Safeguarding adults

Physical abuse is an act by a person or persons which intends to cause feelings of physical pain, injury or other physical suffering or harm. This could include hitting, slapping, burning, pushing, restraining or giving too much medication or the wrong type of medicine.

Example: Sarah cares for John, her long term partner who is disabled. Sometimes Sarah gets angry and hits John. John wants this hitting to stop but doesn’t know how to tell Sarah and is afraid that she will hit him more.

Psychological or emotional abuse is when one person behaves in a way which causes the other person to feel traumatised. This can include making them feel anxious or depressed. This could include being threatened with violent behaviour, being left alone, not being allowed to have something or see someone or made to feel stupid or unworthy.

Psychological abuse can involve manipulation, so people suffering from psychological abuse may not be able to recognise what is happening to them. It can often take place in relationships, which could be spousal or between an adult and their carer or between friends, where one person has more power than the other.

Example: Khadijah is disabled and has care workers who visit her home. They tell her if she doesn’t make their life easier then she’ll have to go into a residential home.

Financial or material abuse is when someone steals or defrauds another person of their money or goods. It can include people directly stealing money from an adult at risk or it could be more subtle, like not giving them control over what they buy with their money. It can include theft of money or property fraud, or putting someone under pressure when writing a will.

Example: Mary’s son takes her pension to do her shopping. Mary is not given a choice over what the money is spent on and she is not given any money herself. Mary has very little food in the house and a lot of what her son buys is out of date or nearing its use by date. Mary has had a few bouts of vomiting and was admitted to hospital due to dehydration.

Sexual abuse is when someone forces another person to either take part in sexual activity or be the recipient of unwanted sexual attention or behaviour, without their consent. This can include rape or other forced sex acts, as well as inappropriate and intimate touching.

Example: Ahmed has learning disabilities and attends a day centre. When he is there another adult touches him in an intimate way, which he doesn’t like. Ahmed has told a worker at the day centre about it but nothing has been done to stop the touching.

This is when a person who requires care is not looked after properly and their needs are not met. It can include not being given food, not having a heated home, being denied social care or being stopped from getting medical attention.

Example: Shaun is looked after at home by a personal assistant. Shaun is not allowed to have the heating on and sometimes there is no food for him to eat. The personal assistant doesn’t give him his prescribed medication.

This is when a person is treated differently or unfavourably because they belong to a certain group. It can be based on race, ethnicity or gender. It can also be because a person is ‘different’.

It can include being made fun of, or being the subject of unkind remarks, because of religion, race, age, sex, disability or sexuality.

Example: Aleksander is disabled and when he is out in the community with his care worker people call him names and shout unkind remarks about the way he walks.

This includes slavery, human trafficking and forced labour. It can include sexual exploitation (where a person is forced to perform sex acts against their will, for example as a sex worker or escort), criminal exploitation (where a person is forced to carry out criminal activity against their will) and domestic servitude (where a person is forced to carry out housework for little or no pay, their movements may also be restricted).

Example: Samuel lived with his mum until she died. After his mum died, Samuel was approached by two men and asked if he would like to come and work for them. Samuel was forced to work as a labourer but was not given the money he was promised. He pays them rent to share a small room with four other men and sleeps in a bunk bed.

This is when people are mistreated because of poor or inadequate care and support, or when continuous poor practice affects the whole care setting. Organisational abuse occurs when staff in an individuals own home, residential home, nursing home or hospital all act in a way which benefits them and not the people they care for. This could mean very strict routines, lack of choice over food or drink or social activities and an unsafe or unhygienic environment.

Example: Ajit lives in a care home where he is often left alone for long periods of time because the care home is short staffed. He is only given a few minutes to eat his evening meal and is shouted at if he takes too long. He then has to go to bed at 7pm.

This is when people neglect their own basic needs including personal hygiene, being appropriately clothed, eating or looking after a personal medical condition.

It can happen to anyone at any time but is often associated with depression, mental health issues, getting older, addiction or cognitive impairments.

Example: Sonia has a mental health condition and lives at home. She has been hoarding things for many years and her home has now become unsafe and unhygienic. She has no heating and cannot use the bathroom as it is full of her possessions. Sonia’s landlord has issued her with an eviction notice.

Organisations must ensure that people have the freedom to choose how and where they live and must work to protect their liberty. Anyone who is deprived of their liberty because they are unable to make a decision for themselves must be protected against this deprivation happening illegally.

There is a set piece of legislation which states that if someone is unable to make a decision, for example about moving into a care home, then any decision made for them has to be in the interest of the person and the least restrictive option.

Follow this link to find out more about deprivation of liberty.

When people are deprived of their liberty, special safeguards have to be put in place to protect them. Abuse can happen when these safeguards aren’t put in place or these safeguards are broken.

Example: Jim’s wife Sally has dementia and her needs have been assessed by Adult Social Care. Sally’s dementia cannot be managed in her own home and Jim wants Sally to go to residential care. A best interest decision is taken that Sally should move to a care home. Once Sally moves into the care home, the home must apply to the local authority for a Deprivation of Liberty Safeguards authorisation because Sally’s dementia means she doesn’t have the capacity to make the decision about living in a care home for herself.

A series of assessments will be carried out by independent assessors and a decision will be made as to whether living in the care home is the least restrictive option for Sally. If this process is not followed and Sally is deprived of her liberty she will be experiencing illegal detainment and will be a victim of human rights abuse and deprivation of liberty abuse.