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Regulation 13: Safeguarding service users from abuse and improper treatment
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 13
The intention of this regulation is to safeguard people who use services from suffering any form of abuse or improper treatment while receiving care and treatment. Improper treatment includes discrimination or unlawful restraint, which includes inappropriate deprivation of liberty under the terms of the Mental Capacity Act 2005.
To meet the requirements of this regulation, providers must have a zero tolerance approach to abuse, unlawful discrimination and restraint. This includes:
- neglect
- subjecting people to degrading treatment
- unnecessary or disproportionate restraint
- deprivation of liberty.
Providers must have robust procedures and processes to prevent people using the service from being abused by staff or other people they may have contact with when using the service, including visitors. Abuse and improper treatment includes care or treatment that is degrading for people and care or treatment that significantly disregards their needs or that involves inappropriate recourse to restraint. For these purposes, 'restraint' includes the use or threat of force, and physical, chemical or mechanical methods of restricting liberty to overcome a person's resistance to the treatment in question.
Where any form of abuse is suspected, occurs, is discovered, or reported by a third party, the provider must take appropriate action without delay. The action they must take includes investigation and/or referral to the appropriate body. This applies whether the third party reporting an occurrence is internal or external to the provider.
CQC can prosecute for a breach of some parts of this regulation (13(1) to 13(4)) if a failure to meet those parts results in avoidable harm to a person using the service or if a person using the service is exposed to significant risk of harm. We do not have to serve a Warning Notice before prosecution. Additionally, CQC may also take any other regulatory action. See the offences section for more detail.
CQC must refuse registration if providers cannot satisfy us that they can and will continue to comply with this regulation.
The regulation in full
13.—
- Service users must be protected from abuse and improper treatment in accordance with this regulation.
- Systems and processes must be established and operated effectively to prevent abuse of service users.
- Systems and processes must be established and operated effectively to investigate, immediately upon becoming aware of, any allegation or evidence of such abuse.
- Care or treatment for service users must not be provided in a way that—
- includes discrimination against a service user on grounds of any protected characteristic (as defined in section 4 of the Equality Act 2010) of the service user,
- includes acts intended to control or restrain a service user that are not necessary to prevent, or not a proportionate response to, a risk of harm posed to the service user or another individual if the service user was not subject to control or restraint,
- is degrading for the service user, or
- significantly disregards the needs of the service user for care or treatment.
- A service user must not be deprived of their liberty for the purpose of receiving care or treatment without lawful authority.
- For the purposes of this regulation—
'abuse' means—- any behaviour towards a service user that is an offence under the Sexual Offences Act 2003(a),
- ill-treatment (whether of a physical or psychological nature) of a service user,
- theft, misuse or misappropriation of money or property belonging to a service user, or
- neglect of a service user.
- For the purposes of this regulation, a person controls or restrains a service user if that person—
- uses, or threatens to use, force to secure the doing of an act which the service user resists, or
- restricts the service user's liberty of movement, whether or not the service user resists, including by use of physical, mechanical or chemical means.
Guidance
Component of the regulation |
Providers must have regard to the following guidance |
13.—(1) Service users must be protected from abuse and improper treatment in accordance with this regulation. |
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13(2) Systems and processes must be established and operated effectively to prevent abuse of service users. |
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13(3) Systems and processes must be established and operated effectively to investigate, immediately upon becoming aware of, any allegation or evidence of such abuse. |
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13(4) Care or treatment for service users must not be provided in a way that– |
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13(4)(a) includes discrimination against a service user on grounds of any protected characteristics (as defined in Section 4 of the Equality Act 2010) of the service user, |
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13(4)(b) includes acts intended to control or restrain a service user that are not necessary to prevent, or not a proportionate response to, a risk of harm posed to the service user or another individual if the service user was not subject to control or restraint, |
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13(4)(c) is degrading for the service user, or |
This list is not exhaustive.
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13(4)(d) significantly disregards the needs of the service user for care or treatment. |
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13(5) A service user must not be deprived of their liberty for the purpose of receiving care or treatment without lawful authority. |
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Related legislation
Related guidance
Challenging behaviour
For all services
Data protection
For all services
Deprivation of liberty
The Deprivation of Liberty Safeguards – At a glance 43 (Social Care Institute for Excellence)
Dignity and respect
For all services
Dignity in Care – SCIE guide 15 (Social Care Institute for Excellence, June 2010 (updated May 2013))
Equality and human rights
For all services
General resource
For all services
National Institute for Health and Care Excellence (NICE)
Mental capacity
For all services
Mental Capacity Act 2005 Code of Practice
Mental health
For all services
Code of Practice: Mental Health Act 1983 (Department of Health)
Provision of mental health care for adults who have a learning disability (Royal College of Nursing)
Provision of mental health care for adults who have a learning disability (Royal College of Nursing)
Personalised care
Guidance on personalisation (Social Care Institute for Excellence)
Restrictive practice/restraint
For all services
Positive and proactive care: reducing the need for restrictive interventions (Department of Health)
Risk assessment
For all services
Health and Safety Executive, Sensible risk assessment in care settings
Risk assessment (Health and Safety Executive)
Safe use of bedrails device bulletin (Medicines and Healthcare Products Regualtory Agency)
Bed rail risk management - Sector information minute SIM 07/2012/06 (Health and Safety Executive)
Safe use of bedrails device bulletin (Medicines and Healthcare Products Regualtory Agency)
Bed rail risk management - Sector information minute SIM 07/2012/06 (Health and Safety Executive)
Safeguarding
For all services
What to do if you're worried a child is being abused (HM Government)
Clinical governance and adult safeguarding (Department of Health)
Adult safeguarding: Resources (Social Care Institute for Excellence)
Safeguarding children and adults (Social Care Institute for Excellence)
Whistleblowing
For all services
Whistleblowing guides (Social Care Institute for Excellence)
- Last updated:
- 06 August 2018