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Safety and safeguarding in the care home

Two of CQC’s Fundamental Standards, which care providers must meet, concern:

  • safety: you must not provide unsafe care or treatment, or put people who use your service at avoidable risk of harm
  • safeguarding from abuse, improper treatment, or neglect.

CQC has lead responsibility for investigating incidents where people in residential homes have been harmed by unsafe or poor quality care or treatment, while the local authority takes the lead in safeguarding cases. There will of course be cases where both agencies are involved.

The obligations of care home owners and managers in respect of safety apply to all the people living and working in their care home. They should have clear policies in relation to both.

For residents, a careful and balanced approach to risk will include assessments which include:

  • beds and other equipment
  • the potential for falls throughout the home
  • the management of drugs and other dangerous substances
  • hot water and hot substances, and surfaces
  • the spread of infection and diseases
  • the possibility of aggression or challenging behaviour.

Risk should never be the reason for restricting the independence of residents unless the risk has been fully assessed, and found to be unacceptably great. The Health and Safety Executive provides general guidance on the protection of care workers and residents from common risks, as well as a practical guide to risk assessment, (see Further Reading).

Safeguarding adults from abuse or neglect is everyone’s business. The Care Act 2014 defines a framework for safeguarding adults. Care providers must have clear policies and procedures which reflect the Care Act statutory guidance (Chapter 14) and their local multi-agency procedures and everyone who works in a care home should understand and follow these procedures.

Making Safeguarding Personal (MSP) is a sector-led initiative which aims to develop an outcomes focus to safeguarding work, and a range of responses to support people to improve or resolve their circumstances. Staff need to engage with people about the outcomes they want, and work with them to get the balance right between choice, and control and safety. Read more about Making Safeguarding Personal (MSP)

All care home managers and staff should be trained in their responsibilities for reporting and recording concerns about abuse or neglect. All care homes must have a whistleblowing policy to guide staff in raising concerns where they feel it is unsafe to do so internally or where a concern has been ignored. The CQC provides a model leaflet for health and care staff about the rights of whistleblowers.

All care homes share their residents’ personal data with partner organisations. Residents have a right to confidentiality in relation to their personal data, and should be assured that this is respected.

Managers should ensure that formal data-sharing agreements with partners set out the security measures which comply with the principles of the Data Protection Act 1998, and the forthcoming General Data Protection Regulation.

Person-centred care for older people in care homes