Adults at risk, capacity, consent, and the person's wishes

Domestic abuse can be an adult safeguarding concern. Across the UK the legal terms and thresholds vary, but the practical issue is consistent: a person with care and support needs may be less able to protect themselves from abuse, neglect, exploitation, intimidation or coercive control. In residential care, frailty, illness, disability, dementia, communication needs or dependency can make self-protection harder.

Important practice points for care staff

• Having capacity does not mean there is no risk: a person with capacity may still be frightened, ambivalent, manipulated or unwilling to act straight away.
• Capacity is decision-specific: do not assume someone lacks capacity because they have dementia, a diagnosis, or need help with daily tasks.
• Coercion can affect how free a choice feels: "I do not want you to do anything" may come from fear as well as preference, so consider the wider context.
• Speak privately whenever possible: a safe conversation is difficult if the abusive person is present, monitoring calls, or acting as the interpreter.
• Support involvement: give clear information, allow enough time, and arrange advocacy or safeguarding support so the person can take part as fully as possible.
• Know the limits of this course: this is not a full capacity law course. England and Wales use the Mental Capacity Act 2005, while Scotland and Northern Ireland use their own legal frameworks and local procedures.

A practical point for senior staff and managers

An adult can be at real risk even if they appear to agree with the person controlling them. Capacity, coercion, fear and safeguarding may all need to be considered together.