What the CQC Looks for When Inspecting Infant and Patient Safety Controls

Safeguarding infants and vulnerable patients is one of the highest-impact responsibilities within an NHS Trust. While incidents are rare, the consequences of failure are severe - clinically, reputationally and regulatorily. As a result, infant and patient safety controls receive close attention during inspections by the Care Quality Commission (CQC).

Understanding what the CQC looks for - and how Trusts can evidence robust safeguarding - is critical for security, maternity, governance and procurement teams.

Safeguarding Is About Evidence, Not Intention

One of the most common misconceptions is that strong safeguarding policies alone are sufficient. In practice, the CQC focuses on how risks are actively controlled, not just how they are described on paper.

Inspectors look for:

• Clear identification of safeguarding risks
• Practical controls in place to reduce those risks
• Evidence that controls are consistently used
• Audit trails that demonstrate oversight and learning

Trusts are expected to show not only what their safeguarding approach is, but how it works day-to-day.

Key Areas the CQC Assesses

1. Risk Identification and Governance

The CQC expects infant and patient security risks to be formally recognised within Trust risk registers and governance frameworks. This includes:

• Recognition of infant abduction and patient absconding as low-frequency, high-impact risks
• Clear ownership of safeguarding responsibilities
• Board-level awareness and oversight

Safeguarding should not sit in isolation within maternity teams; it should link across security, estates, governance and digital services.

2. Physical and Technical Controls

Inspectors assess whether Trusts rely solely on manual processes or whether layered controls are in place. This may include:

• Secure exits and access-controlled doors
• Processes for monitoring movement in sensitive areas
• Technology that supports early detection of risk events

The emphasis is on prevention and early intervention, not reaction after an incident has already occurred.

3. Staff Training and Awareness

Even the strongest systems fail without staff understanding and buy-in. The CQC looks for:

• Evidence that staff are trained on safeguarding procedures
• Clear guidance on what to do when an alert or incident occurs
• Ongoing refresher training and accessible learning resources

Inspectors may speak directly with staff to test whether procedures are understood in practice.

4. Incident Response and Audit Trails

A critical inspection focus is how Trusts respond when something goes wrong. This includes:

• Clear escalation procedures
• Accurate logging of events and alarms
• Evidence of investigation, learning and improvement

Automated audit trails significantly strengthen a Trust’s ability to demonstrate compliance, as they remove reliance on manual reporting and memory.

5. Proportionality and Sustainability

The CQC increasingly considers whether safeguarding controls are:

• Proportionate to the risk
• Sustainable over time
• Aligned with wider NHS objectives, including Net Zero

Solutions that reduce manual workload, avoid unnecessary hardware replacement and minimise environmental impact are viewed favourably when supported by evidence.

From Policy to Proof

A recurring theme in inspections is the gap between policy and practice. Trusts that perform strongly are able to show:

• How safeguarding risks are monitored in real time
• How staff are alerted before an incident escalates
• How data supports assurance to leadership and regulators

This shift from written assurance to operational proof is becoming the standard expectation.

Preparing for Inspection

To strengthen inspection readiness, Trusts should regularly ask:

• Can we clearly explain how infant and patient safety risks are controlled?
• Can we evidence that our controls work in real scenarios?
• Can we quickly provide audit data if requested?

Regular internal reviews, combined with practical training and robust monitoring, reduce inspection risk and improve overall safety.

Final Thoughts

Infant and patient safeguarding is no longer viewed as a niche or purely clinical concern. It is a core governance responsibility that sits squarely within the CQC’s assessment of whether services are safe, well-led and effective.

Trusts that invest in clear governance, practical controls, staff training and auditable oversight are best placed to demonstrate compliance - and, more importantly, to protect their most vulnerable patients.

How Trusts strengthen maternity unit security.