Level 1 safeguarding training and standards

Induction

All new staff members should, within their induction period:

• have a practice/organisational safeguarding induction AND
• complete relevant safeguarding Level 1 e-learning modules

Annually: Level 1 safeguarding update

Level 1 safeguarding updates should be aligned to the RCGP safeguarding standards for general practice and could include:

• topics across the breadth of the five key areas of the safeguarding standards
• child and adult safeguarding, including topics which apply to both e.g. transitional safeguarding, domestic abuse
• practical applications to general practice such as the use of case-based learning
• relevant learning from any local or national safeguarding reviews
• multi-agency and multi-disciplinary safeguarding learning
• relevant safeguarding updates
• role-specific safeguarding training and updates

Updates could be face-to-face or virtual. It could include watching a recorded update.

1. Professional safeguarding responsibilities

Knowledge

• Understand your statutory, legal and professional safeguarding responsibilities as set out in relevant legislation and national safeguarding guidance in the UK nation you work in
• Awareness of professional safeguarding responsibilities as set out in terms of employment
• Awareness of the impact of safeguarding issues on own wellbeing and how to access support as necessary
• Awareness of how and when to raise any concerns about behaviour or actions of colleagues or anyone in a position of trust that have caused harm, or may cause harm to patients or others
• Awareness of practice/organisational policies on managing allegations against staff and whistle blowing policies
• Awareness of local safeguarding professional contact details and referral processes

Capabilities

• Be able to carry out your statutory, legal and professional safeguarding responsibilities as set out in relevant legislation and national safeguarding guidance in the UK nation you work in
• Be able to carry out your professional safeguarding responsibilities as set out in terms of employment
• Ensure that professional competence in safeguarding is maintained and keep up to date with changes in safeguarding
• Be able to recognise how your own beliefs, experience and attitudes might influence professional involvement in safeguarding work.
• Be able to recognise how your own actions impact on others
• Be able to promptly act on any concern about behaviour or actions of colleagues or anyone in a position of trust that have caused harm, or may cause harm to patients or others, including how to report and escalate concerns outside your organisation should this be necessary
• Be able to locate local safeguarding professional contact details and referral processes

2. Identification of abuse and neglect

Knowledge

• Awareness of indicators and signs of child and adult abuse and neglect
• Knowledge of domestic abuse, including coercive control
• Awareness of Adverse Childhood Experiences (ACEs) and their lifelong impact
• Awareness of the impact on child wellbeing of parental issues e.g. parental behaviour, mental and physical health and substance misuse
• Awareness of the increased needs and vulnerabilities of children on child protection plans, Looked After Children, children with disabilities, unaccompanied asylum-seeking children, care leavers, young carers and missing children and that these needs may continue into adulthood
• Understand the basic principles of consent and confidentiality in relation to young people under the age of 18
• Understand the rights of the child as defined in national and international law
• Awareness of which children and adults may be at greater risk of abuse and neglect
• Awareness of the importance of adults’ rights in the safeguarding context and the essential knowledge of relevant legislation e.g. human rights acts and mental capacity legislation
• Awareness of what constitutes an adult at risk
• Awareness that adults who have experienced abuse in childhood may have specific vulnerabilities and risks in adulthood resulting from adverse childhood experiences (ACEs)
• Awareness of the effects of carer behaviour and family factors on adults at risk of abuse, harm or neglect
• Awareness of how to support adults at risk who do not feel able to participate in service support, for example those experiencing coercive control or those who face multiple barriers to services
• Awareness of the significance of health deficits on health and wellbeing through the life course, e.g. homelessness, loneliness and poverty
• Understand that identifying abuse can involve building up a picture over time
• Understand the potential lifelong impact of abuse
• Understand that victims and survivors of abuse may face multiple barriers to healthcare and have awareness of how these barriers can be broken down
• Understand that those who perpetrate abuse may have significant health needs
• Understand actions that may need to take place within the practice to manage high risk persons such as those highlighted to the practice from MAPPA (Multi-agency Public Protection Arrangements) or PPANI (Public Protection Arrangements Northern Ireland) if there are agreed local processes in place with general practice for this to occur
• Awareness of the Prevent programme (for practitioners in England, Wales and Scotland)
• Awareness of the Independent Inquiry into Child Sexual Abuse (IICSA)
• Awareness that children, and adults with care and support needs, who are not being brought to appointments can be an indicator of abuse and/or neglect
• Mental capacity and deprivation of liberty:
  • Awareness of the principles of mental capacity legislation as relevant to the country of practice
  • Awareness of roles and responsibilities in relation to mental capacity legislation
  • Awareness of best interest decision-making
  • Awareness of deprivation of liberty legislation and who to contact within the organisation for advice
  • Awareness of roles such as advocates, powers of attorney, Independent Mental Capacity Advocates and how this relates to job role

Capabilities

• Be able to pass on any safeguarding concerns, even seemingly minor concerns, about a patient/person to the relevant clinician, following practice / organisational procedure
• Be able to identify, and raise concerns in the practice, when children and adults with care and support needs are not being brought to appointments
• Be able to facilitate the use of formal interpreters and communication aids for patients as needed
• Be able to recognise when someone may lack capacity and know who to contact within the organisation for further advice and support
• Be able to approach job role and interactions with patients with an understanding of the impact of trauma exposure
• Be able to learn lessons relevant to role from significant safeguarding events within own practice/patient population, local and national safeguarding reviews
• Be able to provide support as needed to remove barriers to healthcare such as facilitating choice of mode of consultation

3. Responding to abuse and neglect

Knowledge

• Recognise obligations to act when there is a safeguarding concern, including when acting is against the expressed wishes of the person/family/carers
• Awareness of local referral processes for child and adult safeguarding including early help services
• Knowledge of local support services e.g. domestic abuse services
• Knowledge of whom to speak to within the practice/organisation if unsure how to manage any concerns about abuse or neglect e.g. Practice Safeguarding Lead, Practice Manager
• Knowledge of how to escalate concerns about abuse if reported concerns have been dismissed or minimised
• Knowledge of how to promptly manage and report any concerning behaviour or allegations of abuse by a person in a position of trust, including colleagues

Capabilities

• Willingness to listen to children, young people, adults at risk, families and carers and to act on issues and concerns
• Be able to signpost patients to local support services e.g. domestic abuse services
• Be able to confidently signpost patients to emergency services in the event of a life threatening situation e.g. a patient discloses on the phone that they are terrified their partner is going to hurt them
• Be able to seek appropriate advice and report any safeguarding concerns in line with practice/organisation policy and be confident that they have been understood

4. Documenting safeguarding concerns and information

Knowledge

• Awareness of the importance of safely and accurately documenting safeguarding concerns and documentation in the patient record
• Awareness of the safeguarding challenges and risks related to patient online access (if applicable) and how to mitigate these as much as is possible in a general practice context
• Understand when, and what information, needs to be redacted in situations such as medical reports and Subject Access Requests, according to data protection legislation

Capabilities

• Be able to document safeguarding concerns safely and accurately in the patient record
• Be able to safely manage safeguarding information coming into the practice
• Be able to safely and promptly manage requests from other health professionals or external agencies, for information in a safeguarding context
• Be able to mark information not for online access (if applicable)
• Be able to redact information as necessary e.g. for medical reports, Subject Access Requests
• Be able to use standardised and appropriate read codes to be able to conduct searches on vulnerable/at risk registers effectively when filing safeguarding information
• Recognise the safeguarding challenges of patient online access (if applicable) including coercion to access records and have strategies to avoid giving access while seeking help if coercion is suspected

5. Information sharing and multiagency working

Knowledge

• Awareness that multi-agency working and information sharing are essential for effective safeguarding
• Understand that timely, relevant, proportionate and necessary information sharing is fundamental to safeguarding
• Awareness that UK legislation is not a barrier to information sharing – rather it provides a framework to share confidential information safely and appropriately
• Awareness of confidentiality and it's limits
• Understand that legislation and guidance about confidentiality does not prohibit healthcare staff listening to family/friends/carers concerns about patients, especially when there are welfare and safeguarding concerns
• Awareness of how to manage requests for confidential patient information from other agencies such as social care and the police as per practice/organisation policy, protocol and local information sharing agreements
• Awareness of terminologies used in multiagency settings such as safeguarding conferences, strategy meetings, MARAC, MARAM, MAPPA, statutory reviews in order to be able to prioritise information sharing

Capabilities

• Be able to share information appropriately within the practice/organisation for the purposes of safeguarding
• Be able to recognise, and respond appropriately, taking into account confidentiality and its limits, to situations where family/friends/carers contact the practice/organisation with concerns about a patient, especially when there are welfare and safeguarding concerns
• Be able to seek advice when there is any uncertainly about information sharing
• Be able to manage safeguarding information/documents coming in and out of the practice, including coding and marking not for online access (as relevant to role)