You may not be sure if someone is being abused. It is enough that you are worried. You MUST act.
Safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action. This must recognise that adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances.
Abuse or harm is when someone does or says things to make someone upset or frightened. They may be too scared to speak out or to stop them.The person may be abused or harmed on purpose, or by someone who may not realise that what they are doing to you is wrong. Abuse or harm can happen when someone has power over someone, and they do not agree to what is happening.
Abuse can happen anywhere. It may happen at home, in a care home, hospital, day centre or in a public place. Anyone can be an abuser, but it is usually someone known to the person.
Abuse can take many forms and may include: Physical abuse, Domestic abuse, Sexual abuse, Psychological abuse, Financial or material abuse, Modern slavery, Discriminatory abuse, Organisational abuse, Neglect or acts of omission, Self-neglect.
Further information about these types of abuse can be found at SBC - What is abuse
You may become concerned that someone is being abused in a number of ways:
- the person may tell you
- the person may say something that worries you
- you may see something – an incident or an injury or other sign
You might see and/or hear something happen:
- someone being bullied or intimidated
- someone being made to feel frightened or unhappy
- someone in a situation of unnecessary risk
The person or somebody else might say something that gives cause for concern, for example:
- a colleague
- family member
- member of the public
There might be physical signs or unexplained or unusual injuries:
- bruises
- slap marks
- black eyes
- bleeding
- burns or scalding
- cigarette marks
- torn, stained or blood stained clothes
There may be other signs such as:
- inappropriate, dirty or soiled clothes
- no food or drink available for the person
- bills not being paid or services, e.g. telephone cut off
- shortage of money
The person might say things or behave in a way that causes you concern:
- the person may seem unhappy or distressed
- the person may appear frightened, anxious or agitated without an obvious cause, or in relation to certain people
- sleeping problems
- constant visits to the toilet without a medical reason
- other unexplained changes in how the person behaves
The behaviour of a colleague or other person might cause concern:
- dismissive or intolerant attitude
- task / routine orientated rather than person focused
- not a team player; insists on doing tasks on their own or in their way; secretive about contact with clients
- oversteps professional boundaries with clients and colleagues, maybe overfriendly; neglects professional development
What types of abuse are there?
There are many types of abuse. Expand the sections below to read more about each.
Physical Abuse
This includes:
- assault
- hitting
- slapping
- pushing
- misuse of medication
- restraint or inappropriate physical sanctions
Possible indicators of physical abuse are:
- No explanation for injuries or inconsistency with the account of what happened.
- Injuries are inconsistent with the person’s lifestyle.
- Bruising, cuts, welts, burns and/or marks on the body or loss of hair in clumps.
- Frequent injuries.
- Unexplained falls.
- Subdued or changed behaviour in the presence of a particular person.
- Signs of malnutrition.
- Failure to seek medical treatment or frequent changes of GP.
Sexual Abuse
This includes:
- rape
- indecent exposure
- sexual harassment
- inappropriate looking or touching
- sexual teasing or innuendo
- sexual photography
- subjection to pornography or witnessing sexual acts
- indecent exposure, sexual assault, or sexual acts to which the adult has not consented, or was pressured into consenting.
Possible indicators of sexual abuse are:
- Bruising, particularly to the thighs, buttocks and upper arms and marks on the neck.
- Torn, stained or bloody underclothing.
- Bleeding, pain or itching in the genital area.
- Unusual difficulty in walking or sitting.
- Foreign bodies in genital or rectal openings.
- Infections, unexplained genital discharge, or sexually transmitted diseases.
- Pregnancy in a woman who is unable to consent to sexual intercourse.
- The uncharacteristic use of explicit sexual language or significant changes in sexual behaviour or attitude.
- Incontinence not related to any medical diagnosis.
- Self-harming.
- Poor concentration, withdrawal, sleep disturbance.
- Excessive fear/apprehension of, or withdrawal from, relationships.
- Fear of receiving help with personal care.
- Reluctance to be alone with a particular person.
Emotional Abuse
This is when people talk to you in unkind ways. Emotional abuse can be when people say bad things to hurt your feelings, shout at you or threaten you.
Some examples of emotional abuse are:
- Calling you horrible names.
- Blaming you for things when it’s not your fault.
- Treating you like a child.
- Ignoring you.
Psychological Abuse
This includes emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.
Financial or Material Abuse
This is when someone takes your money or things that belong to you without asking. It can also be when someone controls your money or things that belong to you without asking.
You may have a legal guardian or someone has the power of attorney for you. This is someone who would help you look after your money and things that belong to you.
If you have help to look after your money someone should always go to these people if they are supposed to.
Some examples of financial abuse are:
- Someone stealing your money.
- Someone making you pay for other people’s things.
- When you don’t have a say in how your money is spent.
Including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
Neglect and Acts of Omission
Neglect is when people who are supposed to look after you doesn’t look after you properly. Neglect includes: ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating.
Some examples of neglect are:
- Being hungry.
- Being cold a lot of the time.
- Having only dirty clothes to wear.
- Being put in danger.
Discriminatory Abuse
This is when people say or do bad things to you. It can also be when people treat you unfairly or differently.
Examples of discriminatory abuse are someone being treated differently including forms of harassment, slurs or similar treatment because:
- of race - the colour of their skin.
- gender and gender identity,
- age,
- they are disabled.
- of their religion.
- sexual orientation - they are lesbian or gay.
- they speak a different language.
Domestic Violence and Abuse
Domestic violence and abuse is when your current or previous partner or a member of your family hurt you or try and control what you do. Some examples of domestic abuse include psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence. For example:
- forcing you to have sex.
- being forced to marry someone when you do not want to.
- being held against your will or taken somewhere you don’t want to be.
- physical violence against you.
Modern Slavery
Modern slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment. Modern Slavery Helpline Call 08000 121 700 to get help, report a suspicion or get advice. Modern slavery is being forced to work illegally against your will. Some examples of modern slavery are:
- being forced to work in prostitution or pornography.
- carrying out housework or domestic chores with little or no pay.
Organisational Abuse
Organisational abuse including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation. It happens in care homes, hospitals and can even happen in your own home. It can happen once or all the time. Some examples of organisational abuse are:
- care staff calling you names or hitting you.
- care staff not helping you with washing and dressing.
- being left alone in your room all day and care staff ignoring you.
Self Neglect
Self neglect covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. It involves no other perpetrator. Self-Neglect is when you do not look after yourself properly. Some examples of self neglect
- wearing dirty clothes all the time.
- not washing or looking after yourself properly.
- missing doctors appointments.
Who might need a Safeguarding response
Safeguarding duties apply to an adult who:
- has needs for care and support (whether or not the local authority is meeting any of those needs) and;
- is experiencing, or at risk of, abuse or neglect;
- and as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.
These adults for example may be:
- Frail due to age, ill health, physical disability or cognitive impairment, or a combination of these.
- Have a learning disability
- Have a physical disability and/or a sensory impairment
- Have mental health needs including dementia or a personality disorder
- Have a long-term illness/condition
- Users of substances or alcohol
- Be unable to demonstrate the capacity to make a decision and is in need of care and support.
This list is not exhaustive.
For those who do not meet the criteria as an adult at risk of harm but who nevertheless appear to be at high risk there are alternative sources of referral and support.
Find your local GP.