The Care Act 2014 Resource

Identifying and Reporting Abuse and Neglect

Amendment

In September 2024, Section 3, Reporting Abuse was updated to clarify the circumstances when consent to raise a concern can be overridden.

September 2, 2024

1. Categories of Abuse and Neglect

IMPORTANT TO KNOW

The Care Act statutory guidance is clear that the Local Authority should not limit its view about what constitutes abuse and neglect to the examples it provides. The circumstances of each individual case should always be considered.

Category of Abuse	Examples
Physical Abuse	Assault, slapping, hitting, pushing, misuse of medication, restraint, inappropriate physical sanctions
Domestic Abuse Definition: any incident or pattern of abusive behaviour between two people that are personally connected to each other (Domestic Abuse Act 2021). The term ‘personally connected’ means any of the following: They are, or have been, married to each other; They are, or have been, civil partners of each other; They have agreed to marry one another; They are, or have been in an intimate personal relationship with each other; They each have, or there has been a time when they each have had, a parental relationship with the same child; They are relatives.	Physical or sexual abuse, violent or threatening behaviour, controlling or coercive behaviour, economic abuse, psychological or emotional abuse, ‘Honor’ based violence, forced marriage, Female Genital Mutilation (FGM).
Sexual Abuse	Rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography, witnessing sexual acts, indecent exposure, sexual assault, sexual acts to which the adult has not consented or was pressured into consenting to
Psychological Abuse	Emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation, unreasonable withdrawal of services or support networks
Financial or Material Abuse	Theft of money, property or belongings, fraud, internet scamming, coercion in relation to financial affairs or arrangements (e.g. wills, property and inheritance), the misuse or misappropriation of property, money, possessions or benefits
Modern Slavery	Slavery, human trafficking, forced labour and domestic servitude
Discriminatory Abuse	Harassment, slurs or similar treatment in relation to race, gender or gender identity, age, disability, sexual orientation or religion
Organisational Abuse	Neglect and poor practice in a care home, hospital or within an organisation providing Care and Support to an adult in their own home or other setting (for example a day service).
Neglect and Acts of Omission	Ignoring or failing to provide for emotional, medical or physical care needs, failure to provide access to services (e.g. health or Care and Support), withholding the necessities of life (e.g. food, heating, medication)
Self-Neglect	Neglecting to maintain environment, personal hygiene or health, hoarding

2. Identifying Abuse and Neglect

It is important that all professionals and others involved with an adult with Care and Support needs are vigilant on behalf of those adults unable to protect themselves. This includes:

Knowing about different types of abuse and neglect and the signs that they may be occurring (or when there is a risk that they will occur);
Supporting adults to keep safe;
Knowing who to tell about suspected abuse or neglect; and
Supporting adults to think about and weigh up risks and benefits of different options when exercising choice and control.

Anyone can abuse or neglect an adult, including a spouse or partner, other family member, friend, neighbour, stranger, paid staff, volunteer or professional exploiter.

Abuse can occur in any setting in or outside of the place where the adult lives. For example in a public place or in hospital.

IMPORTANT TO KNOW

For further information and guidance about the different types of abuse and neglect, including signs and indicators, see: Types and indicators of abuse (SCIE).

3. Reporting Abuse

The statutory guidance is clear that no professional should ever assume that someone else will raise a concern or pass information onto the Local Authority. Anyone who is aware of, or has information that raises a concern about abuse or neglect should share it with the Local Authority (see below for guidance about consent). Any representative of the Local Authority who becomes aware of abuse or neglect, or the risk of it must pass this information onto the relevant person in the organisation to ensure a timely and appropriate response. Where a criminal offence is thought to have been committed (for example theft or assault) they should also share the information with the police.

IMPORTANT TO KNOW

Under the Care Act the Local Authority is not permitted to enter into a contractual arrangement with any service provider who does not have a clear arrangement in place to prevent abuse and neglect.

Consent

Unless one of the following applies, consent of the adult should be sought before raising a safeguarding concern:

Seeking consent will increase the level of risk posed to them (or a child or other vulnerable adult);
Consent cannot practically be sought (for example, access to the adult is being denied or they cannot be located in a timely way);
The adult lacks capacity to consent, and a decision is made that raising a concern is in their best interests.

If an adult with capacity does not provide their consent, further questions should be asked as necessary to determine whether or not their wishes should be overridden and a concern raised.

A concern should be raised without consent if:

'Vital interests' are at stake;
The adult is being subjected to inhuman or degrading treatment which is having a serious impact on their wellbeing;
Other adults or children are at risk of being abused;
Staff or anyone else in a position of trust is implicated;
There are concerns that the decision to withhold consent has not been made freely, but as a result of undue influence or coercive control.

Note: 'Vital interests' generally apply to life or death situations and serious, immediate concerns for safety.

If consent is not given, and there is no reason to override the adult’s wishes, consideration should still be given to the ways in which risk to the adult could be managed or mitigated. This is recommendation four of Understanding what constitutes a safeguarding concern and how to support effective outcomes (Local Government Association).

Need to know

Always contact the local authority for advice if the adult has not provided consent and you are unclear whether their wishes should be overridden.

IMPORTANT TO KNOW

For further guidance about raising a safeguarding concern, please refer to your local safeguarding adults multi-agency procedures, processes and guidance.

Last Updated: February 12, 2024

v20