It is not always easy, even for those with specialised training, to recognise abuse.  If you have any concern that an adult is in danger, you must report it immediately to Social Services or the Police.

The following signs may indicate the possibility of abuse or neglect.  It is, however, important to remember that none of the following are conclusive proof of abuse and all can have an innocent explanation.

Physical Abuse

Physical Abuse is ‘the non-accidental infliction of physical force that results in bodily injury, pain or impairment’.

Examples of Physical Abuse:

  • Hitting
  • Slapping
  • Kicking
  • Inappropriate restraint or sanctions
  • Force feeding
  • Misuse (or inappropriate withholding) of medication.

Signs and Symptoms of Physical Abuse:

The signs of Physical Abuse are often evident but can also be hidden by the abuser or the victim. Any unexplained injuries should always be fully investigated. Evidence to look out for includes:

  • Any injury not fully explained by the history given
  • Injuries inconsistent with the lifestyle of the Vulnerable Adult
  • Bruises and/or welts on face, lips, mouth, torso, arms, back, buttocks, thighs
  • Clusters of injuries forming regular patterns or reflecting the shape of an object
  • Burns, especially on soles, palms or back, from immersion in hot water, friction burns, rope or electric appliance burns
  • Multiple fractures
  • Lacerations or abrasions to mouth, lips, gums, eyes, external genitalia
  • Marks on body, including slap marks, finger marks
  • Injuries at different stages of healing.

Emotional/Psychological Abuse

Emotional Abuse is defined as ‘the use of threats, humiliation, bullying, swearing and other verbal conduct, or any other form of mental cruelty, which results in mental or physical distress. It includes the denial of basic human and civil rights, such as choice, self-expression, privacy and dignity.’

Examples of Emotional/Psychological Abuse:

  • Intimidation by word or deed
  • Humiliation
  • Harassment
  • Enforced social isolation (including cultural discrimination)
  • Blaming, controlling, threats.

Signs and Symptoms of Psychological Abuse:

  • Change in appetite
  • Low self-esteem, deference, passivity, and resignation
  • Unexplained fear, defensiveness, ambivalence
  • Emotional withdrawal
  • Sleep disturbance
  • Self-harming behaviour.

Neglect/Acts of Omission

Neglect and Acts of Omission (including medical or physical care needs) include the failure to provide access to appropriate health care, social care or educational services and the withholding of the necessities of life such as medication, adequate nutrition and heating.

Under the Mental Capacity Act 2005 (section 44) wilful neglect and ill treatment of a person lacking capacity is a criminal offence.

Examples of Neglect/ Acts of Omission

  • Neglect can be both physical and emotional. It is about the failure to keep a Vulnerable Adult clean, warm and promote optimum health, or to provide adequate nutrition or medication or to prevent an individual from making choices.
  • Neglect of a Duty of Care or the breakdown of a care package may also give rise to safeguarding issues i.e. where a carer refuses access or if a care provider is unable, unwilling or neglects to meet assessed needs. If the circumstances mean that the Vulnerable Adult is at risk of significant harm, then Safeguarding Adults procedures should be invoked.

Signs and Symptoms of Neglect

  • Physical condition of the Vulnerable Adult is poor, e.g. pressure ulcers, unwashed and unkempt
  • Clothing in poor condition, e.g. unclean, wet, ragged.
  • Inadequate physical environment
  • Inadequate diet
  • Untreated injuries or medical problems
  • Inconsistent or reluctant contact with health or social care agencies
  • Failure to engage in social interaction
  • Malnutrition
  • Inadequate heating
  • Medical condition not treated due to failure to give prescribed medication
  • Poor personal hygiene.

Sexual Abuse

Sexual Abuse is defined as ‘direct or indirect involvement in sexual activity without valid consent’. Alerts relating to sexual offences by a worker must be discussed with the police as covered by the Sexual Offences Act. Consent to a particular activity may not be given because:

  • A person has capacity and does not want to give it
  • A person lacks capacity and is therefore unable to give it
  • A person feels coerced into activity because the other person is in a position of trust, power or authority.

Examples of Sexual Abuse:

  • Unwanted physical and sexual contact, e.g. caresses
  • Intercourse with someone who lacks the capacity to consent
  • Rape
  • Indecent exposure
  • Sexual harassment (verbal or physical)
  • Displaying pornographic literature videos or internet sites
  • Gross indecency.

Signs and Symptoms of Sexual Abuse:

  • Significant change in sexual behaviour or attitude
  • Pregnancy in a woman who is unable to consent to sexual intercourse
  • Wetting or soiling
  • Poor concentration
  • Withdrawn, depressed, stressed appearance
  • Unusual difficulty or sensitivity in walking or sitting
  • Stained or bloody underclothing
  • Bruises, bleeding, pain or itching in genital area
  • Sexually Transmitted Infections, urinary tract or vaginal infection;
  • Bruising to thighs or upper arms
  • Self-harming behaviour.

Financial Abuse

Financial Abuse is defined as “the unauthorised and improper use of funds, property or any resources belonging to an individual”.

Those who financially abuse may be people who hold a position of trust, power, and authority or has the confidence of the Vulnerable Adult.

Examples of Financial Abuse:

  • Misuse and/or misappropriation of monies, benefits and/or property
  • Forcing changes to a will or testament
  • Preventing access to money, property, possessions or inheritance.

Signs and Symptoms of Financial Abuse:

  • Unexplained sudden inability to pay bills or maintain lifestyle
  • Unusual or inappropriate bank account activity
  • Lasting Power of Attorney or Enduring Power of Attorney obtained when Vulnerable Adult is unable to comprehend and give consent
  • Withholding of money
  • Recent change of deeds or title of property
  • Unusual interest shown by family or others in the Vulnerable Adult’s assets
  • Person managing financial affairs is evasive or uncooperative.

Discriminatory Abuse

The principles of Discriminatory Abuse are embodied in legislation including the following:

Race Relations Act 1976 (Amendments) Regulations 2003

Disability Discrimination Act 1995

Human Rights Act 1998

Equality Act 2010

Discriminatory Abuse links into all other forms of abuse.

Discriminatory Abuse exists when values, beliefs or culture result in a misuse of power that denies mainstream opportunities to some groups or individuals.

It is the exploitation of a person’s vulnerability, resulting in repeated or pervasive treatment of an individual, which excludes them from opportunities in society, for example, education, health, justice, civic status and protection. It includes where a person or group is treated less favourably than any other person or group based on their colour, sex, age, disability, sexual orientation, religion, status, etc

Examples of Discriminatory Abuse:

  • Unequal treatment
  • Verbal abuse
  • Inappropriate use of language
  • Slurs
  • Harassment
  • Deliberate exclusion
  • Anti-social behaviour – hate incident and hate crimes, see Anti-Social Behaviour Act 2003 and Hate Crime, Specific Types of Abuse Procedure.

Recent change of deeds or title of property

  • Unusual interest shown by family or others in the Vulnerable Adult’s assets
  • Person managing financial affairs is evasive or uncooperative.

Discriminatory Abuse

The principles of Discriminatory Abuse are embodied in legislation including the following:

Race Relations Act 1976 (Amendments) Regulations 2003

Disability Discrimination Act 1995

Human Rights Act 1998

Equality Act 2010

Discriminatory Abuse links into all other forms of abuse.

Discriminatory Abuse exists when values, beliefs or culture result in a misuse of power that denies mainstream opportunities to some groups or individuals.

It is the exploitation of a person’s vulnerability, resulting in repeated or pervasive treatment of an individual, which excludes them from opportunities in society, for example, education, health, justice, civic status and protection. It includes where a person or group is treated less favourably than any other person or group based on their colour, sex, age, disability, sexual orientation, religion, status, etc

Examples of Discriminatory Abuse:

  • Unequal treatment
  • Verbal abuse
  • Inappropriate use of language
  • Slurs
  • Harassment
  • Deliberate exclusion
  • Anti-social behaviour – hate incident and hate crimes, see Anti-Social Behaviour Act 2003 and Hate Crime, Specific Types of Abuse Procedure.