Safeguarding Adults, Level 3

What it covers

The clinician's part in a section 42 enquiry under the Care Act 2014, from noticing what does not fit to recording for legal processes and carrying out a protection plan. Assessing capacity and best interests yourself, advance decisions, and recognising deprivation of liberty after the Supreme Court's 2026 judgment. Domestic abuse risk and Marac, self-neglect, closed cultures, allegations against people in positions of trust, modern slavery, Prevent, confidentiality, coding, meetings, reviews and supervision.

Who it is for

GPs, GP registrars, practice nurses, advanced practitioners, clinical pharmacists, paramedics and other clinicians in general practice who need Level 3, and the practice safeguarding lead. It is the e-learning part of Level 3.

By the end you will be able to

• Apply professional curiosity to records, prescribing and consultations, and act when accounts do not fit.
• Lead or contribute to a section 42 enquiry, record for legal processes, and deliver protection plans.
• Assess capacity in the JB order, decide best interests, and recognise a deprivation of liberty.
• Assess domestic abuse risk with Dash, refer to Marac, and record without alerting the abuser.
• Respond to self-neglect, closed cultures, allegations against staff, modern slavery and radicalisation.
• Share information lawfully without consent, code and protect records, learn from reviews, use supervision.

Modules

1. Curiosity and the section 42 enquiry
2. Capacity, best interests and liberty
3. Domestic abuse: risk and response
4. Neglect, exploitation and positions of trust
5. Sharing, records and learning

This course is the e-learning part of Level 3. The RCN intercollegiate document on adult safeguarding (2024) says half of Level 3 learning should be participatory, such as case discussion, multi-agency learning or supervision, and that part is recorded separately.

Content mapped to the knowledge aspects of the Level 3 learning outcomes of the Core Skills Training Framework (England) v1.1: Safeguarding Adults, and to the Level 3 competences in the RCN 2024 intercollegiate document and the RCGP 2024 safeguarding standards. Law named: Care Act 2014, section 42; Mental Capacity Act 2005, sections 1 to 5.

Sources

• Core Skills Training Framework (England) Statutory/Mandatory Subject Guide v1.1 (Skills for Health), Safeguarding Adults: Level 3 learning outcomes (a) to (s) and delivery notes (archived copy)
• Adult Safeguarding: Roles and Competencies for Health Care Staff, 2nd edition (Royal College of Nursing, July 2024): Level 3 competences, 8 hours over 3 years, 50 per cent participatory
• Level 3 safeguarding training and standards, RCGP safeguarding standards for general practice (Royal College of General Practitioners, 1 October 2024)
• Practice or organisational safeguarding lead, RCGP safeguarding standards for general practice (Royal College of General Practitioners)
• Implementation guide for Level 3 safeguarding adults, with the online course mapped to the intercollegiate outcomes (elearning for healthcare)
• SGA Module 3, Safeguarding Adults: Level 3 (elearning for healthcare portal)
• Care Act 2014, section 42: enquiry by local authority
• Care Act 2014, section 44: safeguarding adults reviews
• Care and support statutory guidance, chapter 14: safeguarding, paragraph 14.17 (self-neglect), paragraphs 14.77 to 14.132 and 14.162 to 14.188 (Department of Health and Social Care)
• Mental Capacity Act 2005, section 2: people who lack capacity
• Mental Capacity Act 2005, section 3: inability to make decisions
• Mental Capacity Act 2005, section 4: best interests
• Mental Capacity Act 2005, section 5: acts in connection with care or treatment
• Mental Capacity Act 2005, sections 24 to 26: advance decisions to refuse treatment, validity, applicability and effect
• Mental Capacity Act 2005 Code of Practice (2007), paragraphs 4.26 to 4.27, 4.38 to 4.46, 4.52 and 4.61; 5.64 and 5.68 to 5.69; 10.66 to 10.67
• A Local Authority v JB [2021] UKSC 52, judgment paragraphs 66 to 79: the matter, the relevant information (including consequences for others, paragraph 73), and the two questions in section 2(1) approached in that sequence
• DL v A Local Authority [2012] EWCA Civ 253: the High Court's inherent jurisdiction survives the Mental Capacity Act for adults whose decisions are compromised by constraint, coercion or undue influence (archived copy)
• A Reference by the Attorney General for Northern Ireland [2026] UKSC 16 (judgment given 2 June 2026): what counts as a deprivation of liberty, press summary and judgment
• UK Supreme Court 2026 judgment on what constitutes a deprivation of liberty (Department of Health and Social Care, 15 June 2026): multifactorial assessment, objection, sedation and covert medication, routes
• Mental Capacity Act 2005, Schedule A1, paragraph 78: urgent authorisation not to exceed 7 days
• Managing medicines in care homes, NICE guideline SC1, recommendation 1.15: covert administration
• Mental Capacity Act 2005 (Independent Mental Capacity Advocates) (Expansion of Role) Regulations 2006, regulations 4 and 5: adult protection cases
• SafeLives Dash risk checklist quick start guidance, including the recommended Marac referral criteria
• Multi-Agency Risk Assessment Conference (Marac): guidance for GPs (SafeLives)
• Serious Crime Act 2015, section 75A: strangulation or suffocation (in force 7 June 2022)
• Serious Crime Act 2015, section 76: controlling or coercive behaviour, as amended from 5 April 2023
• Domestic Abuse Act 2021, section 3: children as victims of domestic abuse
• Modern Slavery: statutory guidance for England and Wales, version 4.8 (Home Office, 18 September 2026), guidance for the NHS, paragraphs 12.43 to 12.53, and 15.95 to 15.96
• Prevent duty guidance: England and Wales (2023), paragraphs 42 to 55 and 211 to 237 (Home Office)
• Notice, check, share (Home Office, 28 August 2026): check the concern with the safeguarding lead; the person who noticed it is best placed to complete the national referral form, with the lead's support
• Confidentiality: good practice in handling patient information (General Medical Council): disclosures for the protection of patients and others, paragraphs 55, 59 and 63 to 70 (archived copy, March 2026)
• Adults at risk, confidentiality and disclosure of information (British Medical Association), quoting the GMC guidance
• Online access to new GP health record information (NHS England): the enhanced review code and safeguarding
• Safeguarding patients from harm or distress: the enhanced review SNOMED code that prevents automatic access to new record entries (NHS England Digital, archived copy)
• Second national analysis of Safeguarding Adult Reviews: April 2019 to March 2023, full report (Local Government Association and ADASS)
• Domestic abuse: learning from tragedy and preventing future deaths (Home Office, 15 September 2026): domestic abuse related death reviews
• Domestic abuse related death review statutory guidance (Home Office, 15 September 2026): scope includes homicides, suicides and unexplained deaths
• Notification of Deaths Regulations 2019, regulation 3: circumstances in which the duty to notify the coroner arises
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, regulation 20: duty of candour
• Care Quality Commission (Registration) Regulations 2009, regulation 18: notification of other incidents, including abuse or allegation of abuse
• How CQC identifies and responds to closed cultures (Care Quality Commission, updated 12 May 2022)
• Working definition of trauma-informed practice (Office for Health Improvement and Disparities)
• Safeguarding children, young people and adults at risk in the NHS: safeguarding accountability and assurance framework, version 3 (NHS England, 21 July 2022), section 4.8.2 named GP for adult safeguarding
• A Guide to Multi-Agency Meetings When Responding to Risk and Harm to Adults, version 2 (Leicester, Leicestershire and Rutland Safeguarding Adults Board, March 2025)
• Help after rape and sexual assault: sexual assault referral centres (NHS)
• Clutter Image Rating tool (Cumbria Safeguarding Adults Board, July 2024)

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