Identifying a concern

This is causing deliberate, physical injury to another person. Signs of this type of abuse might include:

• History of unexplained falls, fractures, bruises, burns, minor injuries.

• Signs of under or over use of medication and/or medical problems left unattended.

• Any injuries not consistent with the explanation given for them

• Bruising and discolouration - particularly if there is a lot of bruising of different ages

• and in places not normally exposed to falls, rough games etc.

• Recurring injuries without plausible explanation

• Loss of hair, loss of weight and change of appetite

• Person flinches at physical contact &/or keeps fully covered, even in hot weather;

• Person appears frightened or subdued in the presence of a particular person or people

This is sustained or extreme emotional mistreatment of an adult by another person. Signs of this type of abuse might include:

• Threats of harm or abandonment

• Deprivation of contact

• Humiliation

• Blaming, controlling, intimidation, coercion, harassment

• Verbal abuse

• Enforced isolation

• removing practical aids or personal assistance

• Privacy not being respected

• Prevention of choice and opinion

• Removed from meaningful activities

Women's Aid describes domestic violence as  "physical, sexual, psychological or financial violence that takes place within an intimate or family-type relationship and that forms a pattern of coercive and controlling behaviour. This can also include forced marriage and so-called 'honour crimes'.  Domestic violence may include a range of abusive behaviours, not all of which are in themselves inherently ‘violent’.” Signs of this type of abuse might include:

•  Unexplained injuries or ‘excuses’ for marks or scars

• Controlling and/or threatening relationship including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence and Female Genital Mutilation.

• Age range extended to 16 yrs

This is when an adult is forced or pressured to commit a sexual act with or for another to which they did not or could not consent. Signs of this type of abuse might include:

• Pregnancy in a woman who lacks mental capacity or is unable to consent to sexual intercourse

• Unexplained change in behaviour or sexually explicit behaviour

• Torn, stained or bloody underwear and/or unusual difficulty in walking or sitting

• Infections or sexually transmitted diseases

• Full or partial disclosures or hints of sexual abuse:

• Self-harming

• Emotional distress

• Mood changes

• Disturbed sleep patterns

• Psychological abuse

• Alteration in psychological state e.g. withdrawn, agitated, anxious, tearful

• Intimidated or subdued in the presence of a carer

• Fearful, flinching or frightened of making choices or expressing wishes

• Unexplained paranoia

• Changes in mood, attitude and behaviour, excessive fear or anxiety

• Changes in sleep pattern or persistent tiredness

• Loss of appetite

• Helplessness or passivity

• Confusion or disorientation

• Implausible stories and attention seeking behaviour

• Low self-esteem

This is the exploitation of someone's finances or personal possessions for their own gain. Signs of this type of abuse might include:

• Disparity between assets and living conditions

• Unexplained withdrawals from accounts or disappearance of financial documents or loss of money

• Sudden inability to pay bills, getting into debt

• Carers or professionals fail to account for expenses incurred on a person’s behalf

• Recent changes of deeds or title to property

• Missing personal belongings

• Inappropriate granting and / or use of Power of Attorney

This would include human trafficking, forced labour, sexual exploitation, domestic servitude and being forced to pay off unrealistic debts. Signs of this type of abuse might include:

• Physical appearance; unkempt, inappropriate clothing, malnourished

• Movement monitored, rarely alone, travel early or late at night to facilitate working hours.

• Few personal possessions or ID documents.

• Fear of seeking help or trusting people.

This is the unequal, unfair or bullying treatment of a person based on their age, disability, gender, status, race, religion (or beliefs), or their sexual orientation. Signs of this type of abuse might include:

• Inappropriate remarks, comments or lack of respect

• Poor quality or avoidance care

• Low self-esteem

• Withdrawn

• Anger

• Person puts themselves down in terms of their gender or sexuality

• Abuse may be observed in conversations or reports by the person of how they perceive themselves

Factors such as overcrowding, poor management, insufficient staff and inadequate risk assessments can lead to harm across a broad spectrum of the above types of abuse. Signs of this type of abuse might include:

• Low self-esteem

• Withdrawn

• Anger

• Person puts themselves down in terms of their gender or sexuality

• Abuse may be observed in conversations or reports by the person of how they perceive themselves

• No confidence in complaints procedures for staff or service users.

• Neglectful or poor professional practice.

This is the failure to attend to the physical or medical needs of a person in the best way for the person themselves. Signs of this type of abuse might include:

• Deteriorating despite apparent care

• Poor home conditions, clothing or care and support.

• Lack of medication or medical intervention

This is a failure to care for oneself or seek help or access to services offered.  This includes neglect or harm to self that threatens personal health and safety (including suicide or suicide attempts). Signs of this type of abuse might include:

• Hoarding inside or outside a property

• Neglecting personal hygiene or medical needs

• Person looking unkempt or dirty and has poor personal hygiene

• Person is malnourished, has sudden or continuous weight loss and is dehydrated – constant hunger, stealing or gorging on food

• Person is dressed inappropriately for the weather conditions

• Dirt, urine or faecal smells in a person’s environment

• Home environment does not meet basic needs (for example not heating or lighting)

• Depression