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Safety is a priority for everyone and leaders embed a culture of openness and collaboration. People are always safe and protected from bullying, harassment, avoidable harm, neglect, abuse and discrimination. Their liberty is protected where this is in their best interests and in line with legislation.
Where people raise concerns about safety and ideas to improve, the primary response is to learn and improve continuously. There is strong awareness of the areas with the greatest safety risks. Solutions to risks are developed collaboratively. Services are planned and organised with people and communities in a way that improves their safety across their care journeys. People are supported to make choices that balance risks of harm with positive choices about their lives. Leaders ensure there are enough skilled people to deliver safe care that promotes choice, control and individual wellbeing.
Safeguarding has always been entrenched in healthcare practices and has long been part of the mandatory training programme for anyone working in health, social care, education and other sectors with possible contact with vulnerable persons. With this kind of familiarity, it can feel like another buzzword, but what really IS safeguarding?
Stopping to really consider the meaning of safeguarding can help us understand the importance of this integral component of good, effective, safe care. Safeguarding is an inherent part of any caring encounter, but it has been formalised as mandatory training on a background of serious, sometimes tragic events. The foundations underpinning safeguarding policies are incredibly important and have led to life-saving interventions.
Local and national policies in healthcare services reflect legislation designed to identify and protect at-risk adults and children.
The Care Act 2014 describes 6 key principles for safeguarding adults: empowerment; prevention; proportionality; protection; partnership; accountability. These are, broadly, designed to ensure that safeguarding practice is person-centred, proactive, and appropriate. The Care Act 2014 is designed to ensure that there is seamless integration between different agencies involved in a person’s care; with a multidisciplinary approach, with health and social care workers all taking a cohesive, interoperative and integrated approach, problems can be identified and managed early and effectively. Previously, granular and disjointed approaches from health and social care agencies have meant that identifying vulnerable people did not necessarily mean that those people were given the ongoing support and protection they needed.
Other legislation which relates to safeguarding can include the Human Rights Act 1998, Sexual Offences Act 2003, Safeguarding Vulnerable Groups Act 2006, the Children and Social Work Act 2017, and more. With such a wide variety of legislation designed to support the legal protection of vulnerable people, it’s important that workers have a good understanding of the backing for their practice.
Healthcare workers meet the most vulnerable people in society, often when they are at their most in need of support. People enter formal care settings due to illness, injury, or sometimes simply when they have reached the kind of crisis point in their everyday lives that brings them into health or social care services. For some, this is the result of abuse or neglect – either by themselves or those who are meant to be caring for them.
The onus on workers encountering people in vulnerable situations is to recognise problems, to mount a proportionate response, and to report and record the facts. A proportionate response may mean simply sharing the information with other appropriate agencies, or it could be the start of a rapid response to an ongoing dangerous situation.
A robust grounding in the legislation and options for response to safeguarding concerns empowers workers to manage these situations with confidence.
Frontline healthcare workers are likely to meet vulnerable people who have reached a crisis point where their physical or mental health is precarious enough to require acute services. Workers who go into people’s homes – emergency services, community nurses and health visitors – are likely to have insight into the kind of living conditions or interactions that raise alarm bells. But safeguarding is relevant to everyone who meets the public, in any role. Anyone who has any contact with the public may just be the person who someone decides to disclose concerns to or may just be the person to notice that something isn’t quite right. Having some safeguarding training can give that person the skills and confidence to speak out.
‘Making every contact count’ is an initiative that aims to encourage healthcare workers to take every opportunity available for health promotion and support. Although originally designed as an approach to healthy living interventions, it can easily translate to safeguarding practices. Health and social care workers are uniquely positioned to identify areas of concern, whether from subtle cues – the unkempt looked-after person, the unsafe home environment, or more explicit evidence like suspicious injuries or disclosure of abuse.
‘Empowerment’ is one of the key principles of the Care Act 2014. Ideally, health and social care workers aim to empower individuals to live without fear, to speak freely without retribution, and to take an active part in choices over their own lives and care. Empowerment can also be used to describe the aims for the workers, too. It isn’t always easy to challenge trauma, neglect and abuse. An individual worker shouldn’t be put in a position where they feel unable to help or unsure what to do. Targeted training for any role within a health or social care organisation can give workers the tools they need to deal with any problems they identify. Serious issues can only be tackled by people who have the confidence and support to do so, in a position of safety.
Safeguarding training can empower staff to identify and tackle concerns. Staff who have had effective safeguarding training should feel confident; they will understand the right avenues for seeking support, and how to elicit a multi-agency support network. Interacting with people who have had safeguarding issues raised can be difficult; it may mean meeting vulnerable people in clearly unsafe situations, but it may also mean meeting the people who are neglecting or abusing the people in their care. Lone worker safety training and training in managing conflict can be an important adjunct to safeguarding.
A trained, competent, and confident healthcare workforce who know how to approach safeguarding issues, who understand their duties and multi-agency referrals, can help break patterns of abuse and neglect. Health and social care workers can change vulnerable people’s lives, preventing trauma and tragedy.
Skills for Health’s Safeguarding offerings are designed to give health and social care workers the toolkit they need to recognise and respond to concerns. Three tiers of training mean that eLearning is tailored towards the likely safeguarding needs for different roles within the sector. Separating safeguarding training into child and adult streams helps to consolidate an understanding of the legislation behind safeguarding and the differing avenues for support. All of our clinical and non-clinical staff are trained to Skills for Health's safeguarding Level 3 for adults and children.
Harassment and bullying remain significant workplace issues despite increasing awareness of the problem. Typical harassment and bullying behaviours range from unwelcome remarks and persistent unwarranted criticism to unwanted physical contact and shouting. Recipients of these inappropriate behaviours are more likely to experience anxiety, stress and a loss of confidence.
What are harassment and bullying?
In the UK, under the Equality Act 2010, harassment is defined as: ‘unwanted conduct related to a relevant protected characteristic, which has the purpose or effect of violating an individual’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for that individual’. Bullying is not specifically defined in UK law but Acas says bullying 'may be characterised as: Offensive, intimidating, malicious or insulting behaviour, an abuse or misuse of power through means that undermine, humiliate, denigrate or injure the recipient’.
Bullying and harassment occur at the more severe end of the workplace incivility spectrum, a spectrum that also includes low intensity deviant acts, such as rude verbal and nonverbal behaviours towards a member of a team, group or organisation. Read our evidence review on workplace incivility and bullying for more detail on workplace incivility
People have the right to be treated with dignity and respect at work and organisations should take any form of incivility and harassment or bullying seriously. People professionals should lead on developing a positive and inclusive culture with zero-tolerance for harassment and bullying. Individuals should feel confident to bring complaints without fear of ridicule or reprisal.
Harassment and bullying may be against one or more people and may involve single or repeated incidents across a wide spectrum of behaviour, ranging from extreme forms of intimidation, such as physical violence, to more subtle forms such as ignoring someone. Examples include:
The continuing issue of sexual harassment in particular has been highlighted in the media. The Women and Equalities Select Committee has held enquiries into Sexual harassment in the workplace with a range of recommendations.
Our Managing conflict in the modern workplace research found that UK employees were almost twice as likely to have experienced bullying than harassment (not of a sexual nature) at work in the previous three years. Almost a quarter of employees thought that challenging issues like bullying and harassment are swept under the carpet in their organisation.
Encouragingly, our research showed a positive change in employees’ confidence about tackling sexual harassment: a third felt more confident to challenge it and a similar proportion felt more confident to raise a complaint about it. Read our guidance on how employers should respond to sexual harassment complaints and build gender-inclusive workplaces. CIPD members can use our more detailed resource pack.
In Great Britain and in summary, harassment because of someone's age, disability, race, religion or belief, sex, sexual orientation and other protected characteristic is unlawful under the Equality Act 2010. Harassment which is entirely unrelated to a protected characteristic isn't covered by the Act.
The Equality and Human Rights Commission has published guidance on harassment and the Equality Act, including a Code of practice on employment. Whilst not legally binding documents, the codes give important guidance on good practice and failure to follow them may be taken into account by tribunals or courts.
The law protects individuals from harassment while applying for a job, in employment and in some circumstances after the working relationship has ended, for example, in connection with the provision of a verbal or written reference. There's also protection for people against harassment on the basis of their membership or non-membership of a trade union and, in Northern Ireland, against harassment on the basis of political belief. (In England and Wales, harassment because of political views isn't always automatically protected although employees who are dismissed because of their political opinions don't need two years’ service to bring an unfair dismissal claim.)
Although the government has removed express protection for this third-party harassment from the Equality Act, liability can still arise from other legal duties, for example breach of contract, direct discrimination, the Protection from Harassment Act 1997 and so on. These other legal duties and good practice mean that employers should continue to take steps to protect employees from harassment from anyone they come into contact with.
The UK legal position on bullying is more complex as there's no single piece of legislation which deals with workplace bullying. Bullying may be covered by:
Bullying might also be covered by a myriad of other legal principles and laws, for example:
Responsibility of employers and employees
Bullying and harassment are still a significant workplace issue.
Employers should put in place a well-communicated policy and guidance that clearly states the organisation’s commitment to promoting dignity and respect at work. Employers’ responsibilities extend to work-related activities, such as work parties or outings.
Employers should be especially aware of ‘cyber bullying’. Our research found that cyber-bullying is more common than inappropriate behaviour at a work social event, with one in ten employees reporting that it happened.
All individuals have a responsibility to behave in ways which support an inclusive and tolerant working environment. Everyone should play their part in making the organisation’s policy a reality and employers should challenge inappropriate behaviour and take action.
Promoting a positive climate at work for everyone based on personal respect and dignity will help to prevent inappropriate behaviour starting. Organisations should send a clear message to all employees that there is zero tolerance for any type of inappropriate behaviour. Senior leaders should have a clear vision and demonstrate strong values that communicate what a climate of dignity and respect looks like.
To help develop such a climate, employers need to understand the key drivers of poor workplace behaviour, bullying and harassment. Our recent evidence review on workplace incivility and bullying explored these drivers.
Employers need to be conscious of the values and attitudes of those who are appointed as leaders and managers. Those with excellent people management skills, particularly constructive and fair leaders, will be more influential than those with technical expertise in building workplaces where respect is valued.
Employers also need to think about the stressors on their people, particularly those who feel overloaded in their role, or unclear how to fulfil their tasks or that they cannot meet job demands. Key to this is allowing staff self-management over their working life through providing them with autonomy to decide how, when and where they work.
Finally, fairness is a key organisational issue that influences workplace behaviour, so understanding what is just and ensuring staff feel decisions and outcomes are fair is key.
A well-designed policy is essential to tackle bullying or harassment. Policies and guidance should be agreed with trade union or employee representatives and communicated to everyone. They should, for example:
All employees should:
The policy should be monitored and regularly reviewed for effectiveness, including:
It’s also essential that line managers understand their role in addressing all forms of inappropriate behaviour, and that they have access to help and support with appropriate confidentiality and sensitivity. There’s more in our Dealing with conflict at work guide.
All dignity at work or anti-bullying policies should be co-ordinated with the organisation’s grievance and disciplinary policy.
All employees who make a complaint should have access to someone inside the organisation trained for this role or an outside sponsored service. This allows them to talk in confidence about any inappropriate behaviour they’ve experienced or witnessed so they can discuss options and decide themselves whether to progress a complaint.
Guidance and counselling can be offered to people whose behaviour is unacceptable, as well as those affected. Simply punishing those responsible for the harassment risks isolating individuals who may not understand that their behaviour is inappropriate and affecting their colleagues.
Dealing with complaints
All complaints should be dealt with promptly. Some may be dealt with internally and informally. But formal procedures should enable an appropriate manager or people professional to take disciplinary steps where needed. A choice of contact should be available in case the person’s manager is the alleged harasser. Employees can also call the Acas helpline for advice.
Listen to our podcast: Handling harassment: are you getting it right?
Our work on managing conflict shows that a growing number of employers and employees are open to using an independent third party to help resolve workplace conflict. Mediation is a voluntary impartial process and can be used in alleged bullying and harassment cases where both parties are willing to participate and the complaint isn't at the serious end of the spectrum.
If informal approaches don’t work or aren’t appropriate, formal procedures should be triggered.
Organisations should have a clear formal policy to deal with all types of grievances and disciplinary issues, including bullying and harassment.
Formal allegations of harassment, bullying or any intimidating behaviour should be treated as a disciplinary offence. Investigation should include:
All sensitive information should be treated confidentially and meet the requirements of data protection law.
NDAs should never be used to cover up inappropriate behaviour and wrongdoing, such as harassment. People professionals have an important role to play in ensuring the ethical use of NDAs and that they are never used as a means to silence alleged victims of unfair treatment such as bullying and harassment. Acas guidance makes very clear that confidentiality clauses should not be used as a matter of routine and that there are many circumstances where it may be inappropriate and/or unlawful to use confidentiality clauses. Confidentiality clauses in settlement agreements will always be unenforceable where they attempt to hide something that cannot legally be kept confidential.
