This article relates to the CQC key question: Is your practice safe?
The support GPs offer their patients often extends beyond narrowly defined health needs to wider welfare considerations. This is particularly important where they see those adults most at risk, either in their own homes or in a care home.
On our inspections, our inspectors will want GPs and all other practice staff to demonstrate their competence in safeguarding adults at risk:
- Demonstrate their understanding of the definition of an adult at risk and the types of abuse they may be subject to.
- Be aware of the internal arrangements for recording a safeguarding adult concern, and this will be set out in a safeguarding adults policy.
- Be aware of the external process for reporting the concern and that this is in line with local multi-agency policy and procedures.
Each practice should have a designated lead for safeguarding adults at risk who should be aware of the respective safeguarding adults lead within the local CCG and the local authority safeguarding adults contact.
In a ‘good’ practice:
- There will be evidence that safeguarding adults at risk is given sufficient priority in the practice.
- Staff will take a proactive approach to safeguarding and focus on early identification.
- Steps are taken to protect people where there are known risks, with appropriate responses to any signs or allegations of abuse and effective work with other organisations to implement protection plans.
- There are active and appropriate engagement in local safeguarding procedures and effective work with other relevant organisations.
Local authorities currently have local procedures in place which reflect the Department of Health’s ‘No Secrets’ guidance. Their approach to safeguarding will change with the introduction of the Care Act 2014 in April 2015. The key changes to safeguarding adults as a result of the Care Act are:
- regulated providers may be required to undertake the safeguarding investigation, and
- definitions of adults at risk and types of abuse have widened.
GP practices should be aware of the work being undertaken locally by their Safeguarding Adults Board to reflect the changes that are taking place.
The Care Act
The Care Act strengthens the requirements around safeguarding adults at risk training. Staff induction training should include awareness that abuse can take place and their duty to report it. The Act encourages more detailed awareness training, including on recognition of abuse and responsibilities with respect to the procedures in their particular agency.
The Act makes these requirements for safeguarding adults boards to ensure they work with their relevant partners, including CCGs, to provide this training. However, GP practices must ensure that all staff working in the practice have the appropriate level of competencies, as described above, to ensure they protect adults at risk. Formal face-to-face training is one way that practice staff can develop their competency in safeguarding adults at risk.
For training in child safeguarding or child protection there is clear guidance from the royal colleges about the appropriate competencies and levels of training for different members of staff. These are clearly defined and, for GPs, need to be demonstrated for purposes of annual appraisal and revalidation. The training requirements for safeguarding adults for GPs and other practice staff are not clearly defined in guidance in the same way.
The Act notes that staff governed by professional regulation (for example GPs and nurses) should understand how their professional standards and requirements underpin their roles to prevent, recognise and respond to abuse and neglect.
For GPs, the GMCs ‘Good medical practice code’ (2013) stresses the need for doctors to protect patients and take prompt action if 'patient safety, dignity or comfort is or may be seriously compromised'. And for nurses, The Code states that they must disclose information if they believe someone may be at risk of harm (NMC Code 2008, to be replaced March 2015).
Practices may find it useful to refer to the BMA's Safeguarding vulnerable adults – a tool kit for general practitioners (2011).
- Professor Nigel Sparrow is senior national GP advisor and responsible officer at the CQC
More CQC resources
- View the full CQC Essentials series on Medeconomics
- CQC's recommended reading to help practices meet regulations and prepare for an inspection