Carevia Knowledge Centre · Safeguarding and culture

What is safeguarding in care homes?

Safeguarding in care homes means protecting people from abuse and neglect while supporting their rights, choices and wellbeing. It includes preventing concerns, recognising when something may be wrong and taking appropriate action. People should be involved in decisions about their safety and supported to explain what they want to happen.

Most care homes have a safeguarding policy and a training matrix. However, these cannot tell you whether a member of staff would recognise something concerning during a busy shift, or feel confident challenging a colleague they have worked alongside for years.

The practical question is whether your safeguarding arrangements work when someone needs them.

What might a safeguarding concern look like?

Some concerns are immediately recognisable, such as someone reporting that a member of staff has hit them. Others can be less obvious, particularly when poor practice has become familiar.

Examples that need attention include:

• Someone appearing frightened around a particular person.
• Unexplained injuries or repeated delays in seeking healthcare.
• Humiliating language, threats or rough handling.
• Missing money or pressure about financial decisions.
• Care being withheld or needs repeatedly left unmet.
• Restrictions being used for staff convenience.
• People’s choices being routinely ignored.

These signs do not, on their own, establish what happened. They give you a reason to listen, explore the concern and take appropriate protective action.

Safeguarding can involve the actions of staff, visitors, relatives or other people living in the home. Organisational routines can also contribute to abuse or neglect. The Care and Support Statutory Guidance describes different forms of abuse and recognises that concerns can arise from individual incidents or patterns of poor care.

What are the different types of abuse?

The statutory guidance identifies ten categories of abuse and neglect. They can overlap. The examples below are illustrative prompts for professional curiosity, rather than proof that abuse has occurred. They are not an exhaustive checklist, and staff should act on concerns without waiting to decide which category fits.

Self-neglect does not automatically require a section 42 enquiry. The response depends on the circumstances, including the person’s needs and ability to protect themselves. Distinguish self-neglect from unmet needs caused by inadequate support.

How can managers promote safeguarding in everyday practice?

Start by making it easy for people to tell you when something does not feel right. This includes people receiving support, relatives, visiting professionals and staff.

Check whether people know who they can speak to and whether communication arrangements work for them. A poster in reception will have limited value to someone who cannot read it or needs support to explain their concern.

For staff, training should connect with situations they might encounter in your service. Ask them what they would do if a colleague handled someone roughly, or if a concern they reported was dismissed. Explore who they would contact if the concern involved the manager.

CQC’s Regulation 13 guidance expects effective safeguarding arrangements, suitable training and staff who understand their responsibilities to prevent, identify and report abuse.

How you respond matters too. Thank people for raising concerns, take them seriously and explain what will happen next, within the limits of confidentiality. Staff need to see that speaking up leads to a considered response.

Do staff know how to raise concerns outside the usual reporting line?

Staff should understand your whistleblowing arrangements, including how to raise a concern if it involves their manager, they fear repercussions or previous reports have not been acted on. Make sure they know the alternative internal contacts and how to contact the local authority safeguarding team or CQC directly.

Explain how staff can raise concerns anonymously through the routes available. Be clear about the difference between anonymous reporting, where they do not provide their identity, and confidential reporting, where their identity is known but its disclosure is restricted as far as possible. Avoid promising absolute confidentiality, and explain that anonymous reports can make follow-up more difficult.

Check understanding through conversations and scenarios. Could a night worker or agency colleague find the relevant contact details without asking the person they are concerned about? Staff should know how to act when the usual reporting route does not feel safe. Your arrangements should make clear that staff must not be victimised for raising concerns.

Example: “We always get everyone up early”

A member of staff explains that everyone is supported to get up before breakfast because it makes the morning run more smoothly. One person regularly asks to stay in bed longer, but staff describe them as “difficult in the mornings”.

There are several questions to explore. What does the person want? What support do they need? Are staff offering a choice, or following a routine that suits the shift? What happens when the person says no?

The explanation “we have always done it this way” does not establish that the arrangement is appropriate.

The manager should address any immediate concern, speak with the person and establish whether other people experience the same routine. Consider the person’s rights, consent and any safeguarding implications, following local procedures.

How does professional curiosity support safeguarding?

Professional curiosity means taking an interest in what is happening, asking questions and looking beyond the first explanation. It is an essential part of safeguarding because small signs can point to a wider issue.

Someone becoming quieter, appearing uncomfortable around a particular member of staff or repeatedly missing an activity may have several explanations. However, accepting “they are always like that” without exploring what has changed could mean an opportunity to recognise a concern is missed.

Being professionally curious does not mean assuming someone has done something wrong. It means keeping an open mind, listening to the person and checking whether the explanation fits what you see, hear and read.

Professional curiosity also means connecting the dots between what the person tells you, their care plan, their history and what happens in practice.

In the early-morning example, what does the care plan say about the person’s preferred routine, and what input have they had into it? Do they want to get up early, or has this become the service’s routine? Were they used to getting up early for work, and does that still make sense to them now? Do they appear unduly tired during the day? What happens when they ask to stay in bed?

These details help you understand whether support reflects the person’s preferences or whether their choices are being overlooked. A lifelong habit can help explain a preference, but it should not replace asking what the person wants today.

Staff do not need to establish the full picture before reporting a concern. Professional curiosity should support prompt action and appropriate escalation, with further enquiries undertaken through the relevant safeguarding procedures.

How can The Noticing Model™ help?

The Noticing Model™ gives staff a structure for acting on their professional curiosity:

• Notice: what did you see, hear or find missing?
• Recognise: why might it matter to the person?
• Respond: what needs to happen now?
• Report: who needs to know, and through which route?
• Reflect: what will we notice sooner next time?

The model’s traps of Trust, Assumption, Familiarity and Reassurance help teams explore why a concern might otherwise be dismissed.

In the early-morning example, familiarity may have made the routine seem acceptable. Staff may assume that it reflects the person’s wishes, or trust that someone else has already checked. A completed care plan may provide reassurance without anyone checking whether the person’s experience matches what is written.

Use scenarios in handovers, supervision and team discussions to explore these assumptions. Ask staff what would make them pause, what else they would want to understand and when they would escalate.

How can the Noticing tools support safeguarding?

The tools within The Noticing Hub™ help teams bring safeguarding into everyday conversations, observations and reflection. Use them alongside your safeguarding procedures, training and reporting arrangements.

• Noticing Scenarios™: Explore situations staff might encounter, including subtle signs of abuse or neglect. Ask what they notice, what else they need to understand and what they would do next. Include concerns involving colleagues or managers so staff can practise explaining alternative reporting routes.
• Noticing Culture™: Explore whether everyday behaviour reflects the service’s values. Do staff feel able to question routines, challenge disrespectful language and raise concerns? Discuss how leaders respond when someone speaks up and what could make reporting feel difficult.
• Noticing Walkaround™: Look at people’s experiences as you move around the service. Notice interactions, choices, engagement and signs of discomfort. Compare what you observe with people’s care plans and conversations, rather than relying only on the appearance of the environment.
• Noticing Supervision™: Give staff space to discuss something that did not feel right, explore assumptions and reflect on their response. Check that they know how to escalate concerns and agree any coaching or support needed.

These discussions can help staff recognise concerns sooner. An immediate safeguarding concern must be acted on promptly; it should not wait for the next scenario session, walkaround or supervision.

What should staff do when a concern arises?

Take immediate steps to protect the person and obtain urgent assistance where needed. Call 999 where there is an immediate emergency. Listen calmly, avoid leading questions and record what the person says accurately. Do not promise secrecy.

Follow your safeguarding procedures and local authority reporting arrangements promptly. Preserve relevant evidence and avoid questioning people in ways that could compromise enquiries.

The manager must consider the external reporting required, including the local authority, police and CQC as applicable. Reporting internally does not replace required external referrals or notifications. If the manager is implicated or does not act, use the alternative reporting and escalation routes without delaying necessary protection.

Keep the person involved and consider their wishes, communication needs and decision-making capacity. Their preferences should inform the response; where information needs to be shared despite their objection, record the reasons. Seek appropriate advice where consent or information-sharing decisions are complex.

The local authority determines whether its duty to make safeguarding enquiries under section 42 of the Care Act applies. Staff should not wait to prove abuse before raising a concern through the appropriate route.

How do I know safeguarding arrangements are working?

Use RAOF™: Read, Ask, Observe and Feedforward to test what happens beyond the policy.

Read: Review concerns, incidents, complaints and relevant care records. Look for repeated issues and whether the response addressed the concern.

Ask: Speak with people about whether they feel safe, listened to and able to raise concerns. Ask staff how they would recognise and escalate concerns, including those involving a colleague or manager. Check whether they understand whistleblowing arrangements and know how to raise concerns anonymously or outside their usual reporting line.

Observe: Look at everyday interactions. Are people’s choices respected? How do staff respond when someone expresses discomfort or disagrees with the support offered?

Feedforward: Use what you find to agree actions, coaching and further checks. Recognise good practice and test whether improvements have made a difference to people’s experiences.

A low number of safeguarding reports does not establish that people are safe. Consider whether it reflects the service’s experience or whether staff are missing concerns, uncertain about reporting or worried about the response.

When you identify improvement work, record ownership, deadlines and how effectiveness will be checked. Our guide to care home audit action plans explains how to follow actions through.