Safeguarding when you work for yourself: spotting abuse and neglect, and who to tell

The contract between each client and carer on PrimeCarers is plain about where this sits. It says PrimeCarers is not responsible for vetting, supervising or monitoring carers or clients during the arrangement, and is not responsible for safeguarding risks that arise while care is being given. It says all safeguarding concerns must be addressed directly between the client and the carer, or to the appropriate statutory bodies. PrimeCarers is an introductory and payment service. It is not an agency, it does not employ you, and it does not provide or supervise care. The checks it makes before you appear to families (identity, right to work, an enhanced DBS check and an online interview) are not supervision of your work. The contract itself is published in full.

The statutory bodies are the council, which leads on adult safeguarding, and the police. The NHS matters too, because a GP is often the professional best placed to notice a change in somebody's health. The Care Act statutory guidance says it is the responsibility of all staff and members of the public to act on any suspicion or evidence of abuse or neglect and to pass their concerns to a responsible person or agency. It also says no professional should assume somebody else will pass on information that may be critical to the adult's safety.

The council's legal duty applies to an adult who has needs for care and support, is experiencing or at risk of abuse or neglect, and because of those needs cannot protect themselves. That is set out in section 42 of the Care Act 2014. You do not have to work out whether somebody meets that test before you call. The guidance says it is not for front line staff to second-guess the outcome of an enquiry when deciding whether to share a concern.

If you have come from an agency and are weighing up working this way, self-employed or agency sets out the other differences, and the rest of the guides for working carers are on carer resources. When you are ready, you can register as a carer on PrimeCarers, set your own rate and choose the clients you work with, or see the carer jobs open near you first.

Two of these need a word of their own because you will meet them more often than the rest in somebody's home.

Financial abuse is the one the guidance singles out. It says financial abuse is the main form of abuse the Office of the Public Guardian investigates, and that where there are other forms of abuse there is likely to be financial abuse too. It covers scams and doorstep crime as well as theft by people the person knows, and it says scams should always be reported to the police and to the council's Trading Standards service. If you handle any of a client's money yourself, handling money for clients covers the records that protect you both.

Self-neglect is different from the others because nobody else is doing it. The guidance says it covers neglecting personal hygiene, health or surroundings, including hoarding, and that it may not lead to a formal safeguarding enquiry. Whether it does depends on whether the person can still protect themselves by controlling their own behaviour. An adult who can make their own decisions is allowed to make choices you would not make, so the starting point is a conversation with them, and then the GP.

Misuse of medication appears under physical abuse, which is worth knowing if you prompt or give medicines. Helping with medication covers what a carer can and cannot do with a client's tablets.

None of the signs above proves anything on its own. A bruise may be from a fall, and an empty fridge may be a missed delivery. The guidance says signs like these show that a closer look may be needed, and the closer look is the council's job, not yours.

1. 1

   Call 999 and ask for the police or an ambulance

   Immediate danger

   Gov.uk says to call 999 if a crime is in progress or somebody is in immediate danger. If somebody is hurt or unwell, ask for an ambulance. Stay with the person if it is safe for you to do so.
2. 2

   Call 101, or report it online to the police

   A crime, not an emergency

   For a crime that is not happening now, such as money going missing or an assault you have been told about afterwards. The statutory guidance says that if you are uncertain about your next steps, you should contact the police for advice.
3. 3

   Ring the council's adult safeguarding team

   An adult at risk

   The council where the person lives, not where you live. Gov.uk's council finder gives you the council from a postcode, and its adult social care pages list how to raise a safeguarding concern.
4. 4

   Tell the GP, or call 111

   Where health is involved

   A sudden change in health, weight or memory, an untreated sore or a medication problem. NHS 111 can direct you to the right help when the GP is closed. Call 999 in an emergency.

Gov.uk's council finder gives you the right council from a postcode, and its page on contacting the police sets out when to use 999 and 101. When you ring the council, say that you are a self-employed carer and want to raise a safeguarding concern about an adult. Give the person's name and address, what you have seen or been told, when, and whether they know you are calling. Say whether you think anybody is at risk right now. You do not need proof, and you do not need to name a type of abuse. The council decides whether a formal enquiry is needed, and the guidance says an enquiry can be as light as a conversation with the adult. The council may tell you little about what happens next, because the information is about somebody else.

Some concerns have a specialist body as well. If you are worried about how an attorney or a deputy is managing somebody's money or decisions, report it to the Office of the Public Guardian. Gov.uk says anyone can report, including care workers, that the OPG will not tell the attorney who made the report, and that it can investigate only where the person lacks the capacity to deal with the issue themselves. If you think a DWP appointee is misusing somebody's benefits, the guidance says to contact the DWP straight away. For domestic abuse, gov.uk's guide to getting help lists the National Domestic Abuse Helpline on 0808 2000 247, free and open 24 hours a day, for anyone worried about a friend, neighbour or loved one. The family-facing guide on what families are told about reporting a safeguarding concern sets out the same routes from their side.

Write it the same day, and ideally before you leave the area. A few lines on your phone are enough, as long as they are dated and you keep them somewhere private. If the concern is about somebody in the household, do not leave anything in the care notes or a diary kept in the house.

Keep your records private in the ordinary way too. The contract asks you to respect the client's confidentiality and to comply with data protection law, and it names the statutory bodies as the place safeguarding concerns go. Sharing what you have seen with the council or the police is not the same as talking about a client with friends or posting about it, which you should never do. The risk assessment guide covers the wider notes worth keeping about a client's home.

Promising a client that you will keep something to yourself is the mistake to avoid. The guidance says it is not appropriate to give assurances of absolute confidentiality where there are concerns about abuse, and that confidentiality must not be confused with secrecy. If somebody starts to tell you something, it is kinder to say early on that you may need to pass it on to people who can help, and that you will tell them if you do.

Capacity is decision-specific. A client may be able to decide who visits them and not be able to manage a large sum of money, and neither of those is yours to rule on. The Mental Capacity Act assumes a person has capacity unless it is shown otherwise, and says an unwise decision is not proof that they lack it. Mental capacity in care: MCA and DoLS goes through the five principles, the two-part test and who decides once somebody cannot.

Stopping your visits can end the only outside contact the person has, so think about that before you walk away from a client. If you decide to stay, keep your notes up to date and keep the council informed of anything new. If you decide to end the arrangement, the notice is 48 hours for hourly care, and 7 days for live-in care once you have been there 168 hours, though the contract lets you leave at once where staying would endanger you. Tell the council you are leaving, so that somebody knows the person will have one fewer visitor.

The same applies in reverse. A family member who is caring for their parent may also be exhausted, and the guidance recognises that a family carer can harm somebody without meaning to. That is still something to raise. The council can offer support to a carer as well as protection to the person they care for, and raising a concern is not the same as accusing anybody.

Whistleblowing law is the other question carers ask here. Gov.uk says you are protected by law as a whistleblower if you are a worker, and lists employees, trainees, agency workers and members of a limited liability partnership. It does not list the self-employed, and it says to get independent advice, for example from Citizens Advice, if you are not sure whether you are protected. That does not change what to do about a concern. Keeping your own safety in mind is part of this too, and lone working and personal safety covers it, while professional boundaries covers gifts and the lines with a client's family.