Dealing with allegations of abuse

Recent investigations into care home abuse have demonstrated what can happen when allegations are covered up or ignored. In this article we review the CQC guidance and outline in detail the steps you need to take to manage and record abuse allegations, and what actions you need to take if you receive one

Every practice should have safeguarding policies in place that identify the actions that staff need to take if they’re made aware of any allegations of abuse. These policies should include the process to follow if you are made aware of a concern, what training is available for staff in order to understand what abuse is, and the expectations of conduct for employees. As the registered person, you’re almost certain to already have these documents in place, but NHS England’s safeguarding policy offers a useful template for practices if you feel that yours needs to be reviewed or refreshed.

Once a practice becomes aware of a safeguarding concern, the CQC states, unequivocally, that they must report it to the regulator if:

  • the person is affected by abuse;
  • they are affected by alleged abuse;
  • the person is an abuser; or
  • they are an alleged abuser.

Specifically, Regulation 18 specifies events or occurrences that affect the health, safety and welfare of people who use services which must be notified to CQC. These include:

  • a serious injury to a service user;
  • abuse, or allegations of abuse;
  • incidents that are reported to, or investigated by, the police; or
  • any event that stops, or may stop, the registered person from running the service safely and properly.
Specifically, Regulation 18 specifies events or occurrences that affect the health, safety and welfare of people who use services which must be notified to CQC.

Are there any exceptions?

The CQC only needs to be informed of an applicable incident if it:

  • took place whilst a regulated activity was being provided; or
  • may have been the result of the regulated activity or how it was provided.
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How does the CQC define an ‘injury’?

The CQC defines ‘injuries’ as those that lead to, or that, if untreated, are likely to lead to, permanent damage – or damage that lasts, or is likely to last, more than 28 days. The CQC does not limit the term ‘injury’ just to physical effects; it can include stress and mental damage too.

Injuries or events leading to psychological harm, include:

  • post-traumatic stress disorder;
  • other stress that requires clinical treatment or support;
  • psychosis;
  • clinical depression;
  • clinical anxiety.

Making a notification

For each type of notification of abuse, there are two ways you can advise the CQC:

  1. an online form – you must use this if you have a CQC online account
  2. a paper form to submit if you do not have an online account.

You can find full guidance on how to notify the CQC of allegations of abuse on the CQC website.

The ‘registered person’ must submit notifications. This is often the registered manager, but they can delegate the task to an appropriate staff member. The important thing is that the notification of abuse is made. It’s essential that practices must still notify CQC of all applicable events even if you have informed your CCG.

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