SCIE Practice guide 09: Dignity in care

Abuse

This section does not attempt to cover the subject of abuse, which encompasses complex and wide-reaching issues that cannot be covered within the remit of this resource. The information below outlines immediate action that should be taken if abuse is suspected and directs you to suitable further resources.

What constitutes abuse?

Abuse is not easily defined and can have complexities stemming from the relationships of individuals involved. 'No secrets' (158kb PDF file) (DH, 2000) offers the following aid to identifying abuse:

• physical abuse, including hitting, slapping, pushing, kicking, misuse of medication, restraint, or inappropriate sanctions
• sexual abuse, including rape and sexual assault or sexual acts to which the vulnerable adult has not consented, or could not consent or was pressured into consenting
• psychological abuse, including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or withdrawal from services or supportive networks
• financial or material abuse, including theft, fraud, exploitation, pressure in connection with wills, property or inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits
• neglect and acts of omission, including ignoring medical or physical care needs, failure to provide access to appropriate health, social care or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating
• discriminatory abuse, including racist, sexist, that based on a person’s disability, and other forms of harassment, slurs or similar treatment.

SCIE has produced practice guidance on making referrals to the Protection of Vulnerable Adults (POVA) list, which is a national register of people who are considered a risk to vulnerable people. The guidance gives more detailed information on the 'warning signs’ of abuse.

What to do?

If there is risk of harm to one or more people, or if you think a crime has been committed, call the police and the local authority adult protection coordinator.

If you are in doubt about whether a situation amounts to abuse or whether it should be treated as a complaint, ask the advice of the local authority adult protection coordinator.

If there is no risk of immediate harm, consider informing one or more of the organisations below, depending on the circumstances:

• For care homes (including nursing homes), domiciliary care services or adult placement schemes, raise your concerns with the service, with the funding authority or the Commission for Social Care Inspection.

• For NHS services, raise your concerns with the service or with the primary care trust (PCT) providing the service.

Each area has multi-agency adult protection procedures which they must follow once suspected abuse has been reported.

Other resources

Action on Elder Abuse (AEA) provide guidance on how to report suspected abuse. AEA also run a helpline which provides confidential support and advice for people who have been abused or know someone who may be suffering abuse. Available weekdays 9am - 5pm on freephone 0808 808 8141.

Link: AEA - What to do and who to contact?

Counsel and Care have produced a factsheet on older people at risk of abuse .

Link: Abuse: older people at risk (PDF file).

No secrets - Department of Health guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse.

Link: No secrets (PDF file)

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