need guidance on the correct reporting pathways, our team has the expertise to help.
Our safeguarding support includes:
- The development of bespoke safeguarding policies and procedures
- Safeguarding audit and gap analysis against CQC Regulation 13 requirements
- Support with CQC statutory notifications relating to safeguarding incidents
- Guidance on Making Safeguarding Personal and person-centred safeguarding responses
- Advice on the Mental Capacity Act 2005 and its application to safeguarding decisions
We work with providers across England, from new providers going through their first CQC registration to established services preparing for inspection or responding to enforcement action.
Our CQC Inspection support
Visit our guidance and support page to see the full range of services we offer, or call 0333 577 0877 to speak with a member of our team.
Frequently asked questions
A CQC compliance consultant helps care providers in England meet the standards set by the Care Quality Commission. This includes preparing for inspections, supporting CQC registration applications, reviewing policies and procedures, and providing ongoing compliance management. At Care Sync Experts, our consultants work directly with your team to identify gaps and build practical solutions.
CQC consultancy costs vary depending on the scope of work. A standalone mock inspection is priced differently to a full registration support package. Care Sync Experts provides transparent pricing with no hidden fees. Call 0333 577 0877 for a quote based on your specific needs.
You don't legally need a consultant to register with the CQC, but many providers find that professional support significantly reduces the time and effort involved. The CQC registration process involves detailed paperwork, evidence requirements, and a fit person interview. Having experienced CQC registration consultants on your side increases the likelihood of a successful first-time application.
A CQC mock inspection is a simulated inspection that mirrors the real CQC assessment process. It covers all five key questions and the 34 quality statements, giving you a detailed report of what's working well and what needs improvement. Mock inspections help you prepare for the real thing and provide evidence of proactive quality assurance.
The CQC aims to process new registration applications within 12 weeks, but timescales vary depending on the complexity of your application and how complete your evidence is when you submit. Using CQC registration consultants can help avoid delays caused by incomplete submissions or missing documentation.
The 34 quality statements sit within the CQC's single assessment framework and describe what good care looks like across the five key questions (safe, effective, caring, responsive, and well-led). They replaced the previous key lines of enquiry and focus on outcomes rather than processes. Care Sync Experts helps providers map their evidence against all 34 statements.
A Requires Improvement rating means the CQC has identified areas where your service doesn't fully meet the required standards. You'll receive a report detailing what needs to change. Care Sync Experts provides targeted compliance improvement support that addresses the specific issues the CQC identified, helping providers move back to Good within one inspection cycle.
Yes. If your service is facing enforcement action from the CQC, whether that's a warning notice, conditions on your registration, or the threat of cancellation, our healthcare crisis management team provides immediate support. We help you respond to the CQC, develop an action plan, and demonstrate the improvements needed to resolve the situation.
The CQC (Care Quality Commission) regulates health and social care in England. The RQIA (Regulation and Quality Improvement Authority) covers Northern Ireland. The CIW (Care Inspectorate Wales) covers Wales. Each regulator has its own framework and requirements. Care Sync Experts provides specialist support for all three regulatory bodies
Preparing staff for a CQC inspection involves making sure everyone understands their role, knows the service's policies, and can articulate how they deliver safe and effective care. Our CQC consultancy includes staff preparation sessions that cover common inspector questions, evidence gathering, and how to demonstrate person-centred care during an inspection visit.
Yes. A significant part of our work is with domiciliary care providers. We support domiciliary care agencies with CQC registration, policy development, mock inspections, compliance audits, and ongoing quality assurance. Our team understands the specific challenges of delivering regulated care in community settings
Care Sync Experts provides bid management and tender writing support for care providers looking to secure NHS and local authority contracts. We help you develop compelling bids that demonstrate your compliance credentials, quality outcomes, and value for money through competitive tender processes and framework agreements.
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