The Care Act has placed safeguarding on a statutory footing for the first time. Accordingly, the extent to which GP practices comply with safeguarding legislation is high on CQC inspectors’ agendas.
Taking advantage of national guidance
It is interesting to reflect on how the conversation has changed so dramatically for practices over the past number of years. Whether GPs should be involved in safeguarding was previously a matter of debate for the sector, with many arguing that GPs should not be saddled with yet another reporting role. With the introduction of the Care Act, and CQC’s Key Lines of Enquiry (KLOEs), the debate has been closed and GPs are confirmed as being at the frontline of safeguarding.
As with every aspect of a GP practice, practice managers are best placed to assess compliance. Practice managers would be wise to conduct regular reviews of their policies and procedures, taking advantage of the national guidance and toolkits available, including those published by CQC and the BMA.
The extent to which safeguarding is embedded within a practice’s systems is central to the CQC inspection process. In compliance with KLOE S3 (‘Are there reliable systems, processes and practices in place to keep people safe and safeguarded from abuse?’) practices must cover the basics. Computer systems must be able to flag whether a child is on the child protection register or at risk, contact details for local safeguarding teams must be easily accessible to all and each practice must have individual designated leads for safeguarding children and safeguarding adults.
As one would expect, it is the implementation of policy that matters most. All staff must be able to provide inspectors with practical examples of how they would identify and report concerns. Knowledge of internal procedures must be mirrored by a comprehensive understanding of the role and responsibilities of external partners.
Practices must be able to evidence that all staff have undertaken appropriate training for their position; whilst the nature of that training is left relatively open in terms of adult safeguarding training, it is specifically defined for children, with different levels of training dependent upon role.
Spot checks and mock inspections are ideal ways to test that staff have understood their training and can explain the practical realities of identifying and reporting safeguarding concerns. Practice managers may want to consider introducing discussion of mock scenarios into practice meetings to instigate debate and identify hesitancy or unfamiliarity with the subject matter.
Staff may have understandable anxieties about the potential conflict between confidentiality and reporting but fears about sharing information must not prevent the necessary safeguarding of children or adults at risk. Training must emphasise both systems and personal responsibility; no staff member should assume that someone else will pass on information which may be critical to keeping an individual safe.
As with everything related to CQC inspections, preparation is key. CQC inspectors will scrutinise your practice; the best way to prepare for that is to apply that same level of scrutiny yourself before they arrive.