Safeguarding

Types of abuse and exploitation

Abuse is the violation of an individual's human or civil rights by any other person or persons. Abuse can range from the small act of not treating someone with proper respect to extreme punishment or torture. Abuse can occur within any relationship where there is an expectation of trust and where action, or lack of action, causes harm or distress. The most common forms of abuse are:

  • Physical abuse includes hitting, slapping, pushing, kicking, misuse of medication, restraint and force-feeding.
  • Sexual abuse includes rape and sexual assault, or sexual acts to which the adult at risk has not consented, or could not consent, or was pressured into consenting.
  • Psychological abuse includes emotional abuse, threats of harm or abandonment, isolation, humiliation, blaming, controlling, intimidation, harassment, verbal abuse, threats or bribes.
  • Neglect and acts of omission: failure to provide appropriate care (e.g. food, medication, clothing, heating, cleanliness and hygiene) and denying religious or cultural needs.
  • Financial or material abuse includes theft, fraud or using a person's money, possessions or property without their consent.
  • Discriminatory abuse includes racism, sexism, ageism and discrimination based on a person's disability or sexual orientation.
  • Domestic abuse includes domestic violence or abuse can be characterised by any of the indicators of abuse outlined in this briefing relating to:
    • psychological
    • physical
    • sexual
    • financial
    • emotional
  • Modern slavery includes:
    • 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.
  • Discriminatory abuse includes:
    • unequal treatment based on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex or sexual orientation 
    • 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 abuse includes:
    • 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
  • 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

Read the NHS flyer: Tackling serious violence - a health perspective

Where does abuse happen?

Abuse can happen anywhere. Abuse may occur in:

  • An someone's own home
  • A relative's or friend's home
  • Nursing, residential or day care settings
  • Hospitals
  • College
  • Custodial settings
  • Any other public place previously assumed safe. 

It can take place when an adult lives alone or with others.

Abuse can occur once, several times, or it can occur many times over a period of days, weeks, months or years.

Who abuses and neglects adults?

Anyone can carry out abuse or neglect, including: 

  • Spouses/partners 
  • Other family members 
  • Neighbours 
  • Friends 
  • Acquaintances 
  • Local residents 
  • People who deliberately exploit adults they perceive as vulnerable to abuse 
  • Paid staff or professionals 
  • Volunteers and strangers.

Six principles of safeguarding

First introduced by the Department of Health in 2011, but now embedded in the Care Act, these six principles apply to all health and care settings.

  1. Empowerment - People being supported and encouraged to make their own decisions and informed consent
  2. Prevention - It is better to take action before harm occurs.
  3. Proportionality - The least intrusive response appropriate to the risk presented.
  4. Protection - Support and representation for those in greatest need.
  5. Partnership - Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.
  6. Accountability - Accountability and transparency in safeguarding practice.