What is Abuse and Neglect?

Physical abuse is deliberately causing physical harm to a child. This might involve punching, kicking, biting, burning, scalding, shaking, throwing or beating with objects such as belts, whips, or sticks. It also includes poisoning, giving a child alcohol or illegal drugs, drowning or suffocation.

Physical harm may also be caused when a parent or carer fabricates the symptoms of illness in a child.

In pregnancy an unborn child can be harmed by domestic abuse.

Emotional abuse is where repeated verbal threats, criticism, ridicule, shouting, lack of love and affection causes a severe adverse effect on a child's emotional development. It includes conveying to children that they are worthless, unloved, and inadequate or valued only insofar as they meet the needs of another person.

Emotional abuse may include not giving a child opportunities to express their views, deliberately silencing them or 'making fun' of what they say or how they communicate.

It may feature inappropriate expectations being imposed on a child, over protection and limitation of exploration and learning, or preventing the child from taking part in normal social interaction.

It may involve seeing or hearing the ill-treatment of another person. It may involve serious bullying (including cyberbullying), causing children frequently to feel frightened or in danger, or the exploitation or corruption of children.

Some level of emotional abuse is involved in all types of ill treatment of children, or it may occur alone

Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, whether or not the child is aware of what is happening. This may involve physical contact including penetrative sex, oral sex, masturbation, kissing, rubbing, or touching outside of clothing, or it may involve non-contact activities such as involving children in watching sexual activities, producing or looking at sexual images, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet).

Abusers can be men, women or other children.

Neglect is the persistent failure to meet a child's basic physical and/or psychological needs, likely to result in serious impairment of the child's health or development.

Neglect is when a parent or carer fails to provide adequate food, clothing, shelter (including exclusion from home or abandonment), medical care, or protection from physical and emotional harm or danger.

It also includes failure to ensure access to education or to look after a child because the carer is under the influence of alcohol or drugs.

In pregnancy neglect may occur as a result of misusing alcohol or drugs. 

This is the physical ill treatment of an adult, which may or may not cause physical injury. 

Types of 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)

Possible signs of physical abuse:

• Multiple bruising
• Fractures
• Burns
• Bed sores
• Fear
• Depression
• Unexplained weight loss
• Assault (can be intentional or reckless)
• Failure to seek medical treatment, or a pattern of visiting different hospitals or doctors over a short period of time.

Sexual abuse includes any sexual act to which the vulnerable adult has not consented and may not understand.

Types of 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

Possible Indicators of Sexual Abuse:

• Loss of sleep
• Unexpected or unexplained change in behaviour
• Bruising
• Soreness around the genitals
• Torn, stained or bloody underwear
• A preoccupation with anything sexual
• Sexually transmitted diseases
• Pregnancy

This is behaviour that has a harmful effect on the person’s emotional health and development or any form of mental cruelty that results in:

• mental distress
• the denial of basic human and civil rights such as self-expression, privacy and dignity
• negating the right of the adult at risk to make choices and undermining their self-esteem
• Isolation and over-dependence that has a harmful effect on the person’s emotional health, development or well-being.

The Social Care Institute of Excellence (SCIE) list the following types of 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

Possible indicators of psychological or emotional abuse:

• Fear
• Depression
• Confusion
• Loss of sleep
• Unexpected or unexplained change in behaviour
• Low self esteem

Financial abuse is a crime. It is the use of a person’s property, assets, income, funds or any resources without their informed consent or authorisation. 

The Social Care Institute of Excellence (SCIE) list the following types of financial 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 – eg. unnecessary or overpriced property repairs and failure to carry out agreed repairs or poor workmanship

Possible indicators of financial abuse:

• Unexplained withdrawals from the bank
• Unusual activity in the bank accounts
• Unpaid bills
• Unexplained shortage of money
• Reluctance on the part of the person with responsibility for the funds to provide basic food and clothes etc.
• Unnecessary property repairs
• Changes in deeds or title to property

Neglect is the failure of any person who has responsibility for the charge, care or custody of an adult to provide the amount and type of care that a reasonable person would be expected to provide.

The Social Care Institute of Excellence (SCIE) list the following types of neglect:

• 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

Neglect can be intentional or unintentional. Intentional neglect such as withholding meals may constitute ‘wilful neglect’ and is a criminal act punishable under law (Mental Capacity Act 2005 Section 44).

Possible signs of neglect:

• 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
• Over-sedation

The Social Care Institute for Excellence (SCIE) have published a General Briefing on Self Neglect , a Manager's Briefing and a Practitioner's Briefing.

They list types of self neglect as:

• 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

Indicators of self-neglect:

• 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

Institutional abuse is the mistreatment or abuse or neglect of an adult by a regime or individuals within settings and services that adults live in or use, that violate the person’s dignity, resulting in lack of respect for their human rights. The individual's needs and wishes are sacrificed for the smooth running of the service.

Institutional abuse occurs when the routines, systems and regimes of an institution result in poor or inadequate standards of care and poor practice which affects the whole setting and denies, restricts or curtails the dignity, privacy, choice, independence or fulfilment of individuals.

The Social Care Institute of Excellence (SCIE) list the following indicators of institutional abuse:

• Lack of flexibility and choice for adults 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 or unnecessary exposure during bathing or using the toilet
• Absence of individual care plans
• Lack of management overview and support

Evidence of any one indicator from the list above should not be taken on its own as proof that abuse is occurring. However, it should alert practitioners to make further assessments and to consider other factors associated with the adult at risk’s situation.

Discriminatory abuse exists when values, beliefs or culture result in a misuse of power that denies opportunity to some groups or individuals. It can be a feature of any form of abuse of an adult, but can also be motivated because of age, gender, sexuality, disability, religion, class, culture, language, race or ethnic origin.

It can result from situations that exploit a person’s vulnerability by treating the person in a way that excludes them from opportunities they should have as equal citizens, for example, education, health, justice and access to services and protection.

The Social Care Institute of Excellence (SCIE) list the following types of 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

Hate Crime

A Hate Crime is any behaviour that someone thinks was caused by hostility, prejudice or hatred of:

• Disability (including physical impairments, mental health problems, learning disabilities, hearing and visual impairment)
• Gender identity (includes people who are transgender, transsexual or transvestite)
• Race, skin colour, nationality, ethnicity or heritage
• Religion, faith or belief (including people without a religious belief)
• Sexual orientation (people who are lesbian, gay, bisexual or heterosexual)