The guidance was developed after the LMC found that many practices in the capital have been caught out in this area during inspections. The LMC said that its analysis of inspection reports showed that this has lead to many practices being given lower ratings.
The LMC has used analysis of 20 CQC reports on London practices that were rated ‘requires improvement’ or ‘inadequate’ to put together ‘insight and practical tips’ to help practices meet CQC expectations on safeguarding.
The LMC said that safeguarding process in relation to vulnerable adults are ‘often less well covered than child protection’ and can be flagged up for scrutiny in CQC inspections.
The LMC has compiled the guidance as a table, showing the most common themes highlighted in the 20 reports, mapped against the five key lines of enquiry that the CQC uses to assess practices in inspections.
Below is a summary of some of the key tips from the guidance:
Safeguarding lead and training:
- Practices should have a named safeguarding lead and a deputy safeguarding lead, who has delegated responsibility to act in the lead’s absence. All staff must know who these people are.
- The safeguarding lead and all GPs (including locums) should have had level 3 safeguarding training.
- Nursing staff should have received level 2 training and practice staff level 1 training.
- The practice needs documented evidence that staff have had appropriate safeguarding training.
- DBS checks for all clinical staff and chaperones (or evidence of a risk assessment), plus appropriate recruitment checks on all staff.
- Safeguarding should be a standing item in practice meetings.
What staff need to know:
- All staff should understand the practice’s safeguarding policy.
- The practice should have a chaperone policy and all staff should know what this is.
- Staff should know how to recognise signs of abuse in children, young people and vulnerable adults, be able to describe various types of abuse and understand their responsibilities around information sharing, documentation of concerns and how to contact relevant agencies inside and out of hours.
- Staff should also know how to report and escalate safeguarding concerns, be aware of significant events and any changes to practice policies and procedures.
- The practice should have a patient consent policy and all staff should understand patients’ consent to care. There should also be a policy for documenting patient consent.
Systems and processes:
- The practice should have a system in place to manage and review risks to children, young people and vulnerable adults.
- The practice should also have a system for identifying and following up those living in disadvantaged circumstances and those at risk, including a system to highlight vulnerable patients on electronic medical records.
- There should be a risk register of vulnerable patients.
- Locum GP packs should include information on safeguarding guidance, referrals and agencies’ contact numbers
- There should be robust information governance in place
- Practices should have a system for following up on hospital referrals for vulnerable patients who fail to attend appointments.
- Practices should have extended appointment slots for older patients and appointments outside school hours for children and young people.
- There should be evidence of recording complaints and significant events and clinical audits being used to drive improvement.
- All relevant policies should be regularly reviewed.
- Notices and posters should be displayed informing patients that chaperones are available.
- There should be evidence of multidisciplinary working and case management for vulnerable patients.
- Information should be available in a variety of accessible formats, i.e different languages, Braille etc