Overview of abuse

Abuse is when someone causes us harm or distress. It can take many forms, ranging from disrespect to causing someone physical or mental pain. It can occur in someone’s home, a care home, a hospital or a public place. Often the people who commit abuse are taking advantage of a special relationship. They may be a family member, friend or paid carer who we expect to trust. Sometimes abuse is not intentional but happens because someone does not have the skills or support needed to care for someone. That does not make the impact of it any less, but it can help to understand how it happened.


In 2019/20, the most common location of alleged abuse in Somerset was in a person’s own home, involving allegations against members of their families or other people known to them

Anyone can become a victim of abuse – it is no reflection of intelligence, strength or worth.  However, people with care and support needs, such as older people or people with disabilities, are more likely to be abused or neglected.  They may be seen as an easy target and may be less likely to identify abuse themselves or report it.  People with communication difficulties can be particularly at risk because they may not be able to alert others.  Sometimes people may not even be aware that they are being abused, and this is especially likely if they have a cognitive impairment.  Abusers may try to prevent access to the person they abuse.


Most incidents investigated in Somerset in 2018/19 concerned people with a physical disability, frailty and sensory impairments, including older people and people with dementia, learning disabilities, or mental health needs

Spotting signs of abuse and neglect

Signs of abuse can often be difficult to detect.  The information below aims to help people who come into contact with people with care and support needs to identify abuse and recognise possible indicators.  Many types of abuse are also criminal offences and should be treated as such.


Remember, abuse is never acceptable and you do not have to put up with it. There is help available to keep you safe and decide what action to take.

Types of abuse

Physical abuse

Types of physical abuse

  • Assault (For example, hitting, slapping, punching, kicking, hair-pulling, biting, pushing)
  • Rough handling
  • Scalding and burning
  • Physical punishments
  • Inappropriate or unlawful use of restraint
  • Making someone purposefully uncomfortable (For example, opening a window and removing blankets)
  • Involuntary isolation or confinement
  • Misuse of medication (For example, over-sedation)
  • Forcible feeding or withholding of food
  • Unauthorised restraint, restricting movement (For example, tying someone to a chair)

Possible indicators that someone is experiencing physical abuse

  • No explanation for their injuries or inconsistency with the account of what happened
  • Injuries are inconsistent with the person’s lifestyle
  • Bruising, cuts, welts, burns, marks on their body or loss of hair in clumps
  • Frequent injuries
  • Unexplained falls
  • Subdued or changed behaviour in the presence of a particular person
  • Signs of malnutrition
  • Failure to seek medical treatment or frequent changes of GP

Domestic violence or abuse

Types of domestic violence or abuse

Domestic violence or abuse can be characterised by any of the indicators of abuse relating to:

  • psychological
  • physical
  • sexual
  • financial
  • emotional

Domestic violence and abuse includes any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are (or have been) intimate partners or family members, regardless of gender or sexuality. It also includes so-called ‘honour ’-based violence, female genital mutilation and forced marriage.

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 money
  • exploitation of resources or money
  • preventing the person from escaping abuse
  • having rules about how the person is allowed to behave day-to-day

Possible indicators that someone is experiencing domestic violence or abuse

  • Low self-esteem
  • Feeling that the abuse is their fault when it is not
  • Physical evidence of violence such as bruising, cuts, broken bones
  • Verbal abuse and humiliation in front of others
  • Fear of outside intervention
  • Damage to their home or property
  • Isolation (e.g. not seeing or keeping in contact with friends and family)
  • Limited access to money

Sexual abuse

Types of sexual abuse

  • Rape, attempted rape or sexual assault
  • Inappropriate touch anywhere
  • Non-consensual masturbation of either or both persons
  • Non-consensual penetration or attempted penetration of the vagina, anus or mouth
  • Any sexual activity that the person lacks the capacity to consent to
  • Inappropriate looking, sexual teasing innuendo or sexual harassment
  • Sexual photography forced use of pornography or witnessing sexual acts
  • Indecent exposure

Possible indicators that someone is experiencing sexual abuse

  • Bruising, particularly to the thighs, buttocks, upper arms or marks on their neck
  • Torn, stained or bloody underclothing
  • Bleeding, pain or itching in the genital area
  • Unusual difficulty in walking or sitting
  • Foreign bodies in genital or rectal openings
  • Infections, unexplained genital discharge, or sexually transmitted diseases
  • Pregnancy in someone who is unable to consent to sexual intercourse
  • The uncharacteristic use of explicit sexual language or significant changes in sexual behaviour or attitude
  • Incontinence not related to any medical diagnosis
  • Self-harming
  • Poor concentration, withdrawal, sleep disturbance
  • Excessive fear/apprehension of, or withdrawal from, relationships
  • Fear of receiving help with personal care
  • Reluctance to be alone with a particular person

Psychological or emotional abuse

Types of psychological or emotional abuse

  • Enforced social isolation (e.g. preventing someone from accessing services, educational and social opportunities and seeing friends)
  • Removing mobility or communication aids or intentionally leaving someone unattended when they need assistance
  • Preventing someone from meeting their religious and cultural needs
  • Preventing the expression of choice and opinion
  • Failure to respect privacy
  • Preventing stimulation, meaningful occupation or activities
  • Intimidation, coercion, harassment, use of threats, humiliation, bullying, swearing or verbal abuse
  • Addressing a person in a patronising or infantilising way
  • Threats of harm or abandonment
  • Cyberbullying

Possible indicators that someone is experiencing psychological or emotional abuse

  • Silence or being quieter when a particular person is present
  • Withdrawal or change in the psychological state of the person
  • Insomnia (e.g. difficulty sleeping)
  • Low self-esteem
  • Uncooperative or aggressive behaviour
  • Signs of distress: tearfulness, anger
  • Apparent false claims, by someone involved with the person, to attract their unnecessary treatment

Financial or material abuse

Types of financial or material abuse

  • Theft of money or possessions
  • Fraud, scamming
  • Preventing a person from accessing their own money, benefits or assets
  • Employees taking a loan from a person using the service
  • Undue pressure, duress, threat or undue influence put on the person in connection with loans, wills, property, inheritance or financial transactions
  • Arranging less care than a person needs to save money to maximise inheritance
  • Denying the person from receiving outside assistance to manage/monitor their financial affairs
  • Denying the person from receiving assistance to access benefits
  • Misuse of the person’s personal allowance in a care home
  • Misuse of the person’s benefits or direct payments in a family home
  • Someone moving into a person’s home and living rent-free without agreement or under duress
  • False representation (e.g. using another person’s bank account, cards or documents)
  • Exploitation of a person’s money or assets (e.g. unauthorised use of their car)
  • Misuse of a power of attorney, deputy, appointees or other legal authority over a person
  • Rogue trading (e.g. charging a person unnecessary or overpriced property repairs, failing to carry out repairs agreed upon them, or poor workmanship)

Possible indicators that someone is experiencing financial or material abuse

  • Missing personal possessions
  • Unexplained lack of money or inability to maintain lifestyle
  • Unexplained withdrawal of funds from accounts
  • Power of attorney or lasting power of attorney (LPA) being obtained after the person has ceased to have mental capacity
  • Failure to register an LPA after the person has ceased to have the mental capacity to manage their finances so that it appears that they are continuing to do so
  • The person allocated to manage financial affairs is evasive or uncooperative
  • The family or others show unusual interest in the assets of the person
  • Signs of financial hardship in cases where the person’s financial affairs are being managed by a court-appointed deputy, attorney or LPA
  • Recent changes in deeds or title to their property
  • Rent arrears and eviction notices (i.e… failing to pay their rent)
  • A lack of clear financial accounts held by a care home or service
  • Failure to provide receipts for shopping or other financial transactions carried out on behalf of the person
  • Disparity between the person’s living conditions and their financial resources (e.g. insufficient food in the house)
  • Unnecessary property repairs

Visit the Devon and Somerset Trading Standards for further information about scam awareness

Discriminatory abuse

Types of Discriminatory Abuse

  • Unequal treatment based on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex or sexual orientation known as ‘protected characteristics under the Equality Act 2010
  • 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

Possible indicators that someone is experiencing discriminatory abuse

  • The person appears withdrawn and isolated
  • Expressions of anger, frustration, fear or anxiety
  • The support on offer does not take account of the person’s individual needs in terms of a protected characteristic

Read Discrimination: your rights for further information

Organisational or institutional abuse

Including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one-off incidents to ongoing ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.

Types of organisational or institutional abuse

  • 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 a person’s dignity and their privacy
  • Failure to manage residents with abusive behaviour
  • Not providing adequate food and drink, or assistance with eating, to the person when needed
  • Not offering a person choice or promoting their independence
  • Misuse of medication
  • Failure to provide care with dentures, spectacles or hearing aids
  • Not taking account of a person’s individual cultural, religious or ethnic needs
  • Failure to respond to abuse appropriately
  • Interference with personal correspondence or communication
  • Failure to respond to complaints raised by the person (or others) about how they are treated

Possible indicators that organisational or institutional abuse is occurring

  • Lack of flexibility and choice for people using the service
  • Inadequate staffing levels
  • People are hungry or dehydrated
  • Poor standards of care
  • People using the service lacking their personal clothing or possessions and the communal use of personal items
  • Lack of adequate procedures
  • Poor record-keeping and missing documents
  • Absence of visitors
  • Few social, recreational and educational activities
  • Public discussion of people’s personal matters
  • Unnecessary exposure of a person during their bathing or when using the toilet
  • Absence of individual care plans
  • Lack of management overview and support

Neglect and acts of omission

Types of neglect and acts of omission

  • Failure to provide or allow access to food, shelter, clothing, heating, stimulation and activity, personal or medical care
  • Providing care in a way that the person dislikes
  • Failure to administer medication as prescribed
  • Refusal of access to visitors
  • Not taking account of a person’s individual cultural, religious or ethnic needs
  • Not taking account of educational, social and recreational needs
  • Ignoring or isolating the person
  • Preventing the person from making their own decisions
  • Preventing access to glasses, hearing aids, dentures etc
  • Failure to ensure privacy and dignity

Possible indicators that someone is affected by neglect and acts of omission

  • Poor environment surrounding them (e.g. dirty or unhygienic)
  • Poor physical condition and/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
  • Accumulation of untaken medication
  • Uncharacteristic failure to engage in social interaction
  • Inappropriate or inadequate clothing


It should be noted that self-neglect may not prompt a Section 42 enquiry. An assessment should be made on a case-by-case basis. A decision on whether a response is required under safeguarding will depend on the adult’s ability to protect themselves by controlling their own behaviour. There may come a point when they are no longer able to do this, without external support.

Types of 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

Possible indicators that someone is self-neglecting

  • Very poor personal hygiene
  • Unkempt appearance
  • Lack of essential food, clothing or shelter
  • Malnutrition and/or dehydration
  • Living in squalid or unsanitary conditions
  • Neglecting household maintenance
  • Hoarding
  • Collecting a large number of animals in inappropriate conditions
  • Non-compliance with health or care services
  • Inability or unwillingness to take medication or treat illness or injury

Modern slavery

Types of modern slavery

  • 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

Possible indicators that someone is experiencing modern slavery

  • Signs of physical or emotional abuse
  • Appearing to be malnourished, unkempt or withdrawn
  • Isolation from the community, seeming under the control or influence of others
  • Living in dirty, cramped or overcrowded accommodation and or living and working at the same address
  • Lack of personal effects or identification documents
  • Always wearing the same clothes
  • Avoidance of eye contact, appearing frightened or hesitant to talk to strangers
  • Fear of law enforcers

Modern Slavery Helpline 0800 0121 700
Further Home Office information on identifying and reporting modern slavery
Visit the Anti-Slavery Partnership website

Information sheets

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Last reviewed: January 2, 2024 by Kailani

Next review due: July 2, 2024

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