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Safeguarding Children Legislation: Guidance for Schools

Claire Watts — Wed, 14 Feb 2024 08:00:00 +0000

If you work or volunteer with or around children, such as in a school setting, you have important safeguarding responsibilities. In order to properly fulfil your safeguarding duties, you need to understand what the law requires and keep up to date with any amendments or changes to it.

In order to make guidance as clear as possible, and to continually strengthen safeguarding procedures, the government frequently revisits and updates safeguarding statutory guidance documents. As a result, it can be difficult to keep track of new requirements and how they impact your role. In this article, we will provide a summary of key legislation and statutory safeguarding guidance for schools.

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Key Legislation in Schools

Working Together to Safeguard Children, one of the key statutory guidance documents for schools (which we shall look at later), defines safeguarding and promoting the welfare of children as:

Providing help and support to meet the needs of children as soon as problems emerge.
Protecting children from maltreatment, within and outside the home and online.
Preventing impairment of children’s mental and physical health or development.
Ensuring that children grow up in circumstances consistent with the provision of safe and effective care.
Promoting the upbringing of children with their birth parents, or otherwise their family network wherever possible and where this is in the child’s best interest.
Taking action to enable all children to have the best outcomes according to the outcomes set out in the Children’s Social Care National Framework.

There are several pieces of important legislation that contribute to the aims above, and influence policy and procedures regarding safeguarding children and young people. In the drop downs below, we give a brief summary of each law and its implications for safeguarding in schools.

The Children Act 1989

This was a revolutionary piece of legislation when it was implemented, as it completely reformed the law relating to children. This Act formed the basis of the current child protection system in England, and layed out the duties and responsibilities of all involved.

Some of the key principles that The Act established include:

The concept of parental responsibility.
The need for the child’s welfare to be the primary concern when a matter under the Act is before a court.
The need to take the child’s feelings and wishes into account.
The notion that children are best looked after by their family unless intervention in family life is essential.

The Act set out the duty of Local Authorities to promote and safeguard the welfare of children in their area. This included a responsibility to ‘promote the child’s educational achievement.’ It also introduced the concepts of children in need and children at risk of significant harm, which are key to ensuring children are appropriately safeguarded and given the level of support relevant to their needs.

A child in need is defined under the Children Act 1989 as: ‘a child who is unlikely to achieve or maintain a reasonable level of health or development, or whose health and development is likely to be significantly or further impaired, without the provision of services; or a child who is disabled.’

Significant harm takes into account many different factors, including:

The severity of ill-treatment.
The duration and frequency of abuse and/or neglect.
The extent of pre-meditation.
The ability of those with parental responsibility to protect the child.

Section 17 of the Act put a duty on the local authority to provide services to children in need in their area.

You may have heard the term section 47 with regards to child protection concerns. This refers to circumstances where a Local Authority is required to carry out an investigation as there is ‘reasonable cause to suspect that a child who lives, or is found, in their area is suffering, or is likely to suffer, significant harm’. The aim of this is to decide whether any action needs to be taken to safeguard the child. This is covered in Section 47 of the Children Act, hence the term.

The Act also covered the functions of Local Authorities in relation to looked after children. This included a duty to safeguard and promote the welfare of children in their care.

You can access the full act, which includes updates, here.

The Children Act 2004

This Act is a development from and amended the Children Act 1989. It provides the legal basis for how social services and other agencies deal with issues relating to children. The principles of the Act are to allow students to be healthy, remain safe, enjoy life, succeed and make a positive contribution.

Following the inquiry into the murder of Victoria Climbié by Lord Laming, the Children Act 2004 made a number of key changes to the child protection framework. (Further changes were then made by the Children and Social Work Act 2017, which amended the 2004 Act in a number of areas).

The Act reinforced that safeguarding children and promoting their welfare, is the responsibility of all people and organisations working with children.

According to a House of Commons briefing (2020), the 2004 Act (as amended), among other things:

Places a duty on Local Authorities in England to make arrangements to promote cooperation with key partners and local agencies, in order to improve the wellbeing of children in that area.
Places a duty on a range of agencies, including Local Authorities, the police and health services, to ensure that they consider the need to safeguard and promote the welfare of children when carrying out their functions.
Establishes the roles and responsibilities of safeguarding partners (the local authority, NHS Clinical Commissioning Groups and the police), which are responsible for determining how safeguarding arrangements should work in their area

The Act also introduced the role of the Children’s Commissioner for England, who is responsible for championing children’s views and interests, in order to promote their welfare. The role’s statutory remit includes ‘understanding what children and young people think about things that affect them and encouraging decision makers to always take their best interests into account’.

Further information about the Children’s Commissioner, and their work, can be found here.

You can access the Children Act 2004 here.

Children and Social Work Act 2017

This Act is concerned with provision for looked after children, other provision in relation to the welfare of children, and the regulation of social workers.

It had four main purposes, which were:

To improve decision making, and support for looked after and previously looked after children in England and Wales.
To improve joint work at the local level to safeguard children, and enable better learning at the local and national levels to improve practice in child protection.
To promote the safeguarding of children by providing for relationships and sex education in schools.
To enable the establishment of a new regulatory regime specifically for the social work profession in England.

This Act includes the requirement for governing bodies in maintained schools and academies to designate a staff member of staff for previously looked after children. This designated staff member is responsible for promoting the education achievement of those previously looked after pupils within the school.

The Education Act 1996

This Act covered a wide range of content relating to statutory education including, amongst other things, defining the stages of education, compulsory school age, the function of the Secretary of State, and roles and responsibilities of the Local Authorities.

It also detailed the requirement that parents (or those with parental responsibility) must ensure that their children of compulsory school age receive appropriate full-time education suitable to their age, ability, aptitude and any special educational needs. This can be by regular attendance at school, at alternative provision, or otherwise (e.g. the parent can choose to educate their child at home).

You can access the full Act here.

The Education Act 2002

This legislation sets out duties and responsibilities for schools in regards to safeguarding children. The Act requires anyone working with children and young people to share information or concerns in relation to a child’s safety and wellbeing.

Section 175 of this Act sets out a requirement for maintained schools, including nursery, early years and further education providers, to make arrangements to safeguard and promote the welfare of children. The roles and responsibilities of schools have also been enhanced and reinforced through publications, such as Keeping Children Safe in Education (which we will look at later in the article).

These provisions are equally applicable to free schools, academies and private providers under the Education (Independent School Standards) Regulations 2014, and the Non-Maintained Special Schools (England) Regulations 2015.

The Education and Training (Welfare of Children) Act 2021 extends this welfare duty to 16-19 academies, special post-16 institutions and independent training providers.

You can access the full Act here.

Education and Skills Act 2008

This Act raised the minimum age at which children could leave education. It contains measures to encourage more young people to participate in learning post-16 and to achieve higher levels of skill and qualification.

The Act:

Raised the age young people stay in education or training until from 16 to 18
Places a duty on young people to participate and on parents to assist their children to participate in such education or training.
Sets out duties on employers to release young people for the equivalent of one day a week to undertake training elsewhere (where the employer does not provide their own training)
Requires Local Authorities to assess the education and training needs of young people aged 16-19 with special educational needs.

You can access the full Act here.

The Safeguarding Vulnerable Groups Act 2006

The Safeguarding Vulnerable Groups Act (SVGA) 2006 was passed to help avoid harm, or risk of harm, by preventing people who are deemed unsuitable to work with children and vulnerable adults from gaining access to them through their work. The Independent Safeguarding Authority was established as a result of this Act.

The Act ensures safer recruitment by providing a system for employers to check the suitability of potential employees or volunteers who will be working with children or vulnerable adults. It covers DBS requirements and essentially prevents unsuitable people from gaining access through work. This act clarifies what is considered regulated activity, and therefore subject to such checks.

You can access the full Act here.

The Equality Act 2010

The Equality Act brought together a range of anti-discriminatory laws, and covers all of Great Britain.

It offers protection from discrimination, harassment and victimisation for nine specific personal characteristics. These are known as protected characteristics under the law.

The nine protected characteristics are:

Age.
Disability.
Gender reassignment.
Marriage and civil partnership.
Pregnancy and maternity.
Race.
Religion or belief.
Sex.
Sexual orientation.

The Act makes it unlawful for a school to discriminate against, harass or victimise a pupil or potential pupil. This includes:

In relation to admissions.
In the way that it provides education for pupils.
In the way that it provides pupils access to any benefit, facility or service.
By excluding a pupil or subjecting them to any other detriment.

Schools should also carefully consider how they are supporting their pupils and students with regard to particular protected characteristics. Provisions within the Act allow schools and colleges to take proportionate, positive action, to deal with particular disadvantages affecting students with a particular protected characteristic. This includes a duty to make reasonable adjustments for disabled children and young people (including those with long term conditions). Positive action could also include providing support for a group of students who share a protected characteristic.

State-funded schools and colleges are subject to The Public Sector Equality Duty (PSED) found in the Equality Act.

The PSED means that schools and colleges have a duty to

Have due regard to the need to eliminate unlawful discrimination, harassment and victimisation (and any other conduct prohibited under the Equality Act).
Advance equality of opportunity and foster good relations between those who share a relevant protected characteristic and those who do not.

This applies to all protected characteristics and equality implications should be taken into account whenever significant decisions are being made or policies developed. The PSED helps schools and colleges to focus on key issues of concern and improving pupil and student outcomes, being mindful that some pupils or students may be more at risk of harm from specific issues such as sexual violence, homophobic, biphobic or transphobic bullying or racial discrimination (KSCIE, 2022).

You can access the Equality Act 2010 here, and DfE guidance, The Equality Act 2010 and Schools here.

The Children and Families Act 2014

This Act seeks to improve services for vulnerable children and support strong families. It underpins wider reforms to ensure that all students and young people can succeed, no matter what their background. It deals with a variety of subjects, from childcare at home to special educational needs (SEN) in schools and issues around adoption.

You can access the full Act here.

Human Rights Act 1998

The Human Rights Act protects, amongst other things, the right to education. Article 2 of the first protocol states that no-one should be denied the right to education. It also states that, ‘in the exercise of any functions which it assumes in relation to education and to teaching, the State shall respect the right of parents to ensure such education and teaching in conformity with their own religious and philosophical convictions.’

The Equality and Human Rights Commission elaborates further on the implications of these rights, as follows:

The right to education does not give you the right to learn whatever you want, wherever you want.
The courts have ruled that the right to education relates to the education system that already exists.
It does not require the government to provide or subsidise any specific type of education.
The government is allowed to regulate the way education is delivered. For example, it can pass laws making education compulsory or imposing health and safety requirements on schools.
Schools are allowed to use admission policies so long as they are objective and reasonable.
Although parents have a right to ensure their religious or philosophical beliefs are respected during their children’s education, this is not an absolute right. As long as these beliefs are properly considered, an education authority can depart from them provided there are good reasons and it is done objectively, critically and caters for a diversity of beliefs and world views.

As well as the rights that are specific to education, a range of other Human Rights may also be applicable in an education context, such as:

Article 3 – No person shall be subjected to torture or inhuman treatment or punishment.
Article 5 – Everyone has the right to liberty and security of person except in a number of defined circumstances.
Article 6 – Everyone is entitled to a fair and public hearing by an independent and impartial tribunal.
Article 8 – Everyone has the right to respect for his private and family life, home and his correspondence.
Article 9 – Everyone has the right to freedom of thought, conscience or religion.
Article 10 – Everyone has the right to freedom of expression.
Article 14 – Prohibition of discrimination.

You can access the full Act here.

Children and Young Persons Act 2008

The purpose of this Act was to reform the statutory framework for the care system in England and Wales. The Act also includes provisions in relation to wellbeing of children and young people, private fostering, child death notification to Local Safeguarding Children Boards and appropriate national authorities and applications for the discharge of Emergency Protection Orders.

With regards to education, the Government includes the following key points in their summary of the Act. The Act:

Placed a duty on governing bodies of maintained schools to designate a member of staff as having responsibility for promoting the educational achievement of registered pupils at the school who are looked after.
Extended the duty on Local Authorities to appoint a personal adviser and keep the pathway plan under regular review to young people who are former relevant children (i.e. care leavers who are over 18) and who start or resume a programme of education or training after the age of 21 but under the age of 25 years.
Required Local Authorities to pay a bursary to a former relevant child who goes on to Higher Education.
Added the provision of short breaks for those who care for disabled children, and services to support family contact for children who are provided with accommodation under health or education legislation, to the range of services that local authorities must provide for children and their families.

You can access the full act here.

Sexual Offences Act 2003

This Act made new provision about sexual offences, their prevention and the protection of children from harm from other sexual acts, and for connected purposes.

The full act can be found here.

You might want to read our Hub article, How To Respond To Harmful Sexual Behaviour.

Voyeurism (Offences) Act 2019

Sometimes referred to as the anti-voyeurism act, this act made ‘upskirting’ an offence.

The Voyeurism (Offences) Act 2019 created two new offences under the Sexual Offences Act 2003, ‘criminalising someone who operates equipment or records an image under another person’s clothing (without that person’s consent or a reasonable belief in their consent) with the intention of viewing, or enabling another person to view, their genitals or buttocks (with or without underwear), where the purpose is to obtain sexual gratification or to cause humiliation, distress or alarm.’

This was reflected in the 2019 updates to the Keeping Children Safe in Education statutory safeguarding guidance.

You can access the full act here.

Counter-Terrorism and Security Act 2015

The Counter-Terrorism and Security Act 2015 contains a duty on schools, colleges and other specified authorities, to have due regard to the need to prevent people from being drawn into terrorism.

The core tasks of the Prevent Duty are:

To tackle the causes of radicalisation and be responsive to the ideological challenges of terrorism.
To safeguard and support those most at risk, through early intervention and ongoing support.
To enable those already engaged in terrorism to disengage and rehabilitate.

DfE guidance regarding the Prevent duty for schools can be found here and you can find further information in our Hub article Prevent Training: What Do I Need To Know? You can access the full act here.

Serious Crime Act 2015

This Act effected a number of proposals set out in the 2013 Serious and Organised Crime Strategy. It built upon existing criminal and civil law.

In relation to safeguarding children, the act introduced measures to enhance the protection of vulnerable children and others, including by strengthening the law to tackle female genital mutilation (FGM) and domestic abuse.

Amongst other things, the act:

Extended the scope of serious crime prevention orders and gang injunctions.
Clarified the offence of child cruelty, to cover cruelty which causes psychological suffering or injury, as well as physical harm.
Replaced outdated references to child prostitution and child pornography in the Sexual Offences Act 2003.
Introduced a new offence of sexual communication with a child.
Created a new offence making it illegal to possess paedophile manuals.
Criminalised patterns of repeated or continuous coercive or controlling behaviour against an intimate partner or family member.

In addition, with specific reference to female genital mutilation (FGM), the Act sought to help stop FGM and protect victims. It:

Extended the extra-territorial reach of the offences in the Female Genital Mutilation Act 2003 so that they apply to habitual as well as permanent UK residents.
Introduced a new offence of failing to protect a girl from risk of FGM.
Granted lifelong anonymity to victims.
Brought in a civil order (FGM protection orders) to protect potential victims.
Introduced a duty on healthcare professionals, teachers and social care workers, to notify the police of known cases of FGM carried out on a girl under 18.

You can access the full act here.

Statutory Safeguarding Guidance

As well as Acts of law, the government issues further statutory guidance regarding safeguarding children and young people. These documents contain guidance which schools must follow, in addition to guidance that schools should follow. The expectation from the government is that schools would need justification for not following any good practice guidance marked ‘should’ but that it is a legal requirement to comply with anything marked ‘must’ (no justification would be acceptable for not complying with those).

The key documents which you need to be aware of are:

Working Together to Safeguard Children
Keeping Children Safe in Education

These documents are updated at intervals, so it is crucial that you familiarise yourself with the current guidelines and keep up on top of any key changes. Doing so will enable you to make any necessary amends to your safeguarding policies or implement new procedures in your organisation, so you can continue to keep children safe from harm.

We will look at these key statutory documents below, providing you with a summary for each and signposting you to the most current versions.

Working Together to Safeguard Children (WTSC)

The Working Together to Safeguard Children statutory guidance document sets out the responsibilities that all organisations in England must fulfil to safeguard children and young people (which applies to anyone under the age of 18).

Last updated in 2023, it is aimed at everyone who comes into contact with children and sets out the concept that every agency, organisation and individual is responsible for working together to safeguard children.

The most recent update seeks to clarify the roles and responsibilities of those working with children and emphasises the need for strong multi-agency collaboration. It also highlights the importance of involving the whole family in the process of safeguarding, including the child themself.

Working Together to Safeguard Children is split into chapters which cover the following topics:

Chapter One: A Shared Responsibility – this new chapter, introduced in 2023, includes expectations for multi-agency working and principles for building strong relationships with parents and carers.

Chapter Two: Multi-Agency Safeguarding Arrangements – this chapter clarifies the roles and responsibilities of those who regularly work with children.

Chapter Three: Providing Help, Support and Protection – this chapter focuses on how early help can be delivered in education and childcare settings before examining how a broader range of organisations can contribute to the welfare of children.

Chapter Four: Organisational Responsibilities – this chapter emphasises the importance of effective information sharing across all organisations involved in safeguarding children.

Chapter Five: Learning from Serious Child Safeguarding Incidents – this chapter examines what can be learnt from unfortunate cases so that safeguarding can be improved in the future.

Chapter Six: Child Death Reviews – this chapter examines the responsibilities of those involved in child death reviews.

Keeping Children Safe in Education (KCSIE)

All education settings (including schools, colleges and state maintained nurseries) must follow the statutory guidance set out in Keeping Children Safe in Education. Keeping Children Safe in Education clearly explains how to fulfil your safeguarding duties and promote the welfare of children. Like in Working Together, here ‘children’ refers to anyone under the age of 18.

This statutory document is split into sections. These may change slightly between amended versions (although the core subjects covered will remain the same). For the guidance which comes into effect from 1 September 2023, the sections are as follows:

Part One: Safeguarding information for all staff.
Part Two: The management of safeguarding.
Part Three: Safer recruitment.
Part Four: Allegations made against/concerns raised in relation to teachers, including supply teachers, other staff, volunteers and contractors.
Part Five: Child-on-child sexual violence and sexual harrassment.
Annex A: Safeguarding information for school and college staff.
Annex B: Further information.
Annex C: Role of the designated safeguarding lead.
Annex D: Host families – homestay during exchange visits.
Annex E: Statutory guidance – regulated activity (children) – supervision of activity with children which is regulated activity when unsupervised.
Annex F: Table of substantive changes from previous version

Current guidance states that everyone who works with children read at least Part One of the guidance, and that those who do not work directly with children read either Part One or the condensed version found in Annex A of the guidance. It is the responsibility of the governing bodies or proprietors, along with the designated safeguarding lead to make sure that this happens.

Over recent years, this guidance has been updated and amended almost annually. You can keep up to date with key amendments by accessing our Hub article, Keeping Children Safe in Education: Key Changes.

Hopefully this summary has helped you to recognise where the key elements of our safeguarding and child protection policies and procedure have their basis. By remaining informed about legislation and statutory guidance as it evolves, you can make sure that your policies and practices are in line with requirements.

Further Resources:

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What are the 8 Caldicott Principles in Health and Social Care?

Victoria O'Regan — Fri, 15 Sep 2023 08:30:00 +0000

For those working within the health and social care sector, the confidentiality of patient and service user information is essential. Understanding what this means in practice, and your roles and responsibilities when it comes to information sharing, is outlined within the Caldicott Principles.

In this article we will outline what the eight Caldicott Principles are, why they were introduced and how they apply within the workplace. We have also provided a free downloadable poster that can be printed and displayed within your setting, to act as a reminder and help to ensure everyone acts in accordance with these principles at all times.

What are the Caldicott Principles?

The Caldicott Principles are fundamentals that organisations should follow to protect any information that could identify a patient – such as their name and their health records. Organisations should always use the Principles as a way of determining whether sharing an individual’s information could identify them, and if it does, whether it is appropriate and relevant for it to be shared.

In 1997, Dame Fiona Caldicott – and the committee she chaired – produced a report regarding confidentiality and the transfer of identifiable patient information within the health service. From this, a set of standards known as the Caldicott Principles were formed. Originally beginning with six principles, subsequent reviews have since taken place, with a seventh and then an eighth principle being added in 2013 and 2020 respectively.

Why Were the Caldicott Principles Introduced?

Not so long ago, our personal information – including that relating to our health – was not protected from public access. This meant that not only could your personal information and health status become public knowledge, but that it could be used inappropriately. For example, those wishing to exert power or control over others and those who would use it as a means to socially discriminate and abuse others, were able to do so.

In the past, there were many stigmas associated with certain health conditions and treatments and the worry over this information becoming known within their community could be a huge source of concern and upset for many. As technology advanced, these concerns understandably became greater.

Therefore, the motivation behind the Caldicott report was the increasing concern about advancements in technology and its capability to distribute information about patients quickly and extensively. The basis of the review was to ensure that confidentiality was not being undermined.

The Caldicott Principles helped to set out what, when and how information could and should be shared – supporting an acceptable level of confidentiality without compromising the quality of care received. The formation of these standards helped to tackle the problems within the National Health Service (NHS) involving patient data and its accessibility, storage and use.

As technological advances and the digitisation of data continues to evolve, keeping up-to-date with developments and the use of technology in health and social care is vital to help you to understand the various ways a patient or service user’s personal information can be used, stored and shared.

The 8 Caldicott Principles

Below is a summary of each of the eight Caldicott Principles as outlined by the National Data Guardian for Health and Social Care. You can find the information in full here.

Principle 1: Justify the purpose(s) for using confidential information

Every proposed use or transfer of personally identifiable information, either within or from an organisation, should be clearly defined and scrutinised. Its continuing uses should be regularly reviewed by an appropriate guardian.

Principle 2: Use confidential information only when it is necessary

Identifiable information should not be used unless it’s essential for the specified purposes. The need for this information should be considered at each stage of the process.

Principle 3: Use the minimum necessary confidential information

Where the use of personally identifiable information is essential, each individual item should be considered and justified. This is so the minimum amount of data is shared and the likelihood of identifiability is minimal.

Principle 4: Access to confidential information should be on a strict need-to-know basis

Only those who need access to personal confidential data should have access to it. They should also only have access to the data items that they need.

Principle 5: Everyone with access to confidential information should be aware of their responsibilities

Action should be taken to ensure that those handling personally identifiable information are aware of their responsibilities and their obligation to respect patient and client confidentiality.

Principle 6: Comply with the law

Every use of personally identifiable data must be lawful. Organisations that handle confidential data must have someone responsible for ensuring that the organisation complies with legal requirements.

Principle 7: The duty to share information for individual care is as important as the duty to protect patient confidentiality

Health and social care professionals should have the confidence to share information in the best interests of their patients and within the framework set out by these principles. They should also be supported by the policies of their employers, regulators, and professional bodies.

Principle 8: Inform patients and service users about how their confidential information is used

Steps should be taken to ensure patients and service users understand how and why their confidential information is used. They should always be provided with accessible, relevant and appropriate information.

Looking for a Course?

Take a look at our catalogue of courses for those working in Health and Social Care. These include courses to help you further your knowledge of data handling, such as our Information Governance training course.

How to Apply the Caldicott Principles

The Caldicott Principles are something that all health organisations should follow and promote to staff to protect patient information. The seventh principle, however, can cause a lot of confusion in healthcare environments. Often, people are uncertain about when it’s acceptable to share information about someone and when it’s not.

There are certain circumstances that override your duty of confidentiality. This is the aim of principle 7: to realise that sharing information can be as important as protecting confidentiality. It’s important that you can successfully balance the need for maintaining confidentiality with the need for keeping people safe.

You should share information about a patient when:

They, or others, are, or might be, at risk of harm.
They are at risk of posing harm to someone else.
A crime could be prevented if the information is shared.
A serious crime has been committed.
A court order or other legal authority has requested the information.

Knowing both when and how to maintain confidentiality in health and social care is not only important to ensure you are upholding your legal responsibilities, but it also helps to build and support trust between yourself and those within your care.

Always follow your organisation’s policies and procedures to make sure you are complying with confidentiality standards and the 8 Caldicott Principles within your day-to-day duties. This could mean that you do not provide the personal information of those within your care without certain identity checks, or it may mean that you do not repeat details of anyone’s personal life or events with those you don’t need to – including other colleagues.

Free 8 Caldicott Principles Poster

You can download our free poster at the link below. Why not display it within your setting to act as a reminder of the key principles of confidentiality.

The 8 Caldicott Principles provide a framework for all health settings to follow to protect identifiable patient information. If you work in a health setting, it’s important that you’re aware of these responsibilities and know what your duties are in relation to them.

Further Resources:

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How to Maintain Confidentiality in Health and Social Care

Nell Hendy — Wed, 12 Apr 2023 08:30:00 +0000

Everybody deserves to have their privacy and personal details respected. This is our right and it’s important that all environments and institutions act accordingly, including schools, businesses, and health and social care sectors.

If you work in health and social care, it’s important that you understand your duty of confidentiality. You must abide by this duty and ensure that you respect your patients’ and clients’ legal right to privacy. In some rare cases, it may be necessary to override your duty of confidentiality, particularly if people are at risk of harm. Read on to find out more.

What is Confidentiality in Healthcare?

The definition of confidentiality in health and social care is keeping sensitive information private and respecting someone’s wishes. It means that professionals shouldn’t share personal details about someone with others, unless that person has said they can or it’s absolutely necessary. ‘Professionals’ in this context includes people like doctors, nurses, social workers, support workers, and employers.

In a health and social care setting, confidentiality means that the practitioner should keep a confidence between themselves and the patient, as part of good care practice. This means that the practitioner shouldn’t tell anyone what a patient has said and their details, other than those who need to know. This also includes not showing anyone – again, other than those who need to know – an individual’s personal notes or computer records.

Want to Learn More?

Our Information Governance Training is designed to help those who work in health & social care, giving you the tools to understand your obligations around data protection. See how else we might be able to support you with our full range of Safeguarding Courses.

Confidentiality in health and social care is important for building relationships with service users. Keeping the necessary information private and respecting an individual’s wishes regarding sensitive information will help build trust. If a service user knows that their private information is going to be kept confidential, they will feel confident in sharing information to get the help and support they need.

It is also important to maintain confidentiality in health and social care as it is your legal duty. There are many different pieces of legislation and different policies in place to ensure that you maintain confidentiality.

How to Maintain Confidentiality in Healthcare

There are many ways that you can maintain confidentiality in health and social care, including:

Reporting any breaches of confidentiality to the appropriate person.
Remaining vigilant to whether the information you share is confidential.
Following your organisation’s policies and procedures relating to confidentiality.
Seeking guidance from the appropriate person when you are unsure about confidentiality.
Communicating with service users to build trust.

How to Maintain Principles of Confidentiality in Childcare

It may also be the case that you frequently handle confidential information about children. The same principles of confidentiality apply in this situation: you should maintain confidentiality but override it if you think the child is at risk. Always be vigilant to recognising the signs or abuse and neglect and tell somebody if you think the child is at risk.

You should view confidentiality on a need to know basis, which means that you only share information when it’s necessary and with people who need to know. Relationships between professionals and children are built on trust, so it’s essential that you uphold a child’s confidentiality unless they are at risk. If you need to share a child’s information, ask for their consent unless there is a compelling reason not to do so. This is important for transparency, trust, and building a relationship.

There are many legislative requirements surrounding confidentiality in health and social care. If you work with patients and their records, then it’s important that you’re aware of patient confidentiality law and the following legislation.

The Common Law of Confidentiality

The principle of confidentiality is broadly taken from common law, which is why it’s called a common law duty of confidentiality. Confidentiality is important for encouraging people to come forward with issues and concerns.

However, there are certain offences and provisions where the duty of confidentiality is overridden. For example, if a girl has been a victim to Female Genital Mutilation (FGM), then this is a criminal offence and the appropriate authorities need to know. Additionally, if there is a serious safeguarding concern and somebody is at risk, then you have a duty to share this information to keep people safe.

The Human Rights Act 1998

The Human Rights Act gives every individual the right to respect for their private and family life. This includes having any personal information held in confidence. This right, however, is not absolute and can be overridden if necessary, such as for a safeguarding concern.

The Care Act 2014

This Act encourages caregivers to take a person-centred approach when safeguarding adults at risk. It also sets out a new way of thinking in relation to adult social care by explaining the importance of sharing information at early stages so that people stay safe.

This Act sets out a number of provisions relating to the health and social care services in England. It covers the integration of information relating to users of health and social services. It also explains the sharing of information for individuals who use health and social care services.

The Data Protection Act and the GDPR both have provisions that explain the way organisations, charities, and businesses must handle information. This includes care settings and provisions relating to clients, patients, and employees. Under Data Protection and the GDPR, personal information must be:

Processed lawfully, fairly, and transparently.
Collected for specified, explicit and legitimate purposes.
Adequate, relevant, and limited to what’s necessary for the purposes of why it was collected.
Accurate and up to date.
Not be kept for longer than is necessary.
Processed in a manner with appropriate security, including protection against accidental loss.

Some examples of information that should be kept confidential include the following:

Relationship concerns – if a service user shares with you information about their relationships or family and asks you not to share the information, you have a duty to keep that information private. For example, if they have begun a romantic relationship with someone. However, if the relationship is a cause for concern, such as a child beginning a relationship with someone much older, you will have to break confidentiality.

Details of health – if a service user discusses their health or condition with you but doesn’t want other service users to know, you have a duty to keep that information confidential. For example, if a service user asks you about another service user’s health, you should inform them that you cannot discuss other service user’s conditions.

Personal details – information regarding a service user’s name, address, age, bank details and more, should be kept confidential. This information should only be shared with individuals that need to know, for example, the service user’s doctor.

There are many uncertainties surrounding confidentiality in health and social care. Common questions express concerns like ‘when shall I disclose confidential information?’ and ‘will I be breaching confidentiality in expressing my concerns?’.

To provide a simple answer: you may, in certain circumstances, override your duty of confidentiality to patients and clients if it’s done to protect their best interests or the interests of the public. This means you may override your duty if:

You have information that suggests a patient or client is at risk of harm.
You have information to suggest that a patient or client is posing a risk of harm to someone else.

In these instances, you should always report your concerns to your manager or supervisor. You should also help and contribute to any further actions that are taken to reduce the risk of harm.

However, sometimes things are not this simple and it can be easy to misread and misunderstand the signs. If you have any concerns about someone, or a confidentiality issue arises, you should always ask your manager or supervisor for advice.

Consider the following scenario, which explains why over-riding confidentiality is sometimes necessary.

Scenario

You are a care worker and you have gone to assist an elderly male at his home. You don’t usually assist this man, but his usual care worker has gone away for the week.

When you are helping him to get dressed, you notice several bruises on his back. When you enquire about these, he explains that his usual nurse attacked him last week and caused the bruises. He believes that he said something silly because the care worker started calling him names and then hitting him.

You are very concerned about this man’s safety when his normal care worker returns. He tells you that he doesn’t want you to tell anybody because the care worker is usually nice and it was just him making a silly comment that caused this to happen. He has become upset and he doesn’t want to get the care worker into trouble.

Conflict

There is a clear conflict in this situation. You believe that you should inform your manager immediately and report the other member of staff. However, the gentleman has begged you not to do this and has told you in confidence, so you don’t want to breach his confidentiality.

Resolution

In this situation, it is acceptable to override your duty of confidentiality. This is necessary to protect the man from further harm.

You should explain to him that you understand why he is upset and doesn’t want to speak out. However, explain that he has experienced a form of abuse that he has a right to be protected from and how you can help him.

Here, you are acting on behalf of the man’s best interests and within the Public Interest Disclosure Act. This means you can override your duty to protect his confidentiality and speak to your manager about what you have found.

You have a duty to protect patient confidentiality in health and social care. However, when a patient or client is at risk of harm or posing a risk to someone else, you may, in certain circumstances, override this duty if it’s done to protect their best interests or the interests of the public.

What to Read Next:

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What are Gender Health Inequalities?

Victoria O'Regan — Fri, 23 Sep 2022 08:30:00 +0000

There are a number of inequalities throughout the health and social care sector that have an impact on the health of many. Gender is one such inequality, with research showing a significant gender health gap in the UK, leading to poorer health outcomes for women.

This article will explain the meaning of gender inequalities, why the relationship between health and gender is so important, how gender affects healthcare, and what the women’s health strategy is.

What are Gender Health Inequalities?

To begin answering this question, it is important to understand that there are differences between the terms sex and gender. The World Health Organisation (WHO) describes the term gender as referring to “socially constructed characteristics of women and men – such as norms, roles and relations of and between groups of women and men”.

Sex on the other hand is described as being “mainly associated with physical and physiological features including chromosomes, gene expression, hormone level and function, and reproductive and sexual anatomy.” There are connections between both sex and gender and both can lead to inequalities in healthcare.

Gender health inequality means having unequal access or opportunity to access healthcare services and treatment due to your sex or gender, leading to poorer health outcomes. There are many other factors that can make someone more susceptible to inequalities in healthcare. For more information on this topic, take a look at our article – What are inequalities in health and social care?

The WHO states that inequalities in healthcare disproportionately affect more women and girls than men and boys. Equality and diversity is a key part of being able to deliver high-quality, person-centred care and support to all throughout the sector. Yet health services within the UK lack vital knowledge and services to equally support the needs of both men and women.

Want to Learn More?

For further insights into the values that under-pin patient care, check out our Equality and Diversity and Person-Centred Care training courses.

Understanding why such inequalities exist requires a much wider perspective on the gender inequalities that exist in many areas of life. The history of learning and power, particularly in medicine was very much focussed on men and heavily influenced by their opinions, perspectives and beliefs.

This amongst many other factors has led to a lack of knowledge and understanding, not only around health concerns that affect only women, but also the different ways men and women can be affected by the same condition. Knowing such inequality exists makes it all the more important to understand the relationship between sex, gender and health.

Why is the Relationship Between Gender and Health Important?

Understanding how an individual’s health can be affected based on their sex or gender is incredibly important in being able to ensure appropriate treatment, services and education are available to support them towards a positive outcome. Both of which can have a significant impact on a person’s risks and susceptibility and to illness.

For example, the relationship between gender and health may also interlink with social inequality. Many women and girls are given less autonomy over their bodies, have less decision making power and face greater discriminatory attitudes from healthcare providers, often making it harder for them to access the services and treatment they need, or receiving an accurate or timely diagnosis.

Gender can also increase a person’s exposure to instances of domestic violence, emergency situations, work injuries, cigarette and alcohol intake and misuse, and certain risk taking behaviours. These are just a few examples, but understanding gender norms, socialisation and societal roles can create a better understanding of the links between gender and health.

The relationship between sex and health affects a person’s risk of disease, disease progression, the treatments given and the overall health outcome. For example, a particular enzyme found in men that binds to the SARS-COV2 virus (COVID-19) may be responsible for more severe outcomes and hospitalisations for men with the virus than women.

What are the Quality of Care Differences Between Men and Women?

How a person views the quality of care that they have received can be subjective and will depend on their individual circumstances and perspective. However, quality of care should be based on core values, including equality and diversity, dignity, respect and compassion in care.

Gender bias means having a preference of one gender over the other. It can be widespread in the health and social care sector and have a negative effect on health outcomes and systemic practices.

Some examples include:

Poor understanding of women’s health issues leading to delayed or misdiagnosis, such as overlooking potential causes of abdominal pain during a woman’s menstrual cycle, or not taking certain symptoms seriously if a woman is going through the menopause. You can learn about some of the common myths and facts around menopause here.
Misdiagnosing a heart attack in a woman due to the idea that they mainly occur in men.
Being less believing of certain symptoms or complaints of pain depending on a person’s gender or character. Such as assuming a ‘manly’ man is being stoic whereas a man who appears less ‘manly’ is being dramatic or emotional.
Treating a patient less favourably because they are gender diverse. Transgender individuals, for example, often experience high levels of mental health illness, due to the discrimination and stigma they face, including within healthcare settings.

How Does Gender Affect Health Care?

We have discussed how gender and sex can affect a persons’ health and the healthcare they are likely to receive, often coming down to reasons such as physiological and social factors. We have also looked at some examples of how gender bias impacts the quality of care an individual receives.

When it comes to healthcare itself, gender and sex pose risks of vast inequality. Some reasons for this include:

A lack of representation of women during clinical trials.
A lack of knowledge on women’s health issues.
Stigma associated with gender norms.
Poor understanding of how conditions affect men and women differently.
Gender bias on a systemic level and amongst healthcare professionals.

A combination of factors are responsible for all inequalities in healthcare, including gender inequality and the issues are often complex and widespread.

6 Ways That Gender Affects Health

The reasons why certain diseases and conditions are more common in one particular sex or gender than the other can be complex. Factors such as genetics, behaviours and hormones can all play a part. Take, for example, six common illnesses that both men and women are affected by.

By understanding the complex relationship between sex, gender and health, professionals can paint a picture of which groups are most impacted by which illness. Some examples of conditions that are more common in one sex over the other include:

Men

Heart disease.
Parkinson’s disease.

Women:

Alzheimer’s disease.
Urinary tract issues.
Osteoporosis.
Strokes.

What is the Women’s Health Strategy?

Women’s health is greatly impacted by inequalities in healthcare, from being underrepresented in research studies to a lack of understanding of certain female-specific issues. A lack of quality and availability of women’s health services leads to poorer outcomes for many, prompting the Government to take formal action.

In 2021, Nadine Dorries, the Minister for Patient Safety, Suicide Prevention and Mental Health, addressed the House of Commons, stating the Government would be creating a government-led national women’s health strategy for England. The first of its kind.

The Government made a call for evidence and emphasised the need to understand the real experiences of the healthcare system from women of all ages and backgrounds. The experiences provided were intended to help focus understanding on six core themes, believed to connect the different areas of women’s health throughout all stages of life. These are:

Placing women’s voices at the centre of their health and care.
Improving the quality and accessibility of information and education on women’s health.
Ensuring the health and care system understands and is responsive to women’s health and care needs across the life course.
Maximising women’s health in the workplace.
Ensuring that research, evidence and data support improvements in women’s health.
Understanding and responding to the impacts of Covid-19 on women’s health.

The aim of this strategy is to tackle the deep-rooted issues within the healthcare system to improve the wellbeing and health outcomes of women and girls, breaking down the barriers faced to improve equal access and support for all.

We all have the right to be treated equally, regardless of our sex or gender. By recognising the systemic issues within the health and social care sector and taking action to tackle the deep-rooted inequalities, the future may offer greater health equality for all.

Further Resources:

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How Can We Work Together to Safeguard Adults?

Victoria O'Regan — Wed, 16 Mar 2022 09:30:00 +0000

Safeguarding involves taking action to protect at risk groups and individuals from harm. It is incredibly important to work together in order to ensure everyone within the community can live a life that is free from harm and abuse. This is a fundamental human right that applies to us all, yet unfortunately this right can be neglected for some people, often due to their age, frailty, having a physical or mental disability, or the fact they lack the capacity to make decisions for themselves.

This article will familiarise you with key safeguarding practices and the legislation surrounding them. This knowledge can help us to understand how to effectively work together to safeguard adults. We will look at how safeguarding could apply to you, examples of safeguarding, and how communities can help to safeguard those around them that are at risk of harm.

Want to learn more?

Why not find out more about recognising the signs of abuse in adults by reading our Signs of Abuse in Adults article. Or you may find our Safeguarding Training courses useful if you would like to gain the necessary knowledge required to meet your safeguarding responsibilities.

What Safeguarding Adults Legislation and Statutory Guidance Applies to You?

Whether you work in the health and social care sector, care for an adult in need, or feel concerned about a loved one or family member, it is important to remember that safeguarding adults is everyone’s responsibility. We can each play our part in protecting people’s right to live in safety and free from harm.

An adult that requires safeguarding, refers to an adult that is aged 18 years or over who is at an increased risk of neglect or abuse because they have certain needs that require care and support. These individual’s are now referred to as ‘adults at risk’ or ‘adults in need’ under the Care Act 2014.

A local government organisation that is responsible for the provision of public services and facilities is known as a local authority (such as a local council). It is this authority that holds the statutory responsibility for safeguarding these individuals, working together with health and social care services to promote safety and wellbeing in local communities.

The framework that sets out these safety standards can be found within The Care Act 2014, a key piece of legislation that relates to individuals with care and support needs. It applies to all those who care for them, setting out the statutory guidance for ensuring effective safeguarding. It also sets out the responsibilities of the Local Authority and provides guidance on how we can all work together to meet the necessary care standards and safeguarding aims.

If you have a duty of care (a legal responsibility) for the safety and wellbeing of adults at risk, you should note that these responsibilities apply to you. When faced with a safeguarding concern, you should:

Ensure the individual’s safety and wellbeing, do they need medical care?
Find out the individual’s views and wishes regarding the safeguarding issue and procedure.
Ensure you maintain any evidence, such as CCTV or clothing worn during a potential assault.
Follow local policies and procedures regarding reporting any incidents/risks.
Remain calm, listen carefully and show understanding and empathy.
Let the individual know that you are required to share information about the issue, including what information will be shared and why.
Make a written record of what they have told you, using their words, along with what you have seen and the actions you took.

As well as the Care Act 2014, there are several important pieces of legislation that have been put in place to help protect adults at risk in the U.K. These include:

Safeguarding Vulnerable Groups Act 2006.
Health and Social Care Act 2012.
Mental Capacity Act 2005.
Equality Act 2010.
Human Rights Act 1998.
Data Protection Act 2018.
Public Interest Disclosure Act 1998.

Examples of Safeguarding Adults

Understanding which individuals are most at risk and the circumstances in which they may suffer abuse and neglect can help you to recognise and identify when a safeguarding concern is present.

We have discussed which individuals are considered at greater risk of harm, so now let us look at some scenarios that demonstrate when an individual is not being properly protected and when safeguarding should be in place:

A lack of provisions, such as food, clothing, toilet access, or shelter.
Not responding to, or supporting, an individual’s emotional needs.
A lack of access to care for personal care needs.
Poor access to medications, medical treatment or care and support.
An inadequate risk assessment being in place, causing risk of harm to the individual or others.
Abandonment or inadequate supervision of an adult in need.
A lack of encouragement to develop or thrive and no wellbeing support available.
Family or staff intentionally withholding information regarding an individual’s entitlements and rights.
An individual’s care plan not being followed, resulting in a lack of person-centred care.
The individual being at an increased risk of, or suspected incidents of, abuse taking place (i.e. physical, emotional, sexual, neglect, financial etc.)

The individuals who find themselves involved in these scenarios could differ in personal circumstances and living conditions. It is important to remember that adults at risk who require safeguarding can live alone, at home with family, or reside in a hospital or care home setting. Do not assume neglect or abuse does not take place solely based on where they live and who they live with.

How to Work Together to Safeguard Adults

As we have mentioned, safeguarding is everyone’s responsibility and the Care Act 2014 sets out several key aims to ensure everyone plays their part. As well as aiming to prevent harm and reduce the risk of abuse and neglect, it also aims to raise public awareness to ensure professionals, staff and communities work together to play their part in preventing, identifying and responding to safeguarding issues.

For the aims set out within the Act to be achieved, a multi-agency framework must be created for safeguarding. There must be integration between healthcare partners and the Local Authority, which involves NHS England and Clinical Commissioning Groups (CGCs) working in close partnership with social care services. The chief officer of police for the area is also integral to these community partnerships to enable effective safeguarding.

The representatives from these partners will form a Safeguarding Adults Board (SAB), set up by the Local Authority. The role of this group is to come together to find the best ways to protect adults in need. If it is believed an individual is either experiencing, or at risk of experiencing, neglect or abuse, cooperation amongst these partnerships is vital as enquiries are carried out.

Remember that every area of the UK has its own Safeguarding Adults Board. If you have concerns and are unsure where to turn regarding safeguarding issues, you can access your local SAB and reporting advice via your local council’s website.

Safeguarding Adults in Your Community

Communities as a whole can play a significant part in preventing, detecting and reporting neglect and abuse. Here are some general tips for how those within the community can help to safeguard their at risk members by taking into account the 6 key principles outlined in the Care Act 2014:

Empower them to make their own decisions where possible, by providing straightforward, jargon-free information, work with advocates where necessary, and by involving them in the process of informing their own care package.
Protect them by contacting the appropriate authorities and following suitable safeguarding procedures when needed.
Prevent them from experiencing abuse and neglect by gaining the appropriate knowledge to recognise the signs of abuse and gain the confidence to report suspected issues without putting the adult at any increased risk of harm.
React with proportionality to any safeguarding issues, react calmly and ensure any next steps taken are done in a way that does not overwhelm the adult and allows them to maintain their dignity and quality of life.
Utilise partnerships. A response can often be quicker and most effective if multiple-agencies report concerns over neglect and abuse, and is more likely to be detected by sharing information between appropriate parties (in-line with the Data Protection Act).
Accountability is important when dealing with an adult at risk. The person or their nominated representative should understand at all times the role of everyone involved in their care and be able to contact them when required.

Be mindful of those around you, do not assume someone else will take action or that it is someone else’s responsibility to report concerns over someone’s wellbeing and safety.

Guidance on Safeguarding Adults Effectively

The information within this article covers the importance of safeguarding adults at risk, highlighting that we all have our part to play in their protection, and that working together is necessary to achieve this. The Department of Health states that safeguarding means ‘protecting an adult’s right to live in safety, free from abuse and neglect’, a basic human right that should apply to us all.

In order to effectively safeguard adults within a community, the appropriate guidance and legislation must be followed. The Local Authority must achieve its aims as set out by the legislative frameworks, ensuring that all parties and organisations involved understand their roles and responsibilities and create a strong multi-agency framework, including a Safeguarding Adults Board (SAB).

The SAB requires a chair to be accountable for their effective collaborative work, and whilst the members of a SAB should offer different skills and experience, to be fully effective they should have safeguarding awareness training, and an understanding of:

Abuse and neglect and the impact they have.
Local safeguarding services.
Their role within the SAB and that of the SAB as a whole.

The best way to ensure safeguarding is effective throughout our communities, is to ensure all those responsible for the safety and wellbeing of adults at risk are appropriately trained and experienced to do so. Anyone wishing to report the possible occurrence or risk of occurrence of abuse or neglect should be supported to do so.

As individuals we should seek to further our knowledge on how best to work together to protect and empower those members of our society that are most at risk of harm.

Further Resources:

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What are Difficult Conversations in Health and Social Care?

Nell Hendy — Wed, 09 Feb 2022 09:30:00 +0000

Communication in health and social care is vital and an invaluable skill regardless of your job role. However, communication skills do not always come naturally and some individuals may require more training than others. It is also harder to communicate during stressful and difficult situations, which are very common within the sector.

This article explains what difficult conversations in health and social care are, as well as example scenarios. We will outline tips on how to prepare for difficult conversations, and provide further guidance on how best to communicate in these situations.

What are Difficult Conversations in Healthcare?

Breaking bad news and having difficult conversations with patients and their families, is expected in health and social care and an integral part of the job. In a single day, you may have to hold difficult conversations with a multitude of people with a variety of educational, cultural and social backgrounds.

It is important you communicate effectively, and in a caring and professional manner. There is a high possibility that you will be dealing with someone who is very emotional. This can sometimes lead to aggression, anger, abuse, hostility and confrontation.

Examples of difficult conversations include informing someone of their diagnosis or worsening health, delivering the news of death to loved ones, organising arrangements for end-of-life care, or responding to a conflict situation. No matter the situation, the conversation is often emotionally charged as the individual may be worried, scared, in pain or distressed.

Ineffective communication when having a difficult conversation can lead to:

An inappropriate choice of words or phrases.
A lack of planned structure in delivering difficult news.
Delivering the news in an inappropriate environment.
Not involving the patient in the decision-making process.
Rushing the patient to agree to a proposed treatment plan.
Not referring the patient to any appropriate support services or resources.

Communication skills can help de-escalate aggression, and can even prevent it from arising in the first place. Therefore, familiarising yourself with the scenarios you may be faced with can help you to prepare and best handle all possible situations.

Communication Scenarios in Healthcare

By understanding the possible situations in which you may have to have a difficult conversation, you are one step closer to being able to prepare for, and handle them, effectively. However, communication is a transitional, dynamic and constantly changing process, so it can be difficult to prepare for every potential scenario.

Below are some examples of situations in which you may have to have a difficult conversation:

Your patient has dementia and can’t fully understand what is happening to them, making them and their family feel anxious.
Your patient is coming to the end of their life and you need to discuss their care options.
You have to inform someone of their diagnosis or worsening health.
You have to deliver the news of death to loved ones.

The following are common reactions you may be faced with when delivering difficult or hard to hear news, with some suggested appropriate responses:

Avoidance – ‘it is important we acknowledge what’s happening’, ‘let’s try to discuss the issue at hand’.

Blame – ‘I understand there may be other people involved, but right now I’d like to keep focused on you and I’.

Silence – ‘it’s important we talk about this as it’s serious’, ‘let’s try and reflect on what’s happened’, ‘I’m keen to hear your view and how we can move forward’.

Anger – ‘it seems you are angry, could you explain to me what you’re feeling so I can understand and try to help you?’.

Crying – ‘let’s take a moment before we continue’, ‘take your time, I know it’s a lot to process’.

Being aware of the possible reactions and situations in which you may need to have a difficult conversation can help you prepare. Also, it is important to keep in mind that poor communication is the primary cause of patient complaints.

How to Prepare for Difficult Conversations

Preparing yourself and the environment before having a difficult conversation is highly important.

When preparing, consider the following:

Ensure you know all the facts about the situation.
Consider where you are going to have the conversation.
Consider how you are going to start the conversation and what you are going to say.
Identify what the person you are talking to already knows.
Consider how they may feel.
How are you going to show compassion and empathy? (Through tone of voice, phrases etc.).
Are you going to talk to them individually or with their family present?
How are you going to help them understand the situation?
Do you know what support is available? For example, contact details to any referrals.
How will you react to crying or any distress they may show?
Are you prepared to answer any questions they may have?
Perhaps find someone you can debrief with before and after a difficult conversation.

Looking to Learn More?

Our Communication Skills in Health and Social Care course covers a variety of communication methods, including barriers to communication and how to overcome them. It also covers how to respond to conflict and hold difficult conversations appropriately and efficiently.

No matter how you prepare before having a difficult conversation, one of the most important elements is showing empathy and compassion throughout. This is part of your duty of care, and central to person-centred care.

Furthermore, the NHS provide a challenging conversations model that outlines six steps. The steps are: prepare, state intention, tell your story, listen to their story, manage reactions and agree next steps. It works on the principle that your job is to deliver the news, hold the discussion and help the individual to understand, as well as addressing and resolving any issues.

How to Communicate in Difficult Situations

As we have already mentioned, preparation is crucial for holding difficult conversations. Once you have prepared yourself and the environment, it is helpful to familiarise yourself with the following steps for communicating.

Follow this ten-step approach when you need to have difficult conversations:

Prepare yourself and the environment as much as you can:
- If possible, find a comfortable and private place to have the conversation.
- Before the conversation, think about how you will end it. Can you offer any advice or referral information for support? Do you know which professional (doctor, nurse, registrar for death) they will speak to next?
- Support yourself, for example who can you talk with to debrief?
Engage and empathise with the person you are talking to from the outset.
Start the conversation with a clear outline of what is going to follow.
Find out some of what the person you are talking to knows, expects, and feels.
At this point and not before, find out if they are with someone, or have someone to talk to afterwards.
Bring the person towards an understanding of the facts, for example, what has happened or is likely to happen.
Use clear terms: either die, dying, death. If you wish to use gentler terms, make sure they can’t be misunderstood.
If they cry, acknowledge with a soft tone of voice and express sympathy. If they apologise for crying, reassure them it’s OK and understandable. If you can, avoid giving further information until they’re slightly calmer.
Move towards ending the conversation – check they have understood everything and answer any questions.
Offer words of comfort and tell them what will happen next.

Poor communication in these situations can lead to confusion and distress, especially when delivering bad news. To further your knowledge, the NHS provide some guidelines for breaking bad news. These guidelines include information on admitting adverse events and potential pitfalls in communication.

Effective communication in health and social care is paramount. Regardless of your job role, you will have to have difficult conversations and ensuring they are carried out appropriately is crucial. Preparation is of the utmost importance to ensure you can communicate everything you need to efficiently, whilst supporting the person you are speaking with.

Further Resources:

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End of Life Planning in Health and Social Care: DNACPR, ADRT and ReSPECT

Victoria O'Regan — Mon, 27 Dec 2021 09:30:00 +0000

Whether due to old age or ill-health, there can be different motivations behind wanting to understand the options available when it comes to end of life care planning and decision making. This process can be difficult for an individual and their loved ones to talk about, but whether you are the dying person, a family member or a health or social worker providing their care, it can provide many benefits for all involved to plan ahead.

Within this article we will look at what end of life care is, why it is important, and provide an overview of DNACPR, ADRT and ReSPECT documentation and their purpose. Having an understanding of end of life care and planning and the associated documentation ensures those responsible for providing care and treatment do so in accordance with the individual’s wishes, most particularly at a time when they are unable to express them for themselves.

Looking to learn more?

Our Basic Life Support Training is designed to give you the knowledge and understanding required to react quickly and appropriately in emergency situations, increasing the safety and quality of care provided.

What is End of Life Care?

End of life care is the support an individual receives in their last weeks, months or even years of life. It is generally said a person is nearing the end of their life if they are expected to die within a year. This is, of course, not always possible to predict. End of life care may only be required for a few hours or it may last for several months to years depending on the circumstances.

Those considered to be nearing the end of life are not just those whose death is iminent, but those with advanced, incurable conditions, such as cancers, organ failure, dementia or motor neurone disease, those with a combination of several health conditions and frailty, and those who suffer an acute life-threatening event such as an accident or stroke.

The aim of end of life care is to allow the individual to die with dignity and respect, live as well as possible for their remaining time and support them to die in a way that takes their personal wishes and preferences into account. End of life care should also extend to supporting the dying person’s loved ones, carers and those important to them.

End of life care can be provided in different locations and by different people. The way a person is supported during end of life care depends on their individual wishes, circumstances and what stage of dying they are at. Care may be provided in the home, hospital, hospice or care home. Several factors may influence this decision, for example if a person deteriorates quite quickly, then moving them from say a hospital to a hospice may cause more distress than leaving them be. Or an individual may choose to move from their care home to a hospice as the pain management is more suited for their needs.

It may be provided by hospital doctors, nurses, care workers, GPs, community nurses, social care workers, as well as various therapists, such as occupational, complementary and physiotherapists. Religious representatives, such as chaplains, may also play an important role in someone’s end of life care as well as family and friends. Everyone has a role to play in end of life care – it is not limited to healthcare professionals. It is, however, important that all those involved have the knowledge and skills required to understand how best to support the dying person.

What are Palliative and Comfort Care?

Palliative care is one term used a lot when discussing end of life care and the two terms are often used interchangeably. Palliative care helps support people with a terminal illness and this can begin from the time of diagnosis and remain until they die.

Therefore, end of life care includes palliative care, but palliative care can begin before a person is dying. It is a holistic approach that does not just deal with the illness itself but looks at the individual as a whole. It addresses any pain and supports the psychological, spiritual and social aspects of the individual’s needs by caring for them in a tailored, person-centred way.

Comfort care is also a term used when discussing end of life care, and again it is included in end of life care as a whole. Pain management and making someone comfortable can happen at any stage of an illness – if treatment is no longer working for an individual then making them comfortable and free from discomfort would be the aim.

The term comfort care is often used when someone is in their last days before death. They may be given a steady stream of sedatives or pain relief to help ease any discomfort or agitation during the latter stages of the dying process. This can bring comfort not only to the dying person but their loved ones also.

Why is End of Life Care Important?

Death is one of the certainties in life – it will happen to us all and there is no doubt it can be an emotional and challenging time for all involved, regardless of the circumstances. End of life care is important in improving the quality of life for the person who is dying and those important to them.

Whether your desire to understand end of life care is to better help a loved one, or because you work in the health and social care sector and your role involves caring for those with a terminal illness or approaching death, the greater your understanding the more support you can offer.

End of life care is important in ensuring that a person and their loved ones get the support they need, they can live with as much quality of life as possible, their choices matter, they can die with dignity and their physical, emotional and spiritual needs are met. The choice of being able to continue to live may have been taken out of their hands, but with high-quality, person-centred end of life care they can choose as much as possible how they wish to die.

When supported in the right way it can open up a dialogue between a dying person and their families, which can provide an opportunity to share how they feel, discuss their wishes for both before and after death and help everyone involved come to terms with what is going to happen throughout the process and beyond. Having these discussions can take away a certain amount of doubt and stress the loved ones may feel when it comes to decision making on the dying person’s behalf.

End of life care is an important way of meeting the standards required to meet a dying person’s physical and mental needs. The national end of life care pathway is what encompasses all the steps that must be taken to ensure this happens. These steps include:

Discussion – have honest and open conversations about what is and what will happen.

Assessment, plan and review – agree a care plan and review any changes to their needs and preferences.

Coordinate care – ensure the appropriate professionals are in place to provide the support required.

Delivery – when the plan is acted on, ensure care is delivered to a high standard in whichever setting is most appropriate and in accordance with their wishes.

Final days – recognise when death is iminent, provide support for the dying person and their loved ones, and understand the wishes of the dying person during and after death.

After death care – understand that end of life care continues after death, support family and facilitate any wishes made by the deceased or their family.

These steps create an important structure to work to, but each step involves very human interactions and emotions. It isn’t just about ensuring a dying person has access to the services they require and that their wishes are respected. The word support is used a lot when talking about end of life care and that is at the heart of the process.

Those providing care should not only be familiar with how to provide practical help and planning, but understand how to talk to a dying person and their loved ones, be able to have those difficult conversations and be empathetic.

Recognising and understanding the way a dying individual will present in their last few days and hours of life can enable the carer to act accordingly and reassure loved ones whilst letting them know what to expect. Someone providing end of life care should always treat a dying person with respect, dignity and bring them comfort, in whatever form their preferences dictate.

Want to learn more?

High-quality end of life care requires compassion in care, promoting dignity and a person-centred approach. Learn more about these key areas by clicking on the links.

We have mentioned throughout that the wishes and preferences of the dying person should be respected and taken into account during end of life care and the importance of having honest, open conversations between the individual, loved ones and caregivers.

All of these aid in creating plans to be put in place. Often called advance care planning, this allows the dying person to express how they wish to be cared for in their last stages of life, including any treatments they do not want to receive. It is important in all stages of life that people are given the right and opportunity to make choices.

There are several documents to be considered when it comes to the medical interventions a person may or may not want and we will look at these in more detail shortly. However, when it comes to an individual sharing their beliefs, values, preferences and wishes that are personal to them but not solely based on medical care, an Advanced Statement is a good way to share this information.

An Advanced Statement can include anything from who will look after their dog when they die to detailing that they prefer to sleep with a lamp on instead of in the dark. This is not legally binding – it doesn’t require a witness but by singing it and perhaps talking through it with their family or a carer, it can help solidify their requests. The information shared should be respected and adhered to by all those involved in their care as much as possible.

Documentation relating to a person’s wishes, whether legally binding or not, should be made available to all caregivers and healthcare professionals regardless of setting. If you are a careworker, familiarise yourself with where this information is kept within your organisation and ensure you are well informed about the requests made by those in your care. There may come a time when the dying individual is unable to express themselves and their wishes, so these written requests can give them back their voice when they can no longer use it.

What Does DNACPR Stand For?

Do not attempt cardiopulmonary resuscitation (DNACPR) is also referred to as a DNR or DNAR but they each mean the same. If a person’s heart stops beating, there should not be an attempt to restart it if a DNACPR is in place. The purpose of the DNACPR is to prevent CPR being performed on an individual – this is the only act these forms relate to and do not prevent any other medical treatment being given.

A doctor will issue and sign this form following a conversation with the individual and often their family or next of kin. They may provide one as an indefinite order or they may put a review date on them. Reaching a decision to issue a DNACPR is usually because a doctor believes CPR would be unlikely to prolong their life and may even do more harm than good. This will be based on many factors such as their frailty, age and existing medical conditions.

If you work in a health and social care setting, it is important to make yourself aware of any formal requests an individual has in place so that if a medical emergency takes place, such as a cardiac arrest, you know how to respond. It is important to note that a DNACPR is not a legally binding document, and if you are unaware whether a DNACPR is in place, CPR should still be given.

What Does ADRT Mean?

Advance Decision to Refuse Treatment (ADRT), is also known as a ‘living will’. Unlike the DNACPR, it is a legally binding document if completed in line with the Mental Capacity Act 2005. An ADRT can be made for anyone aged 18 and over who has capacity. It allows a person to make decisions about their future care and treatment whilst they have the capability, so that if a time comes where they are no longer able to, their wishes can still be carried out.

An ADRT must be clear and specifically state which treatments are to be refused and in which circumstances. It may state the individual does not wish to receive life-sustaining treatment such as being placed on a ventilator, receiving CPR or receiving antibiotics. If this is the case, any request to refuse life-sustaining treatment must be signed by the individual and a witness. It is worthwhile discussing all the options with a clinician or healthcare professional.

What is ReSPECT?

Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) plans are similar to an ADRT but there are differences. The main difference is that a ReSPECT plan is not a legal document. It is intended as a summary, and may highlight other documents in place such as an ADRT or DNACPR. It should be immediately accessible when rapid decisions need to be made about a person’s emergency care. ReSPECT plans are not yet universally used but their uptake is increasing throughout the health and social care sector.

This plan can be created by the individual, with family and healthcare professionals, as a way of recording their shared decisions on what future treatments they would and would not like. It would state what treatment or interventions would not be appropriate for them based on personal preference and clinical judgement and details on how they wish to be cared for. A ReSPECT plan is a useful way of guiding healthcare professionals in making emergency medical decisions when the individual is unable to express their wishes themselves.

There are many elements to end of life care and planning and the approach must always be tailored to the dying person’s individual needs, preferences and circumstances. It can be an emotional and challenging time for all involved, but the focus should always be on supporting a person to die with dignity and respect.

Further Resources:

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Managing Conflict in Health and Social Care: Guidance on Recognising and Handling Confrontations

Victoria O'Regan — Mon, 30 Aug 2021 08:30:00 +0000

Within a health and social care environment, whether you work in the sector or have a loved one requiring care, you can find yourself in highly stressful and emotive situations. It is incredibly important for the wellbeing of the worker, service user and their families if there are good conflict resolution processes in place and any confrontations can be managed calmly and effectively.

Within this article we will explain what conflict in health and social care is, providing examples of some scenarios that can present themselves in a health and social care setting, guidance on how to handle confrontation, and how to implement positive confrontation techniques.

Conflict is natural, we will likely all have experienced it to a greater or lesser extent in our lives. It is not always outwardly expressed and can, rather damagingly at times, simmer under the surface. Conflict can be described as the serious incompatibility of two or more opinions, needs or drives or a serious and often protracted disagreement or argument. When conflict is expressed outwardly it can lead to confrontations between the opposing parties and we will look more into this later in the article.

There can be numerous factors that lead to conflict and a health and social care setting can bring together a diverse group of people in a notoriously challenging environment. It is therefore likely there will be differences in opinions and beliefs, incompatible personalities, varying expectations and power struggles.

There are additional physical and emotional pressures that can heighten any cause of conflict within health and social care settings. Staff are generally working in roles that place many demands on their time and resources. Those utilising the services are often heavily reliant on the care and attention of staff, with those suffering ill-health or reduced independence often feeling anxious. Family members can too have their own opinions and expectations regarding their loved ones’ care. The combination of all these factors increases the potential for conflict.

Types of Conflict in Healthcare

There are many variations of conflict types, some more specific to certain environments than others. Here we will look at five causes of conflict with examples of how they can relate to a health and social care setting.

Information Conflicts – when there is different or insufficient information available or a disagreement on what information is relevant. This can be a very frustrating situation in health and social care because it can heavily impact on the care provided and those implementing it. Lost or missing medical notes, information missed off a prescription and poor handovers are all common examples.

Value Conflicts – incompatible belief systems or trying to impose personal values onto others. A health and social care worker may hold a set of values on the standard of care they believe they should be able to deliver, but time constraints and lack of resources may mean they are unable to achieve this. Values do not tend to be negotiable and this can often lead to conflict between the member of staff and whoever they deem responsible.

Interest Conflicts – competition over needs or resources such as money or time. Service users, patients or their relatives may feel their needs are more necessary than those of others, and they may feel time given by staff is not being justly divided. This can cause conflict between several parties.

Relationship Conflicts – negative emotions, distrust, misconceptions or poor communication between people. The reasons for such conflicts can be many, as stressful environments and emotional situations can breed these emotions very easily.

Structural Conflicts – Oppressive behaviour toward others, a lack of resources or opportunities and the structure of an organisation. Health and social care organisations can have a high turnover of staff; when working in a demanding role, often with staff shortages and high demand, it can be very easy for conflict to arise if they begin to feel undervalued, under-resourced and are not provided with support and opportunities for progression.

Regardless of cause, conflicts can be detrimental to morale, productivity, staff retention and the standard of care and wellbeing of those utilising health and social care services. Every effort should be made to prevent, minimise and resolve conflicts. From aiming to reach a satisfactory solution in which all parties are happy, the issue of ethical dilemmas can occur when it is simply not possible to satisfy everyone.

An example of the link between conflict and ethical dilemmas could be; a family member who is appointed to make medical decisions on behalf of the patient is demanding everything is done to keep their loved one alive. As a medical professional the opinion is that it is time to withdraw life support and doing more could cause pain or discomfort without proving beneficial.

Different Conflict Scenarios in Healthcare

To put some of the conflict types we have discussed into context, here are a couple of conflict scenario examples:

A healthcare assistant is working a busy night shift on a hospital ward. The other healthcare assistants are currently in a side room with a patient who requires two members of staff. Several of the patients are pressing their call bells at once. The healthcare assistant answers the first two bells and can still hear a bell call. As they dash from place to place they notice two nurses at the nurses station laughing together. As they pass a nurse asks if they could please answer the bell as it has been going for a while.

This situation could appear to be a structural conflict as the healthcare worker may feel oppressed and frustrated by staff in a higher position. But it could equally be a relationship conflict – a simple misconception of the situation. The nurse may not be aware that the other staff are busy with another patient, or that the call bell sound was in fact numerous. In this situation the healthcare worker could simply communicate openly, explain calmly and ask for additional support if needed.

A care worker has just begun her day shift in a care home following a handover from the night staff. The handover mentioned a resident had a urine infection and had been presenting as very confused and kept trying to leave the premises, becoming aggressive when they were prevented. They decided to allocate a member of staff to them to act as a distraction and monitor them. A family member of another resident noticed how much one to one time they were receiving and began complaining about favouritism.

This could be an example of an interest conflict as the family member believes the attention was not justly divided. In this situation a member of staff could request a private word to explain. Addressing the issue would prevent any misconception and lingering resentment toward staff.

Whilst not a scenario as such, it seems worth noting here that many situations of confrontation and even aggression can occur most commonly in a health and social care setting due to cognitive, behavioural or medical issues. Dementia, mania, infection, delirium, and autism are a few examples. These may be managed through medications, restraint, and trained support workers and cannot all be successfully managed through positive confrontation techniques.

Interested in Reading More?

Why not check out our other conflict related articles: Signs of conflict in the workplace and Managing Conflict in the Workplace: A Guide for Line Managers.

How to Handle Confrontations

We have looked at possible scenarios of conflict and confrontations you may face and the factors involved. When faced with confrontations it is important to understand how to de-escalate the situation and try to reach a calm resolve. This is known as conflict management or conflict resolution. The best way to manage conflict is to aim to prevent it or reduce its frequency or its intensity.

When practicing conflict management you must identify and handle the conflict in a sensible, fair and efficient manner. The skills required to do this include effective communication such as active listening, problem solving, staying calm and focusing on how to tackle the problem. Within this setting, emotions can play a large part in confrontations, therefore compassion and empathy are often required when managing the situation.

As a health and social care worker, do bear in mind the environment you are in when dealing with any conflict or confrontation. Do not air any grievances in front of service users, patients or their relatives. Go somewhere private and quiet to talk. If the confrontation is with a service user, patient or relative and it is not practical to move the situation away from others, perhaps try screen off the area and talk in calm and quiet tones to limit the distress to others.

How to Handle Confrontation at Work

If you are a health and social care worker and it becomes necessary to handle confrontation with colleagues, here are a few steps to consider:

Act and speak calmly.
Try to implement positive confrontation techniques.
You can seek advice from a manager or mediator or if appropriate just ask them for a chat.
Choose a neutral space away from other colleagues, service users, patients and their families.
Listen and clarify the issue on both sides.
Work together to tackle the problem and seek advice if unable to do so.
Thank them for hearing you out.

How to Handle Confrontation with Family

Handling confrontation with the family members of a service user or patient would be approached in a similar way to colleagues. Do remember they are often going through a difficult time and if it is possible to prevent or avoid conflict then that may provide the most stable and calm environment all round. When that isn’t possible and a resolve regarding someone’s care or treatment is required, these are a few additional things to consider:

Act and speak calmly.
Be patient and understanding – they may need your empathy and compassion.
Actively listen to understand their concerns and requests.
Always remember a patient-centred approach to care and their rights.
Evaluate a solution, which may require multiple parties and healthcare professionals.
Clearly communicate information.
Consider providing additional reading materials for them if being more informed around certain topics would help them.
Decide on a mutually acceptable solution together.

Positive Confrontation Techniques to Implement

Learning how to approach confrontation in a confident and positive manner can be very beneficial to health and social care workers, service users, residents and families. Here are a few techniques to bear in mind:

Avoid a combative state of mind – you may feel you have been wronged, that you are right, and want to make your point, but remember the purpose is to reach a resolve to end the conflict on both sides.
Acknowledgement – sometimes acknowledging the other person’s point of view and any fault on your part is the first step to understanding.
Be aware of emotions – emotions can play a large part in conflict. Be empathetic when needed and know emotions can make an easily resolvable issue seem much greater.
Focus on the problem, not the person – remember addressing the problem is the key to resolving it. Do not be tempted to focus on the person as they may feel attacked.
Keep a calm and neutral voice – shouting or aggressive tones only feeds a conflict. Show you are here to help make the situation better.
Actively listen – you can’t learn the full extent of an issue unless you have all the information. There are times, especially in high stress situations where someone needs a release of their frustrations, where this act can often make the negative feelings pass and allow a more calm discussion and resolve to take place.
Use first person language – saying “I” instead of “you did” helps avoid making the other party feel defensive.

Try implementing these techniques into your communications – they can keep discussions calm and help minimise and even prevent conflicts occuring or escalating, creating an environment more suitable for health and wellbeing.

The health and social care sector will always be susceptible to conflict – it can be a demanding and highly emotive environment. Increasing your awareness of how to recognise where conflicts can arise and how to handle confrontation effectively can help create a more resilient and harmonious industry.

Further Resources:

The post Managing Conflict in Health and Social Care: Guidance on Recognising and Handling Confrontations appeared first on The Hub | High Speed Training.

Designated Safeguarding Lead

High Speed Training — Tue, 27 Oct 2020 15:36:07 +0000

A collation of checklists, posters and guidance designed to support the role of the Designated Safeguarding Lead and relevant procedures.

The post Designated Safeguarding Lead appeared first on The Hub | High Speed Training.

Designated Safeguarding Lead Quiz

Ellie Collier — Thu, 17 Sep 2020 08:30:00 +0000

Further Resources:

The post Designated Safeguarding Lead Quiz appeared first on The Hub | High Speed Training.

Advanced Safeguarding Archives | The Hub | High Speed Training

Safeguarding Children Legislation: Guidance for Schools

Need Safeguarding Training?

Key Legislation in Schools

The Children Act 1989

The Children Act 2004

Children and Social Work Act 2017

The Education Act 1996

The Education Act 2002

Education and Skills Act 2008

The Safeguarding Vulnerable Groups Act 2006

The Equality Act 2010

The Children and Families Act 2014

Human Rights Act 1998

Children and Young Persons Act 2008

Sexual Offences Act 2003

Voyeurism (Offences) Act 2019

Counter-Terrorism and Security Act 2015

Serious Crime Act 2015

Statutory Safeguarding Guidance

Working Together to Safeguard Children (WTSC)

Keeping Children Safe in Education (KCSIE)

Further Resources:

What are the 8 Caldicott Principles in Health and Social Care?

What are the Caldicott Principles?

Why Were the Caldicott Principles Introduced?

The 8 Caldicott Principles

Principle 1: Justify the purpose(s) for using confidential information

Principle 2: Use confidential information only when it is necessary

Principle 3: Use the minimum necessary confidential information

Principle 4: Access to confidential information should be on a strict need-to-know basis

Principle 5: Everyone with access to confidential information should be aware of their responsibilities

Principle 6: Comply with the law

Principle 7: The duty to share information for individual care is as important as the duty to protect patient confidentiality

Principle 8: Inform patients and service users about how their confidential information is used

Looking for a Course?

How to Apply the Caldicott Principles

Free 8 Caldicott Principles Poster

Further Resources:

How to Maintain Confidentiality in Health and Social Care

What is Confidentiality in Healthcare?

Want to Learn More?

Why is Confidentiality Important in Health and Social Care?

How to Maintain Confidentiality in Healthcare

How to Maintain Principles of Confidentiality in Childcare

Confidentiality Policy in Health and Social Care

The Common Law of Confidentiality

The Human Rights Act 1998

The Care Act 2014

The Health and Social Care (Safety and Quality) Act 2015

The Data Protection Act 2018 and the GDPR

Examples of Confidentiality in Health and Social Care

When Can You Break Confidentiality in Health and Social Care?

Scenario

Conflict

Resolution

What to Read Next:

What are Gender Health Inequalities?

What are Gender Health Inequalities?

Want to Learn More?

Why is the Relationship Between Gender and Health Important?

What are the Quality of Care Differences Between Men and Women?

How Does Gender Affect Health Care?

6 Ways That Gender Affects Health

What is the Women’s Health Strategy?

Further Resources:

How Can We Work Together to Safeguard Adults?

Want to learn more?

What Safeguarding Adults Legislation and Statutory Guidance Applies to You?

Examples of Safeguarding Adults

How to Work Together to Safeguard Adults

Safeguarding Adults in Your Community

Guidance on Safeguarding Adults Effectively

Further Resources:

What are Difficult Conversations in Health and Social Care?

What are Difficult Conversations in Healthcare?

Communication Scenarios in Healthcare

How to Prepare for Difficult Conversations

Looking to Learn More?

How to Communicate in Difficult Situations