Abuse, Neglect and Harm
What is abuse?
Abuse can be:
- Physical: This includes hitting, slapping, kicking, misuse of medication, restraint and force-feeding.
- Domestic violence: including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence.
- Financial or material: This includes theft, fraud or using a person's money, possessions or property without consent.
- Psychological/emotional: This includes threats of harm or abandonment, isolation, humiliation, blaming, controlling, intimidation, harassment, verbal abuse, threats or bribes.
- Sexual: This includes sexual assault, rape or sexual acts to which the vulnerable adult has not consented, could not consent, or was pressurised into consenting.
- Neglect or acts of omission: A failure to provide appropriate care (such as. food, clothing, medication, heating, cleanliness, hygiene) and denying religious or cultural needs.
- Discriminatory abuse: This includes racism, sexism, ageism and discrimination based on a person's disability or sexual orientation. Some abuse in this category might also be classed as a hate crime.
- Modern slavery: encompasses slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.
- Self-neglect: this covers a wide range of behaviour around neglecting to care for personal hygiene, health or surroundings and includes behaviour such as hoarding.
Who is most likely to be abused or neglected?
Anyone can be mistreated, exploited or abused at some time in their lives, but some people are particularly prone to these things because they are seen as being easy to take advantage of.
This may be because they are aged, confused, have learning disabilities, physical impairments, mental health issues, poor mobility or a degree of deafness or blindness.
Similarly, people or groups who are in a minority because of their appearance, behaviour or beliefs, can attract harassment and antisocial behaviour.
Who abuses, who neglects?
Simple failure to acknowledge people as individuals or to recognise their past and present contribution to family and society is seriously disrespectful and can lead to a breach of human rights, particularly when they are in need of support; whether it be in group or independent accommodation, being treated as a less than whole person can have seriously detrimental consequences for their health, independence and wellbeing.
Similarly, failure to recognise care needs is neglectful, albeit unintentional perhaps, and deliberately depriving someone of care identified as a need, is neglect.
Many people with care or support needs have family members or intimate partners involved in meeting those needs.
Where there is a care support element to the relationship, this can change the balance of power; shifting control and making either party particularly vulnerable to the risk of abuse or neglect by the other.
How can I prevent mistreatment or neglect to myself or to others?
To be able to avoid harm or neglect, you need to:
- Be aware of the risks you face in daily circumstances, when undertaking certain activities, joining particular groups, disclosing personal information or as a result of making any other choices and decisions.
- You also need to know your rights and the supports and benefits available to help you.
- You need to develop your ability to keep yourself safe and reduce the likelihood of someone seeing you as someone to exploit or someone whose needs can be ignored or given little importance.
- You need to know who and where to report concerns quickly about actual or potential mistreatment or neglect so that it can be stopped.
Belongings and property
- If a trader or utilities worker (gas, water, phone, electricity) called at your door, how would you ensure you know they are who they say they are?
- Do you leave money lying around? How easy would it be for someone (even a family member) to get hold of your purse or wallet without your permission?
- Do you have a 'spy hole' on your front door so that you can see who is calling before you decide whether to open the door to them?
- Do you have a smoke alarm and if so, is it working - is there a working battery in it? This is vital if you smoke or have mobility issues. Have you asked for a home safety check from the Fire Service.
- Are your windows and doors secure?
- Have you ever given anyone your PIN? If you have, do you check your bank balance daily? Remember, you should NEVER give your PIN to anyone.
You as a person
- How much liquid do you drink, or food do you eat (hot or cold), each day? 2 litres (about 4 pints) is a healthy minimum. Dehydration can bring many problems; in a mild form it caused dizziness, headaches and other symptoms, leaving you weaker and less able to protect yourself. In its more severe state it causes long term damage and organ failure.
- Do you eat a good diet - a balanced amount of protein (meat, fish, cheese, eggs), and carbohydrate (rice, potatoes, bread, pasta, and fruit and vegetables)?
- How much alcohol do you drink? It is recommended no more than 3-4 units a day if you're a man, 2-3 units a day if you're a woman. Apart from the effects on your general health, remember: just as it increases the tendency towards violence in some people, it can be very easy to take advantage of someone who is intoxicated.
- How active are you? Recommended activity levels for adults is 30 minutes of moderate-intensity physical activity per day, at least five days a week is good to keep you fit.
Are you assertive?
If you are receiving support - be assertive. To do this you need to simply be:
- Honest and fair with yourself and others
- Able to say directly what it is you want, need or feel - but not at the expense of others
- Able to understand the other person's point of view
- Able to respond in a rational way, for example, when the other person doesn't see your point or understand where you are coming from; continue to calmly explain and ask for their understanding.
- Able to negotiate and reach workable compromises
- Able to have and show respect for others and for yourself
- Assertiveness is not about getting your own way and winning every time, nor is it a way to manipulate other people. It's about adopting behaviour which helps you to communicate your needs clearly to other people, without abusing their human rights.
If you are not able to behave in this way, it increases the likelihood of frustration, disagreements and arguments.
There are many laws in place to protect us: the Human Rights Act, the Data Protection Act, the Mental Health Act, the NHS and Community Care Act, the Care Act 2014 and many more in relation to criminal activity. However, there are basic rights which exist in our everyday dealings with other people.
Did you know you have the right to:
- State your own needs and set your own priorities as a person, regardless of your circumstances
- To be treated with respect as an intelligent, capable and equal human being
- To express your feelings, opinions and values
- To say 'NO' or 'YES' for yourself
- To ask for what you want
- To make mistakes
- To change your mind
- To say you 'don't understand' and ask for more information
- To decline responsibility for other people's problems
- To deal with others without being dependent on them for approval
Your personal space
You can decide who you spend time with, if you are unsure of people who come into your home to provide care or other services, you can ask the organisation to stop them coming, if that fails, you can stop them with support from others.
Buying the services of a tradesperson
Beware bogus traders, who call at your door uninvited and advise you of work that needs doing or services you need. Buying in this way is very risky; you could pay a high price in terms of cost and standard of goods or work.
You can safely obtain contact details for tradespeople from TrustMark. TrustMark offers you an easy, safe and reliable way to avoid rogue traders. In just one phone call you can find traders for all the maintenance and repair jobs in your home and garden.
Healthcare
The NHS provides emergency, urgent and routine hospital care as well as primary care through GPs, dentists, district nursing and other community services. However, there are many steps individuals can take to avoid ill health and to promote a healthy lifestyle.
If you are concerned about the standard of healthcare or clinical practice you can raise these by contacting the National Reporting and Learning Service or find out where to make a direct complaint on the Sefton Clinical Commissioning Groups websites.
Local Authorities
Local Authorities have a duty to provide many services including Care and Support and Community Safety. If you have concerns about care standards, policing or community safety, you can report it.
If you don't get the response you expect you can make a complaint.
The Court of Protection (CoP)
(CoP) is a specialist court for all issues relating to people who lack capacity to make specific decisions. The Court makes decisions and appoints deputies to make decisions in the best interests of those who lack capacity to do so. You can decide now, who you would prefer to make decisions for you in the event of your loosing capacity in the future. Information on the work of the court includes:
- Its powers
- Fees
- Making applications
- Appointing deputies
- Reaching a decision
Citizen's Advice Bureau
The Citizens Advice Bureau helps people resolve their legal, money and other problems by providing free, independent and confidential advice, and by influencing policymakers.
Care Quality Commission (CQC)
CQC regulate care provided by the NHS, local authorities, private companies and voluntary organisations. They aim to make sure better care is provided for everyone - in hospitals, care homes and people's own homes. They also seek to protect the interests of people whose rights are restricted under the Mental Health Act.