Worried about a person

What is abuse?

Abuse can happen anywhere; for example, in someone’s own home, in a public place, in hospital, in a care home or in college. It can take place whether an adult lives alone or with others. Take a look at this Safeguarding Adults easy read leaflet.    Anyone can witness or become aware of information suggesting that abuse and neglect is occurring.

People who require care and support must be able to trust and depend on the people they rely on for help. It is vital that professionals, other staff and members of the public are vigilant on behalf of those unable to protect themselves. No abuse is acceptable.

Safeguarding adults, means protecting an adults 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 of and experience of abuse.

Types of physical abuse – Easy Read

• Assault, hitting, slapping, pushing, kicking, hair pulling, punching
• Rough handling
• Scalding and burning
• Physical punishments
• Inappropriate or unlawful use of restraint
• Making someone purposefully uncomfortable (eg opening a window, removing blankets)
• Misuse of medication (eg sedation)
• Forcible feeding / withholding food

Possible indicators of physical abuse (the following list may be indications of many different problems, it is important not to jump to the wrong conclusion too quickly)

• 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 behaviour in the presence of a particular person
• Signs of malnutrition
• Failure to seek medical treatment or frequent changes of GP

Types of sexual abuse – Easy Read

• Rape
• Indecent exposure
• Sexual harassment
• Inappropriate looking or touching
• Sexual teasing or innuendo
• Sexual photography
• Subjection to pornography or witnessing sexual acts
• Sexual assault
• Sexual acts to which the adult has not consented or was pressured into consenting

Possible indicators of sexual abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

• Bruising, particularly to the thighs, buttocks and upper arms and marks on the neck
• Torn, stained or bloodied underclothing
• Bleeding, pain or itching in the genital area
• Unusual difficulty in walking or sitting
• Pregnancy in a woman who is unable to consent to sexual intercourse
• The uncharacteristic use of sexual language or significant changes in sexual behaviour or attitude
• Self-harming
• Poor concentration, withdrawal, sleep disturbance
• Fear of receiving help with personal care
• Reluctance to be alone with a particular person

Types of psychological abuse – Easy Read

• Emotional abuse
• Threats of harm or abandonment
• Deprivation of contact
• Humiliation
• Blaming
• Controlling
• Intimidation
• Coercion
• Harassment
• Verbal abuse
• Cyber bullying
• Isolation
• Unreasonable and unjustified withdrawal of services or supportive networks

Possible indicators or psychological abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

• An air of silence when the 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

Types of financial / material abuse – Easy Read

• 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
• Employees taking a loan from a person using the service
• Denying access to money
• Misuse of benefits or direct payments in a family home
• Someone moving into a person’s home living rent free without agreement or under duress
• False representation, using another person’s bank account, cards or documents
• Rogue trading – e.g., unnecessary or overpriced property repairs and failure to carry out agreed repairs or poor workmanship

Possible indicators of financial / material abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

• Missing personal belongings
• Unexplained lack of money
• Unexplained withdrawal of funds from accounts
• Power of attorney or lasting power of attorney being obtained after the person has ceased to have mental capacity
• The person allocated to manage financial affairs is evasive or uncooperative
• Rent arrears or 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

Modern Slavery encompasses: – Easy Read

• Slavery
• County Lines
• Cuckooing
• Human trafficking
• Forced labour and domestic servitude
• Traffickers and slave masters using whatever means that have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment

Possible indicators or modern slavery (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

• 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
• Lack of personal effects or identification documents
• Always wearing the same clothes
• Avoidance of eye contact, appearing frightened or hesitant to talk to strangers

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 ongoing ill treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.

Types of organisational abuse – Easy Read

• Ignoring medical treatment and needs
• Ignoring 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

Possible indicators of organisational abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

• The adult is hungry or dehydrated
• Inappropriate use of power on control
• ‘Batch care’ – lack of individual care plans
• Adults referred to, or spoken to with disrespect
• Inflexible services based on convenience of the provider rather than the person receiving services

Types of discriminatory abuse – Easy Read

• Harassment
• Slurs or similar treatment because of:
  • Race
  • Gender, Gender Identity. Gender Reassignment
  • Age
  • Sex or Sexual Orientation
  • Pregnancy and Maternity
  • Marriage and Civil Partnership
  • Disability
  • Sexual orientation
  • Religion and Belief

Possible indicators of discriminatory abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

• The adult appears withdrawn and isolated
• The adult appears frightened and avoids eye contact
• The adult appears withdrawn and avoids contact with other people

Neglect or Acts of Omission – Easy Read

Examples:

• Failure to provide access to food, shelter, clothing, heating, activities, personal or medical care including medication etc.
• Preventing access to glasses, hearing aids, dentures etc
• Providing care in a way that the person dislikes.
• Refusal of access to visitors, ignoring or isolating the person.
• Not taking account of the person’s needs such as cultural, religious, educational, social etc.
• Preventing the person from making their own decisions.
• Failure to ensure privacy and dignity.

Self-neglect is an extreme lack of self-care. – Easy Read

It is sometimes associated with hoarding and may be a result of other issues such as bereavement, loss or addiction. Self-neglect can be caused by mental or physical illness that has an effect on the person’s physical abilities, energy levels, attention, organisational skills, or motivation.

Recognising the signs of self-neglect

Sign of self-neglect can include:

• living in very unclean or unsanitary conditions
• looking dishevelled or wearing inappropriate clothes for the weather
• the presence of vermin, flies or unpleasant smells in or around the home
• property in a poor state of repair or with waste accumulating outside
• neglecting household maintenance, and creating hazards within the home or to a neighbouring property
• poor diet and nutrition
• declining or refusing prescribed medication or other community healthcare support
• refusing to allow access to health or social care professionals in relation to personal hygiene and care
• refusing to allow access to other organisations with an interest in the property
• repeated episodes of anti-social behaviour – either as a victim or source of risk
• being unwilling to attend external appointments with professionals in social care, health or other organisations (such as Housing)
• lack of personal hygiene resulting in poor healing or sores, long toenails, unkempt hair, uncared for facial hair, body odour, unclean clothing
• isolation either of an individual or of a household or family unit
• repeated referrals to Environmental Health

Hoarding can be associated with self-neglect. Hoarding disorder is where someone acquires an excessive number of items and stores them in a chaotic manner, usually resulting in unmanageable amounts of clutter. The items can be of little or no monetary value.

Signs of hoarding can include:

The definition from the Domestic Abuse Act 2021: ‘Any incident or pattern of incidents of controlling, coercive, 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. The abuse can encompass but is not limited to psychological, physical, sexual, financial, emotional abuse.’

Types of domestic abuse – Easy Read

• Psychological
• Physical
• Sexual
• Financial
• Emotional abuse
• So called ‘honour based’ violence

Possible indicators of domestic abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

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

Coercive Control

Most people understand that some forms of domestic abuse can be physical, verbal or both. There’s a more subtle type of abusive behaviour that’s equally harmful which is coercive or controlling behaviour which is now a crime.

Coercive Control is a form of abuse, as set out in Section 1 of the Domestic Abuse Act 2021 it is a strategic form of ongoing oppression and comments that are used to instil fear. The abuser will use tactics, such as limiting access to money or monitoring all communication, as a controlling effort, this usually starts of subtle but then intensifies as the relationship progresses.

Coercive or controlling behaviour is a core part of domestic abuse and coercive behaviour can include:

• Threats, humiliation, intimidation
• Harming, pushing or frightening the person
• Isolating the person from sources of support
• Exploitation of money or support
• Preventing the person from escaping abuse
• Regulating everyday behaviour

Stalking

The polices definition of stalking is that stalking is like harassment, but it’s more aggressive. The stalker will have an obsession with the person they’re targeting.

Someone you know could be stalking you; an ex partner or a person you were friends with, or it might be a stranger. If it’s someone you know, or knew, it doesn’t mean that it’s your fault; it’s still stalking and it’s an offence.

Stalking may include:

• regularly following someone
• repeatedly going uninvited to their home
• checking someone’s internet use, email or other electronic communication
• hanging around somewhere they know the person often visits
• interfering with their property
• watching or spying on someone
• identity theft (signing-up to services, buying things in someone’s name)

It’s stalking if the unwanted behaviour has happened more than once.

Social networking sites, chat rooms, gaming sites and other forums are often used to stalk and harass someone, for example:

• to get personal information
• to communicate (calls, texts, emails, social media, creating fake accounts)
• damaging the reputation
• spamming and sending viruses
• tricking other internet users into harassing or threatening
• identity theft
• threats to share private information, photographs, copies of messages

Honour Based Abuse

In the UK it is illegal to abuse or harm anyone for cultural reasons or reasons of family honour, whether they are a member of the same family or not. For example, it is illegal to punish another family member for what someone considers to be dishonourable behaviour. There are men and women in the UK who have been convicted and sent to prison for harming family members for reasons of honour.

If you are worried about honour-based abuse / violence you can speak to the police. You can also get confidential advice from an organisation called Karma Nirvana on 0800 5999 247

Female Genital Mutilation (FGM)

Female Genital Mutilation (FGM) also known as cutting or female circumcision is illegal in the UK. Practising FGM or taking a girl or woman abroad for FGM is a criminal offence punishable by law.

If you are a victim of FGM, you need to speak with your doctor. There are doctors who specialise in helping FGM victims. You can also ask for advice from one of several national organisations, such as the NSPCC on 0800 028 3550.

Children who are worried that they are in danger of FGM can speak to police, teachers, social workers, or Childline on 0800 1111.