How to Handle a Safeguarding Concern in Care

Safeguarding is the responsibility of every person who works in care — not just managers, not just designated leads, but every member of staff who spends time with vulnerable adults. When a concern is identified, the way it is handled in the first hours and days can make a significant difference to the outcome for the person involved.

This guide explains the types of abuse to be aware of, how to recognise the signs, what to do when a concern is raised, and how to keep records that demonstrate your safeguarding culture to CQC.

Understanding the Types of Abuse

The Care Act 2014 identifies ten types of abuse that adult safeguarding procedures must address:

• Physical abuse — hitting, restraining, or causing physical harm
• Domestic abuse — including controlling or coercive behaviour within a relationship
• Sexual abuse — any sexual contact or behaviour without consent
• Psychological or emotional abuse — threats, humiliation, intimidation, or isolation
• Financial or material abuse — theft, fraud, exploitation, or misuse of a person's money or property
• Modern slavery — trafficking, forced labour, or exploitation
• Discriminatory abuse — abuse linked to a person's race, religion, gender, disability, or sexual orientation
• Organisational or institutional abuse — poor care practices within a service that affect multiple people
• Neglect and acts of omission — failing to meet a person's basic needs, including ignoring medical or physical care needs
• Self-neglect — a person's inability or unwillingness to care for their own health or safety

Recognising the Signs

Abuse is not always obvious. Staff should be alert to changes in behaviour or physical condition that may indicate something is wrong:

Physical signs

• Unexplained bruising, marks, or injuries, particularly in unusual places
• Injuries that are inconsistent with the explanation given
• Signs of malnourishment, dehydration, or poor hygiene
• Pressure sores that should have been prevented with proper care

Behavioural and emotional signs

• Sudden withdrawal, anxiety, or reluctance to be alone with a particular person
• Distress when certain topics are raised
• Fearfulness, confusion, or depression that is new or unexplained
• A person suddenly unable to account for their own money

What to Do When a Concern Is Raised

Every care service must have a safeguarding policy and procedure. Staff should know this procedure before a concern ever arises. The general steps are:

1. Ensure the person is safe — if they are in immediate danger, call 999. If not, make sure they are in a safe environment while the concern is being addressed.
2. Listen, do not investigate — if a person discloses abuse to you, listen carefully and calmly. Do not ask leading questions, do not promise confidentiality, and do not attempt to conduct your own investigation. Your role is to receive the concern and pass it on, not to determine what happened.
3. Record what was said in the person's own words — write down exactly what was said, not your interpretation. Include the date and time, who was present, and any physical observations. Do this as soon as possible while the details are fresh.
4. Report to your designated safeguarding lead immediately — every service must have a named safeguarding lead. Do not delay reporting out of uncertainty or concern about causing trouble.
5. The designated lead makes a referral to the local authority — where there is reasonable cause to suspect abuse or neglect, a referral must be made to the local authority's adult social care team. This is not optional — it is a legal duty under the Care Act 2014.
6. Notify CQC if required — some safeguarding incidents must be reported to CQC as a statutory notification. Your registered manager should be familiar with the notification requirements.

Confidentiality and Information Sharing

Safeguarding overrides normal confidentiality rules. If a person tells you something in confidence and you believe they or someone else is at risk of harm, you must share that information with the appropriate people. You should tell the person that you are required to do this — but you must not let a request for confidentiality prevent you from acting.

Information should only be shared with those who need it to keep the person safe. It should not be discussed with colleagues who are not involved in the situation, and it must never be shared on social media or in any public forum.

When the Concern Involves a Member of Staff

Safeguarding concerns sometimes involve colleagues. This is one of the most difficult situations in care work, but the principle is the same: the safety of the person receiving care comes first.

If you have a concern about a colleague's behaviour:

• Report it to your manager or designated safeguarding lead immediately
• If the concern is about your manager, report to their line manager or directly to the local authority
• Do not confront the member of staff directly — this can compromise any subsequent investigation
• Do not discuss the concern with other colleagues

Where a member of staff is suspected of abuse, they may be suspended pending investigation. This is a protective measure, not a punishment, and does not prejudge the outcome. The local authority's safeguarding team will lead the investigation, working with the provider and, where appropriate, the police.

Keeping Safeguarding Records

Every safeguarding concern, referral, and outcome must be recorded. Good safeguarding records show:

• The date the concern was identified and by whom
• What was observed or disclosed, in the person's own words
• Who was informed and when
• What action was taken by the service
• The outcome of any referral or investigation
• Any changes made to the person's care plan or risk assessment as a result

Building a Safeguarding Culture

Effective safeguarding is not just about having the right procedures — it is about creating an environment where staff feel confident to speak up. Providers who achieve outstanding CQC ratings for safety typically have:

• Regular safeguarding training that goes beyond a yearly e-learning module
• An open-door culture where staff can raise concerns without fear of dismissal or ridicule
• A designated safeguarding lead who is known to all staff and accessible
• Safeguarding discussed openly in team meetings and supervision
• Lessons learned from past concerns shared with the whole team
• Service users who know how to raise a concern and trust that it will be taken seriously