Commissioning care homes: common safeguarding challenges

Common safeguarding issues – Institutionalised care

'Institutional abuse occurs when the routines, systems and regimes of an institution result in poor or inadequate standards of care and poor practice which affects the whole setting and denies, restricts or curtails the dignity, privacy, choice, independence or fulfilment of adults at risk’ (SCIE 2010). For example, people being forced to eat or go to bed at a particular time can be experienced as abuse. The culture of the organisation may promote institutionalised care and may cause 'the practices of well-intentioned staff to deteriorate’. It may also allow intentional abuse to go unreported (Marsland et al. 2007).

Care homes should promote a personalised service through flexibility and avoid strict routines. Staffing rotas should be focused around residents’ individual needs and preferences.

Prevention checklist