Safeguarding Audit Tool for General Practice

Safeguarding Audit tool for General Practice.

1.  Clear lines of accountability for safeguarding children and vulnerable adults

STANDARD / RED / AMBER / GREEN / EVIDENCE
1.1 / There is a practice named safeguarding lead and a deputy for safeguarding children and vulnerable adults / Name of GP lead
Role and responsibilities clear in practice policy
1.2 / All staff members are aware of how to act on any concerns they have that a child and or a vulnerable adult may have been abused, or is at risk of abuse or neglect in line with local guidance. / Knowledge and understanding of Local Concern pathway.
Where accessed and/or displayed

2.Governance arrangements / Quality Assurance

2.1 / An incident reporting system is in place which identifies circumstances/incidents which have compromised the safety and welfare of children and or vulnerable adults. / SEAs
Complaints
2.2 / The Practice regularly reviews cases where there are safeguarding concerns (for both children and vulnerable adults) / Meeting notes
Safeguarding READ coding
Safeguarding Template

3.  Safeguarding policies, procedures and systems

3.1 / All staff members are aware of, practice safeguarding policies and procedures for both children and vulnerable adults.
Policies are accessible and understood by staff at all levels and be consistent with statutory, national and local guidance. / All practice policies and procedures have a version number and a reasonable review timescale to evaluate their effectiveness and to ensure they are up to date and working in practice. Induction process for new staff
Practices away days when policy / procedures discussed
3.2 / Safeguarding policy clearly states with whom staff should discuss and to whom staff should report any safeguarding concerns / Local Concern pathway
Evidence of contact details for internal and external sources of help and advice
3.3 / Safeguarding policy/procedures includes guidance on complaints and whistle blowing which offers a guarantee to staff and service users that using these procedures appropriately will not prejudice their own position or prospects. / Practice complaints policy / procedures
Practice whistle blowing policy
[ demonstrate links between relevant practice policies]
3.4 / Safeguarding policy/procedures includes guidance on how to respond to a disclosure from a child or a young person and or vulnerable adult.
3.5 / Safeguarding policy/procedures includes contact details of appropriate professionals to provide help and support when attempting to resolve cases where there is uncertainty or differing interpretation of the threshold of harm perceived. / List of internal and external contacts for advice and support shown in practice policy
Local concern pathway
3.6 / Safeguarding policy/procedures includes clear guidance on managing allegations against staff and volunteers working with children and vulnerable adults in line with policies and procedures of LSCB / LSAB.
3.7 / Safeguarding policy/procedures includes guidance about the action to take where there is concern a child is being deliberately harmed through fabricating or inducing illness (FII).
3.8 / There is a clear means of identifying in records those children (together with their parents and siblings) who are subject to a child protection plan / READ codes
Alerts
3.9 / There is a process for following up children who do not attend appointments. / Practice DNA policy and procedures to evidence safeguarding issues are considered

4.  Parents/carers experiencing personal problems

4.1 / GPs and their practice staff in working with parents or carers who are experiencing personal problems (including substance misuse, mental health issues, domestic abuse and learning disabilities) must give consideration of the impact these risk factors may have on the ability to care for those dependent on these individuals and where necessary ensure that safeguarding assessments are conducted and appropriate referrals are made.
4.2 / GPs and their staff should be aware and knowledgeable of NICE /RCGP and GMC guidance relevant to safeguarding practice. / Clear reference to guidance in policy and procedures

5.  Sexually Active Young People Under 18yrs

5.1 / Knowledge and evidence of standards expected when Working with Sexually Active Young People under the age of18 years.
5.2 / Aware of Child Sexual Exploitation and know procedures to be followed.

6.  Domestic violence (including Honour Based Violence and Forced Marriage)

6.1 / Information about local services on domestic violence is available to all women whether they are affected by domestic violence or not. This information should include Forced Marriage and Honour Based Violence. / Relevant leaflets available in waiting room and other public accessed areas.
Case discussion with other members of primary / community team members
MERit assessment tool or similar

7.  Information sharing

7.1 / Information sharing protocols in line with national and local guidance are in place within the practice.
The practice is clear about how to handle requests from outside agencies asking to share information about vulnerable children, young people or adults.
7.2 / All staff are aware of Data Protection and Confidentiality issues and this is understood in relation to safeguarding requirements
7.3 / The registered population are informed of the practices information sharing policy with regard to safeguarding children, young people and vulnerable adults

8.  Inter-agency working

8.1 / The Practice initiates and /or engages with multi-disciplinary / multi-agency assessments in their work with children and families; and the single assessment process when working with vulnerable adults
8.2 / The Practice establishes and maintains effective working relationships with health visiting, school nursing, midwifery services, district nurses and other applicable community health staff.
8.3 / GP’s work with partners to protect children and vulnerable adults and participate in reviews as set out in statutory, national and local guidance. This includes Serious Case Reviews; Child Death Overview Processes; MARAC; MAPPA / Evidence of learning from SCRs.
Implementation of action plans.
Number of child deaths / case studies / Form B requested, completed and returned.
8.4 / GP’s make reasonable effort to attend a multi-agency meeting in relation to safeguarding a child or vulnerable adult. [e.g. Child protection conference]
When unable to attend GPs must make available information to inform decision making at child/adult protection conferences.
[No evidence of engagement] / Record of conference invitations
Attendance confirmation
Outcome of meetings
Notes available on patient records
Evidence of reports sent to conference
[fact /opinion]

9.  Safer Working practices

9.1 / Appropriate HR employment processes are followed to ensure staff working with children and or vulnerable adults are suitable for the post to which they are appointed. / Recruitment policy /procedures
CRB checks
9.2 / Appropriate behaviours are demonstrated by all staff when working with children, young people and vulnerable adults in line with national and local guidance. / Chaperone policy
Policy /procedure of IT use.

10.  Looked After Children

10.1 / Account is taken of local and statutory guidance when working with children who are ‘looked after’
­  clinical record makes the ‘looked after’ status of the child clear, so that their needs can be acknowledged
­  ensure that referrals made to specialist services are timely, taking into account the needs and high mobility of children looked after
­  provide, when requested, summaries of the health history of children looked after, including their family history where relevant and appropriate, subject to appropriate consent
­  make sure the GP held clinical record is maintained and updated: it is a unique health record and can integrate all known information about health and health events during the life of the child;
­  review the clinical records of looked after children who are registered with the practice, and make it available for each statutory review of the health plan

11.  Record keeping

11.1 / Registration process is robust, accurate and takes account of the following: full name; address; gender; date of birth; school; names of persons with parental responsibility. Verification is sought were appropriate [e.g. photo ID]
Information is kept up to date
11.2 / The relationship and parental responsibility of any adult that accompanies a child should be verified and recorded at each contact.
11.3 / New patient records are scrutinized for safeguarding concerns and brought to the attention of the practice safeguarding lead. / Summarising policy / procedures
11.4 / All staff will maintain accurate, clear records of their involvement with a child and family on a real time basis.
This includes ensuring that where there are concerns about a child’s welfare, all concerns, discussions about the child, decisions made and the reasons for those decisions must be recorded in writing in the child’s records / Record keeping policy & procedures
11.5 / Practices have a clear means of identifying from records those children (together with their parents and siblings) who are subject to a child protection plan.
11.6 / The practice safeguarding lead will ensure that there are means for identified vulnerable children, young people and adults to be reviewed appropriately
11.7 / Case Conference reports must be entered on all relevant child and adult records.
[Care must to taken to ensure third party information is managed appropriately in the event of the request for release of information]

12. Supervision and support to staff working with children, parents and carers and vulnerable adult

12.1 / Staff working directly with children and vulnerable adults have access to advice and support / Knowledge of local contacts for help / support / case supervision

13. GP and Staff training / continuing professional development

13.1 / GPS and Staff in contact with and who see parents/carers and vulnerable adults in the course of their normal duties are trained and enabled to maintain their competency to be alert to the potential indicators of abuse and know how to act on those concerns in line with local guidance. / Training records of GPs and each member of staff.
Evidence of training appropriate to role and responsibility
Action plan to address training gaps.
GPs to evidence safeguarding updates and CPD through appraisal and revalidation.
13.2 / The practice safeguarding lead ensures the practice is up to date with safeguarding issues and practice / Cascade of safeguarding information / updates within practice.
Attendance at safeguarding updates / multi-agency training / lead on safeguarding case discussions