Safeguarding Adults at Risk

Adult safeguarding is about protecting adults who have care and support needs and who may be experiencing, or be at risk of, abuse or neglect. In pharmacy practice, this may involve people affected by frailty, disability, long-term illness, mental ill-health, cognitive impairment, dependence on others, or social isolation. Some adults may be very clear that they need help. Others may appear anxious, withdrawn, confused, controlled, or reluctant to speak openly.^[1][2][7]

What makes adult safeguarding different is that the adult's wishes, views, and right to be involved matter throughout. That does not mean concerns should be ignored if someone seems hesitant or unable to explain what is wrong. It means you should listen carefully, take the person seriously, and recognise that safety and choice often need to be balanced thoughtfully. At Level 2, your role is to notice when something may not be right, understand immediate risk, and follow the safeguarding route rather than trying to resolve the situation alone.^[3][1][4]

How Concerns May Present

In pharmacy settings, adult safeguarding concerns may emerge through everyday contact. You may notice:^{[6][5][2] [3]}

• an adult who appears frightened, confused, neglected, or unusually dependent on another person
• someone who is never allowed to speak for themselves
• repeated concerns about medication, missed care, poor living circumstances, or controlling behaviour
• a pattern suggesting abuse, neglect, exploitation, or coercion

An adult's wishes should be heard and respected, but signs of abuse or neglect must still be taken seriously.

This matters because some adults may minimise what is happening, feel ashamed, fear consequences, or rely on the very person causing harm. A person may also seem to make choices that place them at risk, while still needing safeguarding support. Your task is not to judge them, but to observe carefully and respond appropriately.^[7][1]

Your Role in Pharmacy Practice

A brief exchange at the medicines counter, a telephone conversation, or a home delivery may be enough to raise concern. If something seems wrong, make a factual record and follow the pharmacy's safeguarding process. Early, respectful action can help protect adults at risk while still recognising their dignity, voice, and right to be involved in what happens next.^{[5][8][4][3][9]}

References (numbered in text) Why we include references

1. Department of Health and Social Care. Care and Support Statutory Guidance: Chapter 14, Safeguarding adults (Care Act 2014). GOV.UK. Find (opens in a new tab)
2. Social Care Institute for Excellence. Types and indicators of abuse: Safeguarding adults. SCIE guidance. Find (opens in a new tab)
3. Making Safeguarding Personal: A guide for implementation. ADASS / national MSP guidance. Find (opens in a new tab)
4. Adult Safeguarding: Roles and Competencies for Health Care Staff. Intercollegiate Document. Royal College of Nursing et al., August 2018. Find (opens in a new tab)
5. NHS England. Pharmacy Quality Scheme guidance and safeguarding requirements for community pharmacy (PQS). NHS England guidance. Find (opens in a new tab)
6. Royal Pharmaceutical Society. Safeguarding: guidance and resources for pharmacy teams (RPS safeguarding pharmacy guidance). Find (opens in a new tab)
7. National Institute for Health and Care Excellence. Decision-making and mental capacity (NICE guideline NG108) – guidance on assessing capacity and supported decision-making. Find (opens in a new tab)
8. General Pharmaceutical Council. Knowledge hub / inspection guidance: safeguarding vulnerable patients (examples include routine follow-up of medicine non-deliveries). Find (opens in a new tab)
9. Department of Health and Social Care. Revisiting safeguarding practice. GOV.UK guidance on roles, referral routes and local authority safeguarding duties. Find (opens in a new tab)