How do we create a “speak-up” culture, so people feel safe to raise concerns?

A strong speak-up culture in care is essential for preventing abuse and poor-quality services. UK law and guidance emphasise that care providers must have clear systems and leadership that protect individuals and respect their wishes. The Care Act statutory guidance sets out adult safeguarding requirements, and CQC Regulation 13 mandates effective arrangements to prevent and respond to abuse.

When staff feel safe to raise concerns, organisations are better able to identify risks early, learn from incidents, and continuously improve care quality.

Make Routes to Raise Concerns Crystal Clear

• Publish a simple flowchart showing who to contact internally (line manager or Designated Safeguarding Lead) and how to escalate externally (local authority safeguarding team or CQC).

• Explain how concerns are triaged, expected timelines for feedback, and how confidentiality is maintained under UK law (PIDA).

• Link to CQC whistleblowing guidance for staff reference.

Clear communication of these pathways ensures staff understand exactly how to act if they observe unsafe practice or abuse.

Lead by Example

Senior staff must actively encourage challenge and raise concerns, thank staff for speaking up, and share “you said / we did” outcomes. This aligns with CQC fundamental standards (Reg 13 safeguarding; Reg 17 governance).

In NHS or integrated services, follow Freedom to Speak Up principles and engage your FTSU Guardian. The National Guardian’s Office provides guidance on how guardians support workers to speak up safely.

Train Everyone (and Refresh Regularly)

All staff should receive training on:

• Recognising abuse and poor care

• How to record and report concerns

• Internal and external reporting routes

• Legal protections for whistleblowers

Refresher training ensures staff remain confident in procedures and compliant with CQC expectations.

Protect People Who Speak Up

Staff should be explicitly reassured that they will not suffer detriment for raising concerns in good faith, in line with PIDA principles. Organisations can provide confidential reporting options, such as dedicated emails or phone lines, to reinforce trust.

Listen to People Who Use Services

A true speak-up culture in care includes listening to service users:

• Residents, families, and children should have everyday opportunities to provide feedback (surveys, “Dear Manager” boxes, forums).

• Working Together 2023 emphasises a culture of listening to children, while adult safeguarding encourages service-user involvement and respect for their wishes.

Join It Up with the Care Act Process

When concerns relate to an adult at risk, follow the local Care Act safeguarding pathway. Involve the person in decisions wherever possible (Making Safeguarding Personal). The local authority decides whether a Section 42 enquiry is required.

How Can Staff Learn More About Speak-Up Culture in Care?

Staff can build confidence and competence through CareTutor’s safeguarding training, which covers how to recognise, record, and report abuse effectively.

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