Regulation 13: Safeguarding service users from abuse and improper treatment

Page last updated: 11 August 2023
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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.—

  1. Service users must be protected from abuse and improper treatment in accordance with this regulation.
  2. Systems and processes must be established and operated effectively to prevent abuse of service users.
  3. Systems and processes must be established and operated effectively to investigate, immediately upon becoming aware of, any allegation or evidence of such abuse.
  4. Care or treatment for service users must not be provided in a way that—
    1. 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,
    2. 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,
    3. is degrading for the service user, or
    4. significantly disregards the needs of the service user for care or treatment.
  5. A service user must not be deprived of their liberty for the purpose of receiving care or treatment without lawful authority.
  6. For the purposes of this regulation—
    'abuse' means—
    1. any behaviour towards a service user that is an offence under the Sexual Offences Act 2003(a),
    2. ill-treatment (whether of a physical or psychological nature) of a service user,
    3. theft, misuse or misappropriation of money or property belonging to a service user, or
    4. neglect of a service user.
  7. For the purposes of this regulation, a person controls or restrains a service user if that person—
    1. uses, or threatens to use, force to secure the doing of an act which the service user resists, or
    2. 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

This sets out the guidance providers must have regard to against the relevant component of the regulation.

13.—(1) Service users must be protected from abuse and improper treatment in accordance with this regulation.

13(2) Systems and processes must be established and operated effectively to prevent abuse of service users.

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.

13(4) Care or treatment for service users must not be provided in a way that–

13(4)(c) is degrading for the service user, or

13(4)(d) significantly disregards the needs of the service user for care or treatment.

13(5) A service user must not be deprived of their liberty for the purpose of receiving care or treatment without lawful authority.