What is Abuse? – wolverhamptonsafeguarding

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What is Abuse?

There are many different types of abuse, and they all result in behaviour towards a person that deliberately causes, or intends to cause them, harm.

Anyone can become an abuser, and most abusers are known by the adult at risk. Abuse can happen anywhere – in the home, in the community, in day or residential care, in hospital, or at college.

Abusers can be:

family members
friends
neighbours
paid carers
health or care professionals
work colleagues

Care Act 2014 identifies 10 categories of abuse:

Physical Abuse

Assault, hitting, slapping, punching, kicking, hair-pulling, biting, pushing
Rough handling
Scalding and burning
Physical punishments
Inappropriate or unlawful use of restraint
Making someone purposefully uncomfortable (e.g. opening a window and removing blankets)
Involuntary isolation or confinement
Misuse of medication (e.g. over-sedation)
Forcible feeding or withholding food
Unauthorised restraint, restricting movement (e.g. tying someone to a chair)

Signs and Indicators:

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

Domestic Violence or Abuse

Domestic violence or abuse can be characterised by any of the following:

psychological
physical
sexual
financial
emotional

Low self-esteem
Feeling that the abuse is their fault when it is not
Physical evidence of violence such as bruising, cuts, broken bones
Verbal abuse and humiliation in front of others
Fear of outside intervention
Damage to home or property
Isolation – not seeing friends and family
Limited access to money

Domestic violence and abuse includes any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been, intimate partners or family members regardless of gender or sexuality. It also includes so called ‘honour’ based violence, female genital mutilation and forced marriage.

Coercive or controlling behaviour is a core part of domestic violence. Coercive behaviour can include:

acts of assault, threats, humiliation and intimidation
harming, punishing, or frightening the person
isolating the person from sources of support
exploitation of resources or money
preventing the person from escaping abuse
regulating everyday behaviour

Sexual Abuse

Rape, attempted rape or sexual assault
Inappropriate touch anywhere
Non- consensual masturbation of either or both persons
Non- consensual sexual penetration or attempted penetration of the vagina, anus or mouth
Any sexual activity that the person lacks the capacity to consent to
Inappropriate looking, sexual teasing or innuendo or sexual harassment
Sexual photography or forced use of pornography or witnessing of sexual acts
Indecent exposure

Signs and Indicators:

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

Psychological or Emotional Abuse

Enforced social isolation – preventing someone accessing services, educational and social opportunities and seeing friends
Removing mobility or communication aids or intentionally leaving someone unattended when they need assistance
Preventing someone from meeting their religious and cultural needs
Preventing the expression of choice and opinion
Failure to respect privacy
Preventing stimulation, meaningful occupation or activities
Intimidation, coercion, harassment, use of threats, humiliation, bullying, swearing or verbal abuse
Addressing a person in a patronising or infantilising way
Threats of harm or abandonment
Cyber bullying

Signs and Indicators:

An air of silence when a particular person is present
Withdrawal or change in the psychological state of the person
Insomnia
Low self-esteem
Uncooperative and aggressive behaviour
A change of appetite, weight loss/gain
Signs of distress: tearfulness, anger
Apparent false claims, by someone involved with the person, to attract unnecessary treatment

Financial or Material Abuse

Theft of money or possessions
Fraud, scamming
Preventing a person from accessing their own money, benefits or assets
Employees taking a loan from a person using the service
Undue pressure, duress, threat or undue influence put on the person in connection with loans, wills, property, inheritance or financial transactions
Arranging less care than is needed to save money to maximise inheritance
Denying assistance to manage/monitor financial affairs
Denying assistance to access benefits
Misuse of personal allowance in a care home
Misuse of benefits or direct payments in a family home
Someone moving into a person’s home and living rent free without agreement or under duress
False representation, using another person’s bank account, cards or documents
Exploitation of a person’s money or assets, e.g. unauthorised use of a car
Misuse of a power of attorney, deputy, appointeeship or other legal authority
Rogue trading – e.g. unnecessary or overpriced property repairs and failure to carry out agreed repairs or poor workmanship

Signs and Indicators:

Missing personal possessions
Unexplained lack of money or inability to maintain lifestyle
Unexplained withdrawal of funds from accounts
Power of attorney or lasting power of attorney (LPA) being obtained after the person has ceased to have mental capacity
Failure to register an LPA after the person has ceased to have mental capacity to manage their finances, so that it appears that they are continuing to do so
The person allocated to manage financial affairs is evasive or uncooperative
The family or others show unusual interest in the assets of the person
Signs of financial hardship in cases where the person’s financial affairs are being managed by a court appointed deputy, attorney or LPA
Recent changes in deeds or title to property
Rent arrears and eviction notices
A lack of clear financial accounts held by a care home or service
Failure to provide receipts for shopping or other financial transactions carried out on behalf of the person
Disparity between the person’s living conditions and their financial resources, e.g. insufficient food in the house

Modern Slavery

Human trafficking
Forced labour
Domestic servitude
Sexual exploitation, such as escort work, prostitution and pornography
Debt bondage – being forced to work to pay off debts that realistically they never will be able to

Signs and Indicators:

Signs of physical or emotional abuse
Appearing to be malnourished, unkempt or withdrawn
Isolation from the community, seeming under the control or influence of others
Living in dirty, cramped or overcrowded accommodation and or living and working at the same address
Lack of personal effects or identification documents
Always wearing the same clothes
Avoidance of eye contact, appearing frightened or hesitant to talk to strangers
Fear of law enforcers

GOV.UK has more information on identifying and reporting modern slavery

Discriminatory Abuse

Unequal treatment based on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex or sexual orientation (known as ‘protected characteristics’ under the Equality Act 2010)
Verbal abuse, derogatory remarks or inappropriate use of language related to a protected characteristic
Denying access to communication aids, not allowing access to an interpreter, signer or lip-reader
Harassment or deliberate exclusion on the grounds of a protected characteristic
Denying basic rights to healthcare, education, employment and criminal justice relating to a protected characteristic
Substandard service provision relating to a protected characteristic

Organisational or Institutional Abuse

Discouraging visits or the involvement of relatives or friends
Run-down or overcrowded establishment
Authoritarian management or rigid regimes
Lack of leadership and supervision
Insufficient staff or high turnover resulting in poor quality care
Abusive and disrespectful attitudes towards people using the service
Inappropriate use of restraints
Lack of respect for dignity and privacy
Failure to manage residents with abusive behaviour
Not providing adequate food and drink, or assistance with eating
Not offering choice or promoting independence
Misuse of medication
Failure to provide care with dentures, spectacles or hearing aids
Not taking account of individuals’ cultural, religious or ethnic needs
Failure to respond to abuse appropriately
Interference with personal correspondence or communication
Failure to respond to complaints

Signs and Indicators:

Lack of flexibility and choice for people using the service
Inadequate staffing levels
People being hungry or dehydrated
Poor standards of care
Lack of personal clothing and possessions and communal use of personal items
Lack of adequate procedures
Poor record-keeping and missing documents
Absence of visitors
Few social, recreational and educational activities
Public discussion of personal matters
Unnecessary exposure during bathing or using the toilet
Absence of individual care plans
Lack of management overview and support

Neglect and Acts of Omission

Failure to provide or allow access to food, shelter, clothing, heating, stimulation and activity, personal or medical care
Providing care in a way that the person dislikes
Failure to administer medication as prescribed
Refusal of access to visitors
Not taking account of individuals’ cultural, religious or ethnic needs
Not taking account of educational, social and recreational needs
Ignoring or isolating the person
Preventing the person from making their own decisions
Preventing access to glasses, hearing aids, dentures, etc.
Failure to ensure privacy and dignity

Signs and Indicators:

Poor environment – dirty or unhygienic
Poor physical condition and/or personal hygiene
Pressure sores or ulcers
Malnutrition or unexplained weight loss
Untreated injuries and medical problems
Inconsistent or reluctant contact with medical and social care organisations
Accumulation of untaken medication
Uncharacteristic failure to engage in social interaction
Inappropriate or inadequate clothing

Self-Neglect

Lack of self-care to an extent that it threatens personal health and safety
Neglecting to care for one’s personal hygiene, health or surroundings
Inability to avoid self-harm
Failure to seek help or access services to meet health and social care needs
Inability or unwillingness to manage one’s personal affairs

Signs and Indicators:

Very poor personal hygiene
Unkempt appearance
Lack of essential food, clothing or shelter
Malnutrition and/or dehydration
Living in squalid or unsanitary conditions
Neglecting household maintenance
Hoarding
Collecting a large number of animals in inappropriate conditions
Non-compliance with health or care services
Inability or unwillingness to take medication or treat illness or injury

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