Neglect & acts of ommission Isolated missed home care visit - no harm occurs Adult is not assisted with a meal/drink on one occasion and no harm occurs Inadequacies in care provision leading to discomfort - no significant harm e.g. occasionally left wet. No access to aids for independence Recurrent missed home care visits where risk of harm escalates, or one miss where harm occurs Hospital discharge, no adequate planning and harm occurs Ongoing lack of care to extent that health and well-being deteriorate significantly e.g. pressure wounds, dehydration, malnutrition, loss of independence/ confidence Failure to arrange access to life saving services or medical care Failure to intervene in dangerous situations where the adult lacks the capacity to assess risk Financial or material abuse is not recorded safely or recorded properly Single or one off incident of missing money and/ or belongings where the quality of the service user’s life has not been affected and little or no distress is caused. Adult not routinely involved in decisions about how their money is spent or kept safe - capacity in this respect is not properly considered Adult’s monies kept in a joint bank account – unclear arrangements for equitable sharing of interest Adult denied access to his/her own funds or possessions of property, possessions or benefits by a person in a position of trust or control. To include misusing loyalty cards Personal finances removed from adult’s control Adult coerced or misled into giving over money or property Fraud/exploitation relating to benefits, income, property or will Theft
Organisational (any one or combination of the other forms of abuse) Lack of stimulation/ opportunities to engage in social and leisure activities SU not enabled to be involved in the running of service Denial of individuality and opportunities to make informed choices and take responsible risk Care-planning documentation not person-centred Rigid/inflexible routines Service users’ dignity is undermined e.g. lack of privacy during support with intimate care needs, pooled Bad practice not being reported and going unchecked Unsafe and unhygienic living environments Staff misusing position of power over service users Over-medication and/or inappropriate restraint managing behaviour Widespread, consistent ill treatment Modern slavery All concerns about modern slavery are deemed to be of a significant/critical level Under control of another/fearful Long periods at work Unable to get medical treatment Poor living conditions/low Regularly moved to avoid detection Lives in work place No health and safety in work place Under control of others e.g. gang master, dealers, pimp for prostitution Subject to violence/threats/ fearful Risk of physical/psychological harm Regularly moved to avoid detection Lives in sheds/lockup /containers Risk of fatality or serious injury No freedom/unable to leave Risk of organ harvesting Wages used for debt Not in possession of ID or passport Subject to forced marriage
Discriminatory/ Hate Crime Isolated incident of teasing motivated by prejudicial attitudes towards an adult’s individual differences Isolated incident of care planning that fails to address an adult’s specific diversity associated needs for a short period Inequitable access to service provision as a result of diversity issue Recurring failure to meet specific care/support needs associated with diversity Recurring taunts Being refused access to essential services Denial of civil liberties e.g. voting, making a complaint Humiliation or threats on a regular basis Hate crime resulting in injury/emergency medical treatment/fear for life Hate crime resulting in serious injury/attempted murder/honour-based violence Self-neglect Self-care causing some concern - no of harm or distress Property neglected but all main services work Some evidence of hoarding - no major impact on health/safety First signs of failing to engage with professionals Property neglected Evidence of hoarding Lack of essential amenities No access to support Refusing medical treatment High of clutter /hoarding Insanitary conditions in property Won’t engage with professionals Problematic substance misuse Potential fire risk/gas leaks Multiple reports from others Self-neglect is life threatening Lack of self-care results in significant deterioration in health/wellbeing Chaotic substance misuse Environment injurious to health Potential fire risk or gas Others affected by Multiple reports from agencies Behaviour risk to self/others Failure to arrange access to lifesaving services or medical care Life in danger without intervention Chaotic substance misuse Environment injurious to health* Imminent fire risk/gas leaks Access obstructed within property Multiple reports from other agencies Behaviour poses risk to self/others