Dr Richard Dune

06-09-2025

Image by Rido81 via Envato Elements

A complete guide to safeguarding adults: Care Act duties, CQC requirements, training levels, abuse categories, and leadership in safe care

Safeguarding adults in health and social care has never been more vital. Rising numbers of safeguarding concerns, emerging risks such as online scams, financial exploitation, and coercive control, alongside sharper scrutiny from the Care Quality Commission (CQC), demand that providers demonstrate robust systems, confident staff, and strong, visible leadership. Failures in safeguarding not only harm individuals but also undermine public trust and expose organisations to significant regulatory and reputational risks.

In this blog, Dr Richard Dune explores the scale of safeguarding challenges in England, the UK and globally, and examines the legislation and regulatory frameworks that underpin safeguarding duties.

What is safeguarding adults in health and social care?

At its core, safeguarding ensures that every adult can live in safety, free from abuse, neglect, and exploitation. The principle, enshrined in the Care Act 2014, places safeguarding at the heart of adult social care in England. Section 42 of the Act defines safeguarding as:

“Protecting an adult’s right to live in safety, free from abuse and neglect.” 

(Care Act 2014, s.42)

Safeguarding goes beyond preventing harm. It is about promoting dignity, independence, and well-being. It empowers adults to make their own choices, even where those choices carry risk, while ensuring safeguards are in place for those who lack capacity or are subject to coercion. In practice, safeguarding adults is everyone’s responsibility: from frontline care workers to senior managers, boards, regulators, and policymakers. To be effective, it must be fully embedded into organisational governance, workforce training, and daily service delivery.

The scale of adult safeguarding concerns

Safeguarding concerns continue to grow across the UK and globally. The numbers tell a powerful story:

• England - In 2022 - 23, local authorities recorded 541,535 safeguarding concerns, a 9% rise from the previous year. One in three resulted in a Section 42 enquiry under the Care Act (NHS Digital, 2023).
• UK - The UK Study of Abuse and Neglect of Older People (2021) revealed that 1 in 5 adults over 65 experienced some form of abuse in the past year, most commonly psychological abuse and neglect.
• Global - The World Health Organization (WHO) (2022) estimates that 1 in 6 people aged 60+ experience abuse each year. Shockingly, in institutional care settings, almost two-thirds of staff admitted to some form of abusive behaviour in the past year.

Key insight - Safeguarding is not a marginal issue. It is a daily reality across hospitals, care homes, GP surgeries, supported living, and domiciliary care services. Every provider must demonstrate vigilance, robust training, and a culture that prioritises safety and dignity.

Safeguarding adults legislation and regulatory framework

Providers must understand the legal frameworks that define safeguarding duties in health and social care. Below is a timeline of key legislation and regulations.

Types of abuse in safeguarding adults

The statutory framework identifies ten categories of abuse. Providers must ensure all staff can recognise these and act appropriately:

• Physical abuse - Hitting, slapping, rough handling, misuse of medication or restraint.
• Domestic abuse - Physical, sexual, emotional, financial abuse, and coercive control in intimate/family settings.
• Sexual abuse - Any sexual activity without consent or where capacity is lacking.
• Psychological or emotional abuse - Threats, humiliation, intimidation, isolation.
• Financial or material abuse - Theft, fraud, exploitation, coercion over money or property.
• Modern slavery - Human trafficking, forced labour, domestic servitude.
• Discriminatory abuse - Unequal treatment based on protected characteristics, e.g., age, disability, race, religion, sex.
• Organisational abuse - Unsafe cultures in services, poor governance, neglectful practices.
• Neglect and acts of omission - Failure to provide basic care (e.g., food, medication, personal care).
• Self-neglect - Failure of an individual to meet their own care needs, often linked to hoarding.

Key message - Abuse may occur as single incidents, repeated patterns, or systemic failings. Safeguarding requires staff to apply professional curiosity and not dismiss warning signs.

Best practice in safeguarding adults

Best practice in safeguarding adults is learned through real cases and applied in training. The following examples highlight lessons and standards that shape safer care:

Safeguarding adults training requirements

The RCN Intercollegiate Document (2024) and the UK Core Skills Training Framework (CSTF) set clear expectations for safeguarding adults training:

• Level 1 - All staff must recognise abuse and know how to raise concerns.
• Level 2 - Staff in regular contact must be able to document, advocate, and refer concerns.
• Level 3 - Registered professionals must apply legal frameworks, undertake risk assessments, and contribute to Section 42 enquiries.
• Levels 4-5 - Named/designated professionals provide leadership, governance, and assurance.

Training should be competency-based, refreshed every three years, and adapted to changes in legislation, guidance, or local safeguarding risks.

The role of leaders and organisations in safeguarding adults

Managers and leaders are pivotal in embedding safeguarding into organisational culture. 

Best practice includes:

• Clear policies aligned with the Care Act, MCA, HRA, and CQC standards.
• Regular audits of safeguarding practice, training compliance, and outcomes.
• Multi-agency collaboration with SABs, police, housing, health, and voluntary partners.
• Supportive supervision to help staff manage the emotional impact of safeguarding work.
• Transparent reporting to boards and regulators, with lessons embedded from SARs, DHRs, and complaints.

Leadership takeaway - Safeguarding is not optional. It must be led from the top, resourced properly, and embedded in governance frameworks.

Safeguarding adults and CQC compliance

The Care Quality Commission (CQC) enforces safeguarding standards through its Fundamental Standards:

• Regulation 12 - Safe care and treatment
• Regulation 13 - Safeguarding service users from abuse and improper treatment
• Regulation 17 - Good governance
• Regulation 20 - Duty of candour.

Under the CQC Single Assessment Framework (2023–25), safeguarding is cross-cutting. Inspectors expect providers to demonstrate:

• Staff training aligned to CSTF and RCN competencies
• Robust safeguarding policies and incident reporting systems
• Evidence of Making Safeguarding Personal in practice
• Governance and audit trails showing learning from incidents.

Provider insight - Failing to embed safeguarding not only risks harm. It results in Inadequate ratings, enforcement action, and reputational damage.

Conclusion - Safeguarding adults as a core duty

Safeguarding adults in health and social care is non-negotiable. It is a statutory duty, regulatory requirement, and moral imperative. Failures in safeguarding, whether through missed visits, poor governance, self-neglect, or institutional abuse, have devastating consequences.

By embedding safeguarding principles into daily practice, providers ensure compliance with the law, protect dignity, and build trust with the people they serve.

Strengthening safeguarding with ComplyPlus™

At The Mandatory Training Group, we help health and social care providers strengthen safeguarding systems and evidence compliance. Our services include:

• Safeguarding Adults Training (Levels 1-3) - CPD-accredited, aligned with CSTF and RCN competencies
• Statutory and Mandatory Training Packages - Tailored for regulated providers
• ComplyPlus™ Compliance Software - Manage policies, training, audits, and incidents in one secure platform
• Consultancy Services - Expert advice on governance, safeguarding reviews, and inspection readiness
• Policies and Procedures Toolkits - Compliant with the Care Act statutory guidance and CQC expectations

Learn more by visiting our Safeguarding Adults Courses.