Types of abuse and neglect

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Introduction

The Care and Support Statutory Guidance | GOV.UK sets out 10 types of abuse and neglect:

Domestic abuse

This includes psychological, physical, sexual, financial or emotional abuse. The abuser is a family member, partner or an ex-partner.

It may be a one-off incident or a pattern of incidents or threats. It can include violence, controlling or coercive behaviour.

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

Domestic abuse also includes so called ‘honour’-based violence. For example, forcing a person to marry or undergo genital mutilation.

Signs of domestic abuse

Low self-esteem.
Feeling that the abuse is their fault when it is not.
Physical evidence of violence, such as cuts, bruising or 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.

Discriminatory abuse

This is abuse or unequal treatment because of a person’s:

race
age
gender identity
religion
sexuality
physical or learning disability
mental health needs

Or any other protected characteristics of the Equality Act.

Signs of discriminatory abuse

The person appears withdrawn and isolated.
Expressions of anger, frustration, fear or anxiety.
Lack of respect shown to an individual.
Signs that someone is receiving sub-standard service.
Denial of rights, such as to health care, in education or at work.

Discriminatory abuse is also called ‘hate crime’. Hate crime is a criminal offence against someone motivated by prejudice or hate because of who they are.

This can include:

threats, bullying or intimidation
threatening or offensive mail, texts or emails
verbal abuse
damage to property
physical assaults

It is important to report all hate incidents, even if you think nothing can be done. It helps the police and other agencies to identify what is happening in our communities. Hate crimes are not only crimes against the victim, but also against a particular group.

Financial or material abuse

This includes:

misusing or stealing a person’s money or belongings
fraud, postal or internet scams tricking people out of money
pressuring a person into making decisions about their financial affairs. This includes decisions involving wills and property.

Signs of financial or material abuse

Missing personal possessions.
Unexplained lack of money or inability to maintain their lifestyle.
Unexplained withdrawal of funds from accounts.
A lasting power of attorney (LPA) set up after the person lost 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 managing financial affairs is evasive or uncooperative.
The family or others show an unusual interest in the person’s assets.
Signs of financial hardship in cases where a court-appointed deputy, attorney or LPA manages the person’s financial affairs.
Recent changes to property deeds or title.
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.
A gap between the person’s living conditions and their financial resources e.g. lack of food or heating.
Unnecessary property repairs.

Modern slavery

This includes:

human trafficking
slavery
domestic servitude
forcing someone to work for little or no pay (including in the sex trade)
holding someone against their will, torture, abuse or bad treatment by others.

Signs of modern slavery

Signs of physical or emotional abuse.
Malnourished, unkempt or withdrawn.
Isolated from the community, seeming under the control or influence of others.
Living in dirty, cramped or overcrowded housing and living and working at the same address.
Lack of personal items or identification documents.
Always wearing the same clothes.
Avoiding eye contact, appearing frightened or hesitant to talk to strangers.
Fear of the police or authorities.

Advice about modern slavery and how to combat it

The Home Office has a range of modern slavery guidance.

Neglect

Neglect involves not meeting a person’s physical, medical or emotional needs. This may be deliberate, or by failing to understand these. It includes not providing essentials, such as medication, food, water, shelter and warmth.

Signs of neglect

Living in a dirty or unhygienic environment.
Poor physical condition 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.
Untaken medication.
Avoiding social interaction when it is out of character.
Inappropriate or inadequate clothing.

Organisational abuse

This includes neglect and providing poor care in a care setting. This might be a hospital, a care home, or in a person’s own home. It may be a one-off incident, repeated incidents or ongoing ill treatment.

The abuse may be due to the organisation’s processes and practice.

Signs of organisational abuse

Lack of flexibility and choice for people using the service.
Service users being hungry or dehydrated.
Poor standards of care.
Lack of personal clothing and possessions or communal use of personal items.
Misuse of medication.
Inappropriate restraint methods.
Sensory deprivation, for example not providing hearing aids or glasses.
Regimented routines, for example, around mealtimes and bedtimes.
Poor record keeping, missing documents and an absence of individual care plans.
Denial to or absence of visitors.
Few social, recreational and educational activities.
Inadequate staffing levels and a lack of supervision and training.
Lack of management overview and support.

Physical abuse

This includes:

being hit, slapped, kicked or pinched
inappropriate restraint
force-feeding
knowingly giving someone too much or too little medication

Signs of physical abuse

Unexplained injuries, or the explanation does not add up.
Clusters of injuries forming regular patterns.
Finger marks or slap marks.
Emotional distress or fear.
Multiple fractures.
Inappropriate use of physical restraint.
Medication misuse.
Injuries at different stages of healing.

Psychological or emotional abuse

Abusive behaviour includes:

verbal abuse, shouting or blaming
ridiculing or humiliating
bullying or cyberbullying (in person or online)
controlling someone using intimidation or fear
ongoing harassment or isolation

Signs of psychological or emotional abuse

A change in behaviour when a particular person is present.
Change in appetite.
Low self-esteem, deference, passivity or resignation.
Fear, defensiveness or ambivalence.
Bottling up emotions.
Sleep disturbance.
Uncooperative or aggressive behaviour.
Signs of distress, such as tearfulness or anger.

Self-neglect

When someone is unable or unwilling to care for their own essential needs, it is self-neglect. This includes their health and surroundings.

Signs of self-neglect

Very poor personal hygiene and unkempt appearance.
Lack of food, clothing or shelter.
Malnutrition or dehydration.
Living in squalid or unsanitary conditions.
Neglecting household maintenance.
Hoarding.
Having a lot of animals which are kept in inappropriate conditions.
Lack of engagement with health or social care services.
Unable or unwilling to take medication or treat illness or injury.

Sexual abuse

This involves making someone take part in sexual activity when they do not, or cannot, agree to this.

It includes rape, indecent exposure and inappropriate looking or touching. It also includes sexual activity if the other person is in a position of power or authority.

Signs of sexual abuse

Changes in behaviour or attitude. This includes poor concentration, depression, withdrawal, sleep disturbance, and self-harming.
Bruising, particularly to the thighs, buttocks and upper arms and marks on the neck.
Pregnancy in women who are unable to consent to sexual intercourse.
Bleeding, pain or itching in the genital area.
Unusual difficulty in walking or sitting.
Infections, such as unexplained genital discharge or sexually transmitted diseases.
Incontinence which is not related to any medical diagnosis.
Torn, stained or bloody underwear.
Excessive fear or apprehension of relationships.
Fear of receiving help with personal care.
Reluctance to be alone with a particular person.