What is abuse?

Safeguarding is EVERYBODY’S business

Register with us
Sign up for our mailing list
Leave this site now

What is abuse? – Adults

Abuse can happen anywhere; for example, in someone’s own home, in a public place, in hospital, in a care home or in college. Anyone can witness or become aware of information suggesting that abuse and neglect is occurring.

People who require care and support must be able to trust and depend on the people they rely on for help. It is vital that professionals, other staff and members of the public are vigilant on behalf of those unable to protect themselves. No abuse is acceptable.

Types of Abuse

  • Assault, hitting, slapping, pushing, kicking, hair pulling, punching
  • Rough handling
  • Scalding and burning
  • Physical punishments
  • Inappropriate or unlawful use of restraint
  • Making someone purposefully uncomfortable (eg opening a window, removing blankets)
  • Misuse of medication (eg sedation)
  • Forcible feeding / withholding food

Possible indicators of physical abuse (the following list may be indications of many different problems, it is important not to jump to the wrong conclusion too quickly)

  • No explanation for injuries or inconsistency with the account of what happened
  • Injuries are inconsistent with the person’s lifestyle
  • Bruising, cuts, welts, burns and / or marks on the body or loss of hair in clumps
  • Frequent injuries
  • Unexplained falls
  • Subdued behaviour in the presence of a particular person
  • Signs of malnutrition
  • Failure to seek medical treatment or frequent changes of GP
  • Rape
  • Indecent exposure
  • Sexual harassment
  • Inappropriate looking or touching
  • Sexual teasing or innuendo
  • Sexual photography
  • Subjection to pornography or witnessing sexual acts
  • Sexual assault
  • Sexual acts to which the adult has not consented or was pressured into consenting

Possible indicators of sexual abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

  • Bruising, particularly to the thighs, buttocks and upper arms and marks on the neck
  • Torn, stained or bloodied underclothing
  • Bleeding, pain or itching in the genital area
  • Unusual difficulty in walking or sitting
  • Pregnancy in a woman who is unable to consent to sexual intercourse
  • The uncharacteristic use of sexual language or significant changes in sexual behaviour or attitude
  • Self-harming
  • Poor concentration, withdrawal, sleep disturbance
  • Fear of receiving help with personal care
  • Reluctance to be alone with a particular person
  • Emotional abuse
  • Threats of harm or abandonment
  • Deprivation of contact
  • Humiliation
  • Blaming
  • Controlling
  • Intimidation
  • Coercion
  • Harassment
  • Verbal abuse
  • Cyber bullying
  • Isolation
  • Unreasonable and unjustified withdrawal of services or supportive networks

Possible indicators or psychological abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

  • An air of silence when the particular person is present
  • Withdrawal or change in the psychological state of the person
  • Insomnia
  • Low self-esteem
  • Uncooperative and aggressive behaviour
  • A change of appetite, weight loss/gain
  • Signs of distress: tearfulness / anger
  • Apparent false claims, by someone involved with the person, to attract unnecessary treatment
  • Theft
  • Fraud
  • Internet scamming
  • Coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions
  • Employees taking a loan from a person using the service
  • Denying access to money
  • Misuse of benefits or direct payments in a family home
  • Someone moving into a person’s home living rent free without agreement or under duress
  • False representation, using another person’s bank account, cards or documents
  • Rogue trading – e.g., unnecessary or overpriced property repairs and failure to carry out agreed repairs or poor workmanship

Possible indicators of financial / material abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

  • Missing personal belongings
  • Unexplained lack of money
  • Unexplained withdrawal of funds from accounts
  • Power of attorney or lasting power of attorney being obtained after the person has ceased to have mental capacity
  • The person allocated to manage financial affairs is evasive or uncooperative
  • Rent arrears or eviction notices
  • 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
  • Slavery
  • County Lines
  • Cuckooing
  • Human trafficking
  • Forced labour and domestic servitude
  • Traffickers and slave masters using whatever means that have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment

Possible indicators or modern slavery (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

  • 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
  • Lack of personal effects or identification documents
  • Always wearing the same clothes
  • Avoidance of eye contact, appearing frightened or hesitant to talk to strangers

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.

  • Ignoring medical treatment and needs
  • Ignoring emotional or physical care needs
  • Failure to provide access to appropriate health, care and support or educational services
  • The withholding of the necessities of life, such as medication, adequate nutrition and heating

Possible indicators of organisational abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

  • The adult is hungry or dehydrated
  • Inappropriate use of power on control
  • ‘Batch care’ – lack of individual care plans
  • Adults referred to, or spoken to with disrespect
  • Inflexible services based on convenience of the provider rather than the person receiving services
  • Harassment
  • Slurs or similar treatment because of:
    • Race
    • Gender, Gender Identity. Gender Reassignment
    • Age
    • Sex or Sexual Orientation
    • Pregnancy and Maternity
    • Marriage and Civil Partnership
    • Disability
    • Sexual orientation
    • Religion and Belief

Possible indicators of discriminatory abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

  • The adult appears withdrawn and isolated
  • The adult appears frightened and avoids eye contact
  • The adult appears withdrawn and avoids contact with other people
  • Failure to provide access to food, shelter, clothing, heating, activities, personal or medical care including medication etc.
  • Preventing access to glasses, hearing aids, dentures etc
  • Providing care in a way that the person dislikes.
  • Refusal of access to visitors, ignoring or isolating the person.
  • Not taking account of the person’s needs such as cultural, religious, educational, social etc.
  • Preventing the person from making their own decisions.
  • Failure to ensure privacy and dignity.

It is sometimes associated with hoarding and may be a result of other issues such as bereavement, loss or addiction. Self-neglect can be caused by mental or physical illness that has an effect on the person’s physical abilities, energy levels, attention, organisational skills, or motivation.

Recognising the signs of self-neglect

Sign of self-neglect can include:

  • living in very unclean or unsanitary conditions
  • looking dishevelled or wearing inappropriate clothes for the weather
  • the presence of vermin, flies or unpleasant smells in or around the home
  • property in a poor state of repair or with waste accumulating outside
  • neglecting household maintenance, and creating hazards within the home or to a neighbouring property
  • poor diet and nutrition
  • declining or refusing prescribed medication or other community healthcare support
  • refusing to allow access to health or social care professionals in relation to personal hygiene and care
  • refusing to allow access to other organisations with an interest in the property
  • repeated episodes of anti-social behaviour – either as a victim or source of risk
  • being unwilling to attend external appointments with professionals in social care, health or other organisations (such as Housing)
  • lack of personal hygiene resulting in poor healing or sores, long toenails, unkempt hair, uncared for facial hair, body odour, unclean clothing
  • isolation either of an individual or of a household or family unit
  • repeated referrals to Environmental Health

Hoarding can be associated with self-neglect. Hoarding disorder is where someone acquires an excessive number of items and stores them in a chaotic manner, usually resulting in unmanageable amounts of clutter. The items can be of little or no monetary value.

Signs of hoarding can include:

  • keeping or collecting items that may have little or no monetary value, such as junk mail and carrier bags, or items they intend to reuse or repair
  • finding it hard to categorise or organise items
  • having difficulties making decisions
  • struggling to manage everyday tasks, such as cooking, cleaning and paying bills
  • becoming extremely attached to items, refusing to let anyone touch or borrow them
  • having poor relationships with family or friends
  • a lack of personal or professional visitors to the home
  • refusal to open the door fully to callers or to accept deliveries
  • visible clutter in the home
  • window blinds or curtains continually drawn
  • a build-up of waste or other items in the garden or failing to take their bins out for collection
  • very regular deliveries to the home

A diagnosis of Hoarding Disorder can only be made by a specialist medical practitioner.

The definition from the Domestic Abuse Act 2021: ‘Any incident or pattern of incidents of controlling, coercive, 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. The abuse can encompass but is not limited to psychological, physical, sexual, financial, emotional abuse.

  • Psychological
  • Physical
  • Sexual
  • Financial
  • Emotional abuse
  • So called ‘honour based’ violence

Coercive or controlling behaviour is a core part of domestic abuse and coercive behaviour can include:

  • Threats, humiliation, intimidation
  • Harming, pushing or frightening the person
  • Isolating the person from sources of support
  • Exploitation of money or support
  • Preventing the person from escaping abuse
  • Regulating everyday behaviour

Possible indicators of domestic abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

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

Most people understand that some forms of domestic abuse can be physical, verbal or both. There’s a more subtle type of abusive behaviour that’s equally harmful which is coercive or controlling behaviour which is now a crime.

Coercive Control is a form of abuse, as set out in Section 1 of the Domestic Abuse Act 2021 it is a strategic form of ongoing oppression and comments that are used to instil fear. The abuser will use tactics, such as limiting access to money or monitoring all communication, as a controlling effort, this usually starts of subtle but then intensifies as the relationship progresses.

Section 76 of the Serious Crime Act 2015 provides for the offence of controlling or coercive behaviour, where the perpetrator and the victim are personally connected. Under the current legislation personally connected means intimate partners, or former intimate partners or family members who live together.

The amendment to the legislation removes the co-habitation requirement, ensuring that post-separation abuse and familial domestic abuse is provided for when the victim and perpetrator do not live together.

“Controlling or coercive behaviour is an insidious form of domestic abuse, and we are committed to ensuring all victims are protected. We recognise that coercive or controlling behaviours may escalate following separation, and that members of a victim’s extended family may be involved in control or coercion”.

Victoria Atkins MP, Minister for Safeguarding, Written Ministerial Statement, 1st March 2021

There is a website developed by ripfa.org.uk which is dedicated for social workers and other health and social care practitioners to allow them to increase their knowledge and skills when working with situations involving coercive control.

In the UK it is illegal to abuse or harm anyone for cultural reasons or reasons of family honour, whether they are a member of the same family or not. For example, it is illegal to punish another family member for what someone considers to be dishonourable behaviour. There are men and women in the UK who have been convicted and sent to prison for harming family members for reasons of honour.

If you are worried about honour-based abuse / violence you can speak to the police. You can also get confidential advice from an organisation called Karma Nirvana on 0800 5999 247

Female Genital Mutilation (FGM) also known as cutting or female circumcision is illegal in the UK. Practising FGM or taking a girl or woman abroad for FGM is a criminal offence punishable by law.

If you are a victim of FGM, you need to speak with your doctor. There are doctors who specialise in helping FGM victims. You can also ask for advice from one of several national organisations, such as the NSPCC on 0800 028 3550

Children who are worried that they are in danger of FGM can speak to police, teachers, social workers, or Childline on 0800 1111

What is abuse? – Children

A child is defined as anyone who has not yet reached their 18th birthday.

Safeguarding and promoting the welfare of children is defined as:

  • protecting children from maltreatment
  • preventing impairment of children’s health or development
  • ensuring that children are growing up in circumstances consistent with the provision of safe and effective care.
  • taking action to enable all children to have the best life chances.

Child abuse is:

  • A form of maltreatment of a child
  • Somebody may abuse or neglect a child by inflicting harm, or by failing to act to prevent harm
  • Children may be abused in a family or in an institutional or community setting by those known to them or, more rarely, by others (e.g. via the internet)
  • Children may be abused by an adult or adults, or another child or children

Types of Abuse

May involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child

May also be caused when a parent or carer fabricates the symptoms of, or deliberately induces illness in a child

Indicators of physical abuse:

  • Unexplained injuries or burns, particularly if they are recurrent
  • Untreated injuries or lingering illness not attended to
  • Admission of punishment which appears excessive
  • Shrinking from physical contact
  • Significant changes in behaviour without explanation
  • Fear of returning home
  • Acts of aggression or bullying of others
  • Unexplained pattern of absences from school which may be due to hiding bruises or injuries
  • Persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development
  • May involve conveying to a child that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person
  • May include not giving the child opportunities to express their views, deliberately silencing them or ‘making fun’ of what they say or how they communicate
  • May feature age or developmentally inappropriate expectations being imposed on children
  • These may include interactions that are beyond the child’s developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction
  • May involve seeing or hearing the ill-treatment of another
  • May involve serious bullying causing children frequently to feel frightened or in danger, or the exploitation or corruption of children
  • Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone

Indicators of emotional abuse

  • Continual self-depreciation
  • Fear of new situations
  • Inappropriate emotional responses to painful situations
  • Self-harm
  • Eating problems
  • Depression or withdrawal
  • Displays of obsessive/compulsive behaviours
  • Substance use including alcohol
  • Air of detachment
  • Social isolation
  • Child is often scapegoated
  • Parents display inconsistent emotional warmth and are highly critical or apathetic towards their child
  • Child is rarely comforted when distressed
  • Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening
  • May involve physical contact, including assault by penetration (for example rape, buggery or oral sex) or non penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing
  • May also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet)
  • Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children

Indicators of sexual abuse

  • Bruises, scratches, burns or bite marks on the body
  • Refusing to stay with certain people or go certain places
  • Aggressiveness, anger, anxiety, tearfulness, withdrawal
  • Excessive and inappropriate sexual behaviour or language which is out of character
  • Irregular or disturbed sleep pattern
  • Genital pain/ soreness or sexually transmitted infections
  • Wetting the bed at night and/or nightmares
  • Pregnancy
  • Becoming withdrawn
  • Low self-esteem or signs of anxiety and depression
  • Sudden and unexplained behavioural or emotional change
  • Persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development
  • May occur during pregnancy as a result of maternal substance use

Once a child is born, neglect may involve a parent or carer failing to:

  • provide adequate food, clothing and shelter (including exclusion from home or abandonment)
  • protect a child from physical and emotional harm or danger
  • ensure adequate supervision (including the use of inadequate care-takers)
  • ensure access to appropriate medical care or treatment
  • It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs

Indicators of neglect

  • Constant hunger, tiredness
  • Poor personal hygiene and/or persistently dirty
  • Poor standard of hygiene in the home that affects the child’s health or a living environment that is unsafe
  • Untreated medical problems
  • Low self-esteem
  • Poor social relationships
  • Severe or persistent infestation e.g. Scabies or Headlice
  • Seeking affection from adults
  • A form of child sexual abuse
  • It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity:
    • in exchange for something the victim needs or wants, and/or
    • for the financial advantage or increased status of the perpetrator or facilitator
  • The victim may have been sexually exploited even if the sexual activity appears consensual
  • Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology
  • Children rarely self-report child sexual exploitation

Indicators of child sexual exploitation

  • Acquisition of money, clothes, mobile phones etc without plausible explanation
  • Gang-association and/or isolation from peers/social networks
  • Exclusion or unexplained absences from school, college or work
  • Leaving home/care without explanation and persistently going missing or returning late
  • Excessive receipt of texts/phone calls
  • Returning home under the influence of drugs/alcohol
  • Inappropriate sexualised behaviour for age/sexually transmitted infections
  • Evidence of/suspicions of physical or sexual assault
  • Relationships with controlling or significantly older individuals or groups
  • Multiple callers (unknown adults or peers)
  • Frequenting areas known for sex work
  • Concerning use of internet or other social media
  • Increasing secretiveness around behaviours
  • Self-harm or significant changes in emotional well-being

There is no agreed statutory definition of child criminal exploitation (CCE). In North Lincolnshire, the definition of CCE is that which:

Involves exploitative situations, contexts and relationships where a child (or a third person or persons) receive ‘something’ (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of them completing a task on behalf of another individual or group of individuals; this is often of a criminal nature.

CCE often occurs without the child’s immediate recognition, with the child believing that they are in control of the situation. In all cases, those exploiting the child/young person have power over them by virtue of their age, gender, intellect, physical strength and/or economic or other resources.

Violence, coercion and intimidation are common, involvement in exploitative relationships being characterised in the main by the child or young person’s limited availability of choice resulting from their social/economical and/or emotional vulnerability.

Children’s involvement in CCE is indicative of coercion or desperation rather than choice. CCE is a complex form of abuse and it can be difficult for those working with children to identify and assess

County Lines

County lines is the police term for urban gangs supplying drugs to suburban areas and market and coastal towns using dedicated mobile phone lines or ‘deal lines’. It involves CCE as gangs use children and vulnerable people to move drugs and money. Gangs establish a base in the market location, typically by taking over the homes of local vulnerable adults by force or coercion in a practice referred to as ‘cuckooing’.

Indicators of child criminal exploitation

  • Persistently going missing from school or home and/or being found out of area
  • Unexplained acquisition of money, clothes or mobile phones
  • Excessive receipt of texts/phone calls and/or having multiple handsets
  • Relationships with controlling/ older individuals or groups
  • Leaving home/care without explanation
  • Suspicion of physical assault/unexplained injuries
  • Parental concerns
  • Carrying weapons
  • Significant decline in school results/performance
  • Gang association or isolation from peers or social networks
  • Self harm or significant changes in emotional wellbeing.
  • Slavery
  • County Lines
  • Cuckooing
  • Human trafficking
  • Forced labour and domestic servitude
  • Traffickers and slave masters using whatever means that have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment

Possible indicators or modern slavery (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

  • 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
  • Lack of personal effects or identification documents
  • Always wearing the same clothes
  • Avoidance of eye contact, appearing frightened or hesitant to talk to strangers
  • Harassment
  • Slurs or similar treatment because of:
    • Race
    • Gender, Gender Identity. Gender Reassignment
    • Age
    • Sex or Sexual Orientation
    • Pregnancy and Maternity
    • Marriage and Civil Partnership
    • Disability
    • Sexual orientation
    • Religion and Belief

Possible indicators of discriminatory abuse (the following list may be indications of many different problems; it is important not to jump to the wrong conclusion too quickly)

  • The child appears withdrawn and isolated
  • The child appears frightened and avoids eye contact
  • The child appears withdrawn and avoids contact with other people

In the UK it is illegal to abuse or harm anyone for cultural reasons or reasons of family honour, whether they are a member of the same family or not. For example, it is illegal to punish another family member for what someone considers to be dishonourable behaviour. There are men and women in the UK who have been convicted and sent to prison for harming family members for reasons of honour.

If you are worried about honour-based abuse / violence you can speak to the police. You can also get confidential advice from an organisation called Karma Nirvana on 0800 5999 247

Female Genital Mutilation (FGM) also known as cutting or female circumcision is illegal in the UK. Practising FGM or taking a girl or woman abroad for FGM is a criminal offence punishable by law.

If you are a victim of FGM, you need to speak with your doctor. There are doctors who specialise in helping FGM victims. You can also ask for advice from one of several national organisations, such as the NSPCC on 0800 028 3550

Children who are worried that they are in danger of FGM can speak to police, teachers, social workers, or Childline on 0800 1111

Leave this site now

REPORT A CONCERN or speak to someone if you’re not sure:

North Lincolnshire

Concerned about an adult? Call the Safeguarding Adults Team on:

01724 297000

Concerned about a child: 01724 296500

North East Lincolnshire

Concerned about an adult? Call Focus on 01472 256256 (option 2)

Concerned about a child? Call the Integrated Front Door on 01472 326292 (option 2, option 2)

In all circumstances, if you are concerned that an adult or child is in immediate danger, call 999

© Copyright - Carers Support Service - built by Crystal Pyramid Ltd. www.cplinternet.net