Unit 1.3: Safeguarding Adults and Children

• Topic 01

  Safeguarding Legislation

  45 questions
• Topic 02

  Categories of Abuse and Recognition

  51 questions
• Topic 03

  Safeguarding Procedures and Referral Pathways

  45 questions
• Topic 04

  Mental Capacity Act and Deprivation of Liberty Safeguards

  45 questions

A few questions from this unit, with the answer and a full explanation. The complete bank is available when you start practising.

1. A local authority completes a section 42 enquiry for an adult at risk but concludes that no further action is needed. A nurse disagrees with this conclusion and believes the person is still at risk. What options are available to the nurse?

   • A
     The nurse must report the local authority's decision to the Care Quality Commission as an improper conclusion to a statutory enquiry
   • B
     The nurse should refer the matter to the police as a criminal investigation, bypassing the local authority entirely
   • C
     The nurse must accept the local authority's conclusion; once a s.42 enquiry is complete no further action can be taken by individual professionals
   • D
     The nurse can raise their concern with the trust safeguarding lead, request that the conclusion of the enquiry is formally reviewed, or make a new referral to the local authority if there is new or additional information
     Correct answer
   Explanation

   If a nurse believes a s.42 enquiry conclusion is wrong or that there is ongoing risk, they can: raise the concern with the trust's safeguarding lead, request a formal review of the conclusion, or make a fresh referral if new information has emerged. Accepting an inadequate conclusion without further action could place the person at ongoing risk. The nurse should document their disagreement clearly. NHS safeguarding leads can formally challenge local authority conclusions through the SAB escalation process.

2. A nurse is reviewing a patient's safeguarding care plan and wants to ensure all six Care Act safeguarding principles are reflected. Which of the following correctly lists all six principles?

   • A
     Empowerment, Prevention, Privacy, Protection, Partnership, Accountability
   • B
     Empowerment, Prevention, Proportionality, Protection, Partnership, Transparency
   • C
     Empowerment, Prevention, Proportionality, Prosecution, Partnership, Accountability
   • D
     Empowerment, Prevention, Proportionality, Protection, Partnership, Accountability
     Correct answer
   Explanation

   The six principles in the Care Act 2014 statutory guidance are:

   • Empowerment.
   • Prevention.
   • Proportionality.
   • Protection.
   • Partnership.
   • Accountability.

   Common errors include substituting 'Transparency' for 'Accountability', 'Autonomy' for 'Empowerment', 'Promotion' for 'Prevention', or 'Prosecution' for 'Proportionality'. All six must be considered in safeguarding practice.

3. A patient with Korsakoff's syndrome can understand information when it is presented but has profound anterograde amnesia and cannot retain it. The clinical team debates whether the patient passes Stage 2 of the capacity test. What is the correct legal conclusion?

   • A
     The patient should be assessed by a psychiatrist; Korsakoff's syndrome creates a medical exception to the standard two-stage test
   • B
     The patient's capacity depends on the complexity of the decision; for simple yes/no questions they retain capacity, but for complex decisions they do not
   • C
     The patient passes Stage 2 because they can communicate a preference; the communication element of the test takes priority over retention in the MCA framework
   • D
     The patient fails Stage 2 because the inability to retain information, even when understanding is momentarily present, means the patient cannot use or weigh information in making the decision — retention is an explicit element of the functional test
     Correct answer
   Explanation

   Korsakoff's syndrome (a severe anterograde amnesia typically resulting from thiamine deficiency) is characterised by the inability to retain new information. Under the Stage 2 functional test, inability to retain information is an explicit criterion — one that, if failed, establishes lack of capacity regardless of the other criteria. The patient's ability to understand in the moment does not rescue the assessment if they cannot retain the information long enough to weigh it and reach a decision. Stage 1 is satisfied by the neurological impairment causing the amnesia.