HR and healthcare: Safeguarding adults

In the healthcare sector, the term ‘duty of care’ encompasses a fundamental moral and legal obligation to ensure that the individuals within a care setting are safe from harm. At the heart of this obligation is the practice of safeguarding adults.

For healthcare providers, ranging from primary care to private social care and specialised education facilities, safeguarding is a continuous commitment to dignity, safety, and the preservation of human rights. While clinical staff are often on the front lines of identifying risks, the HR department serves as the structural authority within any effective safeguarding strategy.

At Sapphire HR, we understand that creating a safe environment starts with the people you hire, the culture you foster, and the systems you implement. As HR specialists in the health and social care sectors, we are committed to supporting organisations in navigating the complexities of safeguarding adults.

Defining adult safeguarding

To effectively implement a strategy for safeguarding adults, we must first define what it means and who it protects. In a healthcare context, safeguarding adults refers to the proactive measures taken to enable people to live free from abuse, neglect, and exploitation.

Who is a vulnerable adult?

While the term ‘vulnerable adult’ is commonly used, contemporary legislation, such as the Care Act 2014, often refers to ‘adults at risk’. These are individuals aged 18 or over who:

• Have needs for care and support (whether or not the local authority is meeting those needs)
• Are experiencing, or are at risk of, abuse or neglect
• As a result of those care and support needs, are unable to protect themselves from either the risk of, or the experience of, abuse or neglect

In healthcare settings, vulnerability is often heightened. Patients may be incapacitated by illness, living with cognitive impairments like dementia, or dealing with physical disabilities that make them dependent on others for their most basic needs. This dependency creates a power imbalance that, if left unmonitored, can be exploited.

The spectrum of abuse and neglect

Safeguarding adults involves identifying and preventing various forms of harm. It is a common misconception that abuse is always physical. In reality, HR and clinical leaders must be vigilant against:

• Domestic abuse: Incidents of controlling, coercive, or threatening behaviour between those who are or have been intimate partners or family members.
• Sexual abuse: Direct or indirect involvement in sexual activity without consent.
• Psychological and emotional abuse: Threats of harm, humiliation, blaming, or isolation.
• Financial or material abuse: Theft, fraud, or pressure in connection with a person’s property, inheritance, or financial transactions.
• Modern slavery: Encompassing slavery, human trafficking, and forced labour.
• Discriminatory abuse: Harassment or slurs based on race, gender, age, disability, or sexual orientation.
• Organisational abuse: This is particularly relevant to HR, as it involves neglect and poor care practice within a specific care setting, often stemming from poor management, inadequate staffing, or a lack of training.

Why safeguarding is critical to patient safety and dignity

The primary goal of safeguarding adults is to ensure that every individual receives care in a manner that respects their autonomy and dignity. When safeguarding fails, the consequences are catastrophic, not just for the victim but for the integrity of the healthcare organisation.

Protecting patient dignity

Dignity is the right of a person to be valued and respected for their own sake. In a care setting, this means helping with personal hygiene without shame, communicating clearly, and respecting privacy. Effective safeguarding protocols ensure that staff view patients as individuals with rights, rather than tasks to be completed.

Ensuring wellbeing and trust

Healthcare relies on a foundation of trust. Patients and their families must believe that the facility is a place of healing, not harm. A robust safeguarding culture promotes psychological safety, ensuring that patients feel comfortable expressing concerns without fear of retribution or neglect.

Preventing systematic failures

By prioritising safeguarding adults, organisations can identify near misses or low-level concerns before they escalate into serious incidents of abuse. This proactive approach is essential for maintaining the high standards of safety required by regulatory bodies.

The legal and regulatory landscape

Healthcare organisations operate within a strict legal framework designed to protect the vulnerable. Failure to adhere to these standards can lead to criminal prosecution, heavy fines, and the loss of registration.

The Care Act 2014

The Care Act 2014 is the primary piece of legislation governing safeguarding adults in England. It shifted the focus from intervention to prevention, outlining the legal duties of local authorities and their partners (including healthcare providers) to protect adults at risk.

CQC regulations

The Care Quality Commission (CQC) monitors, inspects, and regulates health and social care services. Regulations 18 and 19 serve as the key pillars for safeguarding during the recruitment and onboarding process, requiring that all employees are appropriately trained, supervised, and competent to protect adults from the risk of abuse.

The Mental Capacity Act 2005

The Mental Capacity Act 2005 is crucial when safeguarding adults who may lack the mental capacity to make specific decisions for themselves. It ensures that any action taken on their behalf is done in their best interests and is the least restrictive option possible.

The role of HR in safeguarding adults

While safeguarding is everyone’s responsibility, HR plays a unique and pivotal role. HR is responsible for people management, ensuring that those employed to provide care are fit to do so.

1. Safer recruitment and vetting

The first line of defence in safeguarding adults is ensuring that unsuitable individuals are never hired. HR must implement rigorous Safer Recruitment processes, which include:

• Enhanced DBS checks: Ensuring all staff have appropriate criminal record clearances.
• Comprehensive reference checks: Verifying employment history and specifically asking previous employers about any safeguarding concerns.
• Identifying gaps: Carefully scrutinising CVs for unexplained gaps in employment that could hide periods of dismissal or disciplinary action.
• Values-based interviewing: Assessing whether a candidate’s personal values align with the compassionate, respectful requirements of healthcare work.

2. Training and awareness

Safeguarding adults involves curating a continuous learning environment. This includes ensuring every new hire understands the organisation’s safeguarding policy on day one, providing updated training that reflects new legislation or emerging risks, and ensuring managers understand how to handle disclosures.

3. Fostering a ‘speak up’ culture

HR is responsible for creating a workplace where employees feel safe to raise concerns about a colleague’s behaviour. This involves making it clear how to report concerns and guaranteeing protection for whistleblowers, while encouraging an environment where staff concerns can be discussed openly.

4. Managing allegations against staff

When an allegation of abuse is made against an employee, HR must manage a delicate balance: protecting the vulnerable adult while ensuring a fair and legal process for the employee. HR ensures that:

• The individual is suspended if necessary to protect patients
• The incident is reported to the local authority Safeguarding Adults Board (SAB) and the CQC
• Internal disciplinary procedures are followed alongside any criminal investigations

Responding to safeguarding concerns

Early intervention is critical. Staff must be trained to recognise the subtle signs of abuse, which are often not as obvious as a physical bruise.

Indicators of abuse or neglect include:

• Sudden withdrawal, agitation, or fear of a specific staff member
• Unexplained injuries, poor hygiene, or sudden weight loss (indicating nutritional neglect)
• A patient’s room being consistently dirty or a lack of basic amenities
• Unexplained withdrawals from a patient’s account or missing personal belongings

Documentation and reporting

HR must ensure that there are clear, easy-to-use systems for reporting concerns. Documentation must be accurate and factual without assumptions or personal opinions. Incidents also must be reported immediately to the designated safeguarding lead and handled with the utmost confidentiality to protect all parties involved.

Why healthcare providers should outsource their HR support

The healthcare sector is currently facing unprecedented pressure. Between staffing shortages, rising costs, and increasingly complex regulatory requirements, organisations require an HR provider that is fully conversant in the nuances of safeguarding adults.

Outsourcing your HR support to specialists like Sapphire HR allows you to focus on clinical delivery while we ensure your people processes are compliant.

The HR Unlimited difference

The risks associated with safeguarding adults require a hands-on, strategic approach. This is why we recommend our HR Unlimited Elite package.

Our Elite Package is designed specifically for organisations that require a higher level of involvement and expertise. Here is how it supports your safeguarding mission:

• The Elite Package includes 16 hours of HR On Demand support. We spend time in your facility, helping to audit your safeguarding culture and ensuring policies are watertight.
• As you expand, we help you scale your safeguarding protocols accordingly.
• We create custom safeguarding policies, whistleblowing procedures, and staff handbooks tailored to your specific healthcare setting.
• If a serious safeguarding allegation arises, our Elite clients have direct access to senior consultants who can lead the investigation, manage regulatory reporting, and handle the disciplinary process from start to finish.
• We regularly review your personnel files. By using software from our dedicated Human Resources Information System (HRIS) partner, Breathe HR, you can centralise, manage, and process employee data to ensure that DBS checks, training records, and references are always compliant and CQC-ready.

Safeguarding adults is a profound responsibility that defines the character of a healthcare organisation. It requires vigilance, empathy, and a rigorous commitment to professional standards. By integrating robust HR practices into your safeguarding strategy, you create a shield that protects your patients, your staff, and your reputation.

Let us help you build a culture of safety and accountability. Contact us today for support.