Background There has been a rise in safeguarding cases within the hospice, reflecting the trend seen nationally. Recorded incidents rose from 9 in 2018/2019 to 499 in 2022/2023.The jump in numbers can be attributed to the following:

• Introduction of Safeguarding Advocates across all teams.

• Increasing safeguarding training for all staff and volunteers.

• Introducing an incident reporting platform across the organisation.

• COVID-19. Nationally, we saw a jump in safeguarding incidents which was mirrored within our organisation.

The exponential increase in reported cases since the programme was introduced is reassuring as it indicates the measures introduced have had an impact.

Aims To improve the identification and handling of safeguarding cases across the organisation and ensure continued compliance with Care Quality Commission (CQC) standards.

Methods Safeguarding Advocates were introduced in 2018 and now represent all departments. A new handbook, role descriptor and training programme were created and piloted by seven staff from across departments. Impact has been monitored through an ongoing review, quarterly workshops and performance indicators reported annually to governors and CQC. Safeguarding introduced as a standing agenda item for team meetings, where staff have the opportunity to raise concerns and Advocates attend quarterly workshops, reporting back areas for development.

Results and conclusions Feedback suggest that quarterly workshops are beneficial and that training has raised awareness: this is reflected in staff bringing more cases forward. A Safeguarding Audit undertaken in 2016 was repeated in 2023 to measure the impact of the programme. This found a:

• Slight increase in the proportion who had received some training and felt reasonably confident about dealing with safeguarding situations from 54% to 56%.

• Increase in awareness of who the Safeguarding Leads are from 67% to 91%.

• Increase in proportion of people feeling that they would benefit from training from 67% to 70%.

But a reduction in the proportion who felt confident in dealing with any safeguarding situation from 17% to 12%.

Training improvements are required to increase staff confidence, including tailored training for individual departments. This innovative scheme is ongoing. Training and support for Advocates continues to evolve and develop.