⚕️Care Handbook

Safeguarding Alert Form

Use this form to document and raise a safeguarding concern. Complete as fully as possible and submit to your designated safeguarding lead. All safeguarding concerns must be taken seriously and reported promptly. Under the Care Act 2014, you have a duty to report any suspicion of abuse or neglect.

If someone is in immediate danger, call 999. If you suspect a crime has been committed, contact the police. Do not confront the alleged perpetrator. Preserve any evidence. Report to your designated safeguarding lead immediately.

Your duty: Under Section 42 of the Care Act 2014 and Regulation 13 of the Health and Social Care Act 2008, all care workers must report concerns about abuse or neglect. You do not need proof — a reasonable suspicion is enough to raise a concern. Never promise confidentiality. The local authority will decide whether a Section 42 enquiry is needed.

Types of Abuse — Recognise the Signs

Abuse can take many forms. Familiarise yourself with the different types of abuse and their signs so that you can recognise concerns and take action. Click on each type to learn more.

Physical Abuse

The use of physical force that results in bodily injury, pain, or impairment. This includes hitting, pushing, slapping, inappropriate use of restraint, or misuse of medication.

Signs to look for:

  • Unexplained injuries, bruises, or welts
  • Injuries in various stages of healing
  • Marks on wrists or arms suggesting restraint
  • Fear of certain staff or visitors
  • Reluctance to discuss injuries
  • Unexplained fractures or falls
Sexual Abuse

Any sexual activity to which the person has not consented or could not consent, or was pressured into consenting to. This includes sexual assault, sexual harassment, or inappropriate touching.

Signs to look for:

  • Unexplained sexually transmitted infections
  • Bruising or marks in intimate areas
  • Distress during personal care
  • Changes in behaviour or mood
  • Torn or stained underclothing
  • Reluctance to be alone with certain people
Psychological / Emotional Abuse

The infliction of mental or emotional anguish through verbal or non-verbal acts. This includes threats, humiliation, intimidation, harassment, or isolation from family and friends.

Signs to look for:

  • Withdrawal or fearfulness
  • Low self-esteem or unexplained tearfulness
  • Avoidance of eye contact
  • Change in appetite or sleep pattern
  • Reluctance to speak openly
  • Appearing anxious or agitated
Financial or Material Abuse

The illegal or unauthorised use of a person's funds, property, or resources. This includes theft, fraud, exploitation, coercion in relation to finances, or misuse of a Lasting Power of Attorney.

Signs to look for:

  • Unexplained withdrawals from bank accounts
  • Missing personal possessions
  • Unpaid bills despite adequate funds
  • Sudden changes to wills or financial arrangements
  • Unexplained lack of money for day-to-day items
  • Reluctance by family to pay for care despite ability
Neglect and Acts of Omission

The refusal or failure to fulfil obligations to a vulnerable person. This includes failing to provide food, shelter, clothing, medical care, or personal hygiene — or withholding these necessities of life.

Signs to look for:

  • Malnutrition or unexplained weight loss
  • Dehydration
  • Untreated medical conditions or pressure sores
  • Poor personal hygiene or unchanged incontinence wear
  • Inadequate clothing or bedding
  • Withdrawn or apathetic behaviour
  • Unkept environment
Discriminatory Abuse

Abuse motivated by discriminatory attitudes towards a person's age, disability, gender, race, religion, sexual orientation, or other protected characteristic. This includes harassment, slurs, or denial of services.

Signs to look for:

  • Lack of respect for cultural or religious needs
  • Unequal treatment compared to other residents
  • Derogatory remarks about age, disability, or background
  • Exclusion from activities based on a protected characteristic
  • Denial of access to appropriate services
Organisational / Institutional Abuse

Abuse occurring within a care setting where the regime, routine, or culture denies people dignity, choice, or control. Includes rigid routines, lack of person-centred care, and institutional practices.

Signs to look for:

  • Rigid routines that do not respond to individual needs
  • Lack of choice in daily life (meals, bedtimes, activities)
  • Inappropriate use of restraint or sedation
  • People treated in a depersonalised way
  • Poor staffing levels or high staff turnover
  • Lack of management oversight or accountability
Self-Neglect

An adult who is unable to care for themselves and refuses essential services, leading to a deterioration in their health or living conditions. This can be complex to manage as adults have the right to make unwise decisions if they have capacity.

Signs to look for:

  • Persistent inability to maintain personal hygiene
  • Living in squalor or hazardous conditions
  • Refusal of essential care or medical treatment
  • Hoarding behaviour
  • Malnutrition or dehydration due to self-neglect
Domestic Abuse

Any incident or pattern of incidents of controlling, coercive, or threatening behaviour between people who are or have been intimate partners or family members, regardless of gender or sexuality.

Signs to look for:

  • Controlling behaviour by a family member or partner
  • Fear of a particular visitor
  • Unexplained injuries coinciding with visits
  • Reluctance to speak in front of certain people
  • Coercion in financial or care decisions
Modern Slavery

Encompasses slavery, human trafficking, forced labour, and domestic servitude. People can be trafficked and exploited in care settings, particularly those with uncertain immigration status or who are dependent on others.

Signs to look for:

  • Signs of physical or psychological abuse
  • Person appears to be under the control of another
  • Lack of personal identification or documents
  • Unable to speak freely or appear frightened
  • Working excessively long hours with no or low pay

Safeguarding Alert Form

Reporter Details

Person at Risk

Concern Details

Alleged Perpetrator (if known)

Witnesses

Actions Taken

Referral

What Happens After You Raise a Concern

After you raise a safeguarding concern, a series of steps will follow. The local authority will decide whether to carry out a Section 42 enquiry under the Care Act 2014. Here is what to expect:

1

Ensure Immediate Safety

The first priority is always the safety and welfare of the adult at risk.

  • Take immediate action to protect the person from further harm
  • Call emergency services (999) if there is an immediate risk to life
  • Separate the person from the alleged perpetrator if safe to do so
  • Ensure any medical needs are addressed promptly
  • Preserve any physical evidence (do not clean up or move items)
2

Report Internally

All safeguarding concerns must be reported within the organisation without delay.

  • Report to your line manager or the designated safeguarding lead immediately
  • If the concern involves the manager, report to the next senior manager or the local authority directly
  • Record your concern in writing — include dates, times, names, and what was observed or reported
  • Do not confront the alleged perpetrator at this stage
  • Do not promise confidentiality to the person raising the concern
3

Report Externally

The safeguarding lead or manager must report to the local authority and other agencies as required.

  • Contact the local authority safeguarding team within 24 hours (or immediately if there is ongoing risk)
  • Submit a safeguarding alert/referral using the local authority's process
  • Notify the CQC if required (Regulation 18 — notification of abuse or allegation of abuse)
  • Contact the police if a crime may have been committed
  • Inform the person's GP if medical assessment is needed
  • Notify the commissioning body / local authority if the person is funded by them
4

Cooperate with the Investigation

The local authority will lead the Section 42 enquiry under the Care Act 2014.

  • Cooperate fully with the local authority safeguarding enquiry
  • Provide all records, statements, and evidence as requested
  • Ensure staff are available for interview by investigators
  • Do not destroy or alter any records related to the concern
  • Follow any instructions from the safeguarding lead or investigating officer
  • Maintain confidentiality — share information only on a need-to-know basis
5

Implement Safeguards and Support

Ensure ongoing protection and support for the adult at risk throughout the process.

  • Implement any safeguarding plan agreed with the local authority
  • Provide emotional and practical support to the person at risk
  • Ensure the person has access to an advocate if needed (under the Care Act 2014)
  • Review and adjust the care plan to address identified risks
  • Arrange additional supervision or monitoring as needed
  • Support staff who may be affected by the investigation
6

Review and Learn

After the investigation concludes, review what happened and take steps to prevent recurrence.

  • Review the outcome of the safeguarding enquiry and any recommendations
  • Update risk assessments and care plans accordingly
  • Implement any changes to policies, procedures, or training identified by the investigation
  • Conduct a lessons-learned review with staff (maintaining confidentiality)
  • Share anonymised learning with the wider team where appropriate
  • Monitor the situation to ensure the safeguarding plan remains effective
  • Consider whether a safeguarding adults review (SAR) is required for serious cases

Whistleblowing

If you feel unable to report a safeguarding concern through your organisation's internal procedures — for example, if the concern involves your manager — you can raise it externally through whistleblowing.

  • Public Interest Disclosure Act 1998 (PIDA): Protects workers who blow the whistle on wrongdoing in the workplace. You are protected from victimisation or dismissal if you raise a concern in good faith.
  • CQC Whistleblowing: You can report concerns directly to the CQC, who have a duty to investigate and can take enforcement action against providers.
  • Local Authority: You can contact the local authority safeguarding team directly if you are unable to report internally.

Authoritative Resources

Important Notice:The safeguarding resources provided by Care Handbook are for guidance only and do not replace your organisation's safeguarding policies or local authority procedures. If you suspect abuse or neglect, follow your organisation's safeguarding procedure and report to your designated safeguarding lead immediately. In an emergency, call 999. All safeguarding concerns must be reported to the local authority under the Care Act 2014. Never promise confidentiality when someone discloses abuse.