What is abuse?

Safeguarding is EVERYBODY’S business

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

Physical

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

Sexual

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

Psychological/Emotional

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

Financial/Material

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

Modern Slavery

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

Organisational

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

Discriminatory

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

Neglect or Acts of Omission

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.

Self Neglect

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.

Domestic Abuse

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.

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

What is Coercive Control

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.

Honour base abuse

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

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

Physical

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

Emotional

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 misuse 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

Sexual

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

Neglect

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 abuse

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

Child Sexual Exploitation

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

Child Criminal Exploitation

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.

Modern Day Slavery

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

Discriminatory Abuse

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

Honour Based Abuse

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

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.

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

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

What is abuse?

What is abuse? – Adults

Types of Abuse

Signs of hoarding can include:

What is abuse? – Children

Types of Abuse

The Carers’ Support Centre

Staff Documents

Brigg office

Grimsby office