What it covers
The clinician's part in safeguarding adults at Level 3: professional curiosity, weighing risk, section 42 enquiries under the Care Act 2014 and making safeguarding personal. Capacity, coercion and deprivation of liberty after the Supreme Court's 2026 judgment, domestic abuse risk and Marac, carers and families, exploitation and financial abuse, self-neglect and hoarding, closed cultures, allegations against staff, and young adults leaving children's services. Lawful sharing, records, police requests and court, professional challenge, and learning from reviews and deaths, each worked through a practice case.
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 weigh risk defensibly.
- Contribute to a section 42 enquiry and protection plan, keeping the adult's wishes central.
- Assess capacity and coercion, and recognise a deprivation of liberty after the 2026 judgment.
- Assess domestic abuse risk with Dash, refer to Marac, and record without alerting the abuser.
- Respond to exploitation, financial abuse, self-neglect, closed cultures, staff allegations and young adults' transition.
- Share lawfully, code and protect records, challenge decisions, and learn from reviews and deaths.
Modules
- Your Level 3 role
- Assessing and weighing risk
- Section 42 and other agencies
- Capacity, coercion and hard decisions
- Domestic abuse
- Carers and families
- Exploitation and financial abuse
- Self-neglect and hoarding
- Closed cultures and allegations against staff
- Young adults, ages 16 to 25
- Sharing, records, police and the courts
- Planning, challenge and learning from reviews
This course is the e-learning part of Level 3. The Royal College of Nursing (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
- 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)
- Care Act 2014, section 10: assessment of a carer's needs for support
- Care Act 2014, section 68: safeguarding enquiries and reviews, independent advocacy support
- Care and Support (Eligibility Criteria) Regulations 2015, regulation 3: needs which meet the eligibility criteria, carers
- Care and support statutory guidance (updated 22 July 2025), chapter 14: paragraphs 14.2, 14.6, 14.13, 14.25, 14.37 to 14.48, 14.57 to 14.61, 14.77 to 14.111 and 14.202
- Care and support statutory guidance, chapter 6: carer's assessment, paragraphs 6.16 to 6.21 and 6.74 (combined assessments)
- Care and support statutory guidance, chapter 10, paragraph 10.26: planning for a breakdown in the caring relationship
- Mental Capacity Act 2005, section 9: lasting powers of attorney (no authority until registered)
- Mental Capacity Act 2005, section 11: lasting powers of attorney, restrictions (life-sustaining treatment needs express provision)
- Mental Capacity Act 2005, section 20: restrictions on deputies (no refusal of life-sustaining treatment)
- Mental Capacity Act 2005, section 24: advance decisions to refuse treatment
- Mental Capacity Act 2005, section 26: effect of advance decisions
- Mental Capacity Act 2005, section 44: ill-treatment or neglect
- Mental Capacity Act 2005 Code of Practice (2007), paragraphs 2.8, 2.11, 4.26 to 4.27, 5.42 to 5.43, 7.22 to 7.31 and 10.66 to 10.67
- Changes to the definition of deprivation of liberty (Department of Health and Social Care, published 15 June 2026, last updated 22 September 2026): collection page and update history
- Find out if someone has an attorney, deputy or guardian acting for them (Office of the Public Guardian): free register search, reply within 5 working days
- View a lasting power of attorney (Office of the Public Guardian): access codes for organisations
- Universal Principles for Advance Care Planning (NHS England and partners, March 2022)
- Domestic Abuse Act 2021, section 1: definition of domestic abuse
- Domestic Abuse Act 2021, section 2: definition of personally connected
- Domestic Abuse: statutory guidance (Home Office, July 2022, last updated 13 April 2023), accessible version: paragraphs 32, 37 to 39, 118, 154, 162, 184, 210 to 211, 294, 418 to 419 and 433 to 436
- Domestic abuse in England and Wales overview: November 2025 (Office for National Statistics): 1.5 million men and 2.2 million women aged 16 and over, year ending March 2025
- SafeLives Dash risk checklist quick start guidance and checklist (2019): 24 questions, recommended Marac referral criteria (archived copy)
- Multi-Agency Risk Assessment Conference (Marac): guidance for GPs (SafeLives), referral, sharing and safe recording (archived copy)
- Men's Advice Line (Respect): helpline 0808 8010327
- Respect Phoneline: helpline 0808 8024040 for people worried about their own abusive behaviour
- RCGP safeguarding standards for general practice: impact of safeguarding on the wellbeing of GPs and staff (Royal College of General Practitioners)
- Making Safeguarding Personal (Local Government Association with ADASS)
- Myths and realities about Making Safeguarding Personal (Local Government Association, 2019)
- Crime and Policing Act 2026, sections 65 and 66: controlling another's home for criminal purposes (cuckooing), Royal Assent 29 April 2026, not in force at Royal Assent
- Crime and Policing Act 2026 (Commencement No. 4) Regulations 2026, SI 2026/1090, made 15 October 2026, with the table of earlier commencements: section 65 not yet commenced
- Criminal exploitation of children and vulnerable adults: county lines (Home Office, 2023): definition, methods including cuckooing, plugging and debt bondage, signs, and what to do
- Modern Slavery: statutory guidance for England and Wales, version 4.9 (Home Office, 15 October 2026), guidance for the NHS, paragraphs 12.43 to 12.53, and 15.95 to 15.96
- Care and support statutory guidance (Department of Health and Social Care): paragraphs 1.12 to 1.14 (wellbeing and self-neglect), 14.17 to 14.36 (types of abuse, financial abuse, scams), 14.108, 14.112 to 14.132 (allegations and positions of trust), 14.134, 14.162 to 14.179 (safeguarding adults reviews)
- Care Act 2014, section 45: supply of information to a Safeguarding Adults Board
- Care Act 2014, section 58: assessment of a child's needs for care and support
- Care Act 2014, section 66, inserting Children Act 1989 section 17ZH: section 17 services continue after 18 until the adult assessment reaches a conclusion
- Care Act 2014, Schedule 2, paragraph 4: the Safeguarding Adults Board annual report, including review findings
- Children Act 1989, section 23CZB: personal adviser for former relevant children aged 21 to 25 who ask
- Bridging the Gap: transitional safeguarding and the role of social work with adults (Department of Health and Social Care and Research in Practice, June 2021)
- Second national analysis of Safeguarding Adult Reviews: April 2019 to March 2023, stage 2 report (Local Government Association and ADASS): shortcomings by domain, executive function, power of entry, transition, GP findings
- Adult Safeguarding: Roles and Competencies for Health Care Staff, 2nd edition (Royal College of Nursing, July 2024): sexual exploitation, self-neglect, positions of trust, Level 3 knowledge and skills including transitional safeguarding and challenge
- Sexual Offences Act 2003, section 30: sexual activity with a person with a mental disorder impeding choice
- Sexual Offences Act 2003, sections 38 and 42: care workers, sexual activity with a person with a mental disorder
- How CQC identifies and responds to closed cultures (Care Quality Commission, updated 12 May 2022): definition, inherent risk factors and warning signs
- Stopping over medication of people with a learning disability and autistic people (STOMP) and STAMP (NHS England, archived copy June 2026)
- Hoarding disorder (NHS website): a mental health condition; a GP will usually refer to a mental health specialist
- Clutter Image Rating tool (Cumbria Safeguarding Adults Board): nine images per room, levels 1 to 3
- Mental Health Act 1983, section 135: warrant to search for and remove patients
- Police and Criminal Evidence Act 1984, section 17: entry for the purpose of arrest, saving life or limb
- Police and Criminal Evidence Act 1984, sections 11 and 12: excluded material and personal records, including health records
- Mental Capacity Act 2005, section 2(5): powers not exercisable in relation to a person under 16
- Mental Capacity Act 2005, section 9: a lasting power of attorney needs a donor aged 18 or over
- Mental Capacity Act 2005, section 24: an advance decision is made after reaching 18
- Family Law Reform Act 1969, section 8: consent by persons over 16 to medical treatment
- Domestic Abuse Act 2021, section 1: definition of domestic abuse, both aged 16 or over and personally connected
- Confidentiality: good practice in handling patient information (General Medical Council): paragraphs 17 to 19, 55, 59, 63 to 71 and 87 to 93, including MAPPA and formal reviews (archived copy, March 2026)
- Providing witness statements or expert evidence as part of legal proceedings (General Medical Council, in effect 30 January 2024), paragraphs 12 to 17 (archived copy)
- Criminal Justice Act 2003, section 325: arrangements for assessing risks posed by certain offenders (MAPPA), including the duty to co-operate and disclosure under subsections (4) to (4B)
- Criminal Justice Act 2003, section 327: relevant sexual, violent and terrorist offenders
- Redacting information for online record access, version 1.3 (NHS England, 13 March 2025, archived copy May 2026)
- Data Protection Act 2018, Schedule 3, paragraph 5: the serious harm test for health data in subject access
- Data Protection Act 2018, Schedule 2, paragraph 16: protection of the rights of others in subject access
- Notification of Deaths Regulations 2019, regulations 2 and 3: duty to notify the coroner, including neglect and self-neglect
- An overview of the death certification reforms (Department of Health and Social Care): statutory medical examiner system from 9 September 2024
- Coroners and Justice Act 2009, section 1: duty to investigate violent or unnatural deaths, deaths of unknown cause and deaths in state detention
- Learning from lives and deaths: people with a learning disability and autistic people (LeDeR) (NHS England, archived copy July 2026)
- Adults who disclose non-recent abuse, Derby and Derbyshire Safeguarding Children Partnership procedures (updated 9 September 2026): no time limit, current contact with children, referral routes
- National Association for People Abused in Childhood (NAPAC): support line 0808 801 0331
- National Stalking Helpline (Suzy Lamplugh Trust): 0808 802 0300, advice for victims and referrals from professionals
- Housing Act 1996, section 189(1)(e): priority need for a person homeless as a result of being a victim of domestic abuse (inserted from 5 July 2021)
- Management of NHS Numbers and PDS records: restricting access to a patient's record (sensitive status), National Back Office (NHS Digital, archived May 2026)
- Make a lasting power of attorney (GOV.UK): the certificate provider confirms the donor is acting by choice and understands what they are doing
- Care Act 2014, section 19: power to meet urgent needs without an assessment
- Care Act 2014, section 20: duty and power to meet a carer's needs, including by care for the adult needing care (subsection 7)
- Modern Slavery Act 2015, section 45: defence for slavery or trafficking victims who commit an offence, with Schedule 4 exclusions
- Criminal exploitation of children and vulnerable adults: county lines (Home Office, 2023): closure orders in cuckooing, the duty to notify, the section 45 defence, arrest as a reachable moment, and people placed out of area
- Multi-agency public protection arrangements (MAPPA): Guidance (Ministry of Justice, April 2024), paragraphs 1.12 (levels of management), 3.51 (general practitioners), 9.2 and 14.12 to 14.13 (information ownership and requests for minutes)
- Good medical practice 2024, paragraph 69: contemporaneous records, as extracted in the General Medical Council's witness guidance (archived copy, June 2025)
- National Domestic Abuse Helpline (Refuge)
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