Types of abuse, neglect, and harm

Abuse and neglect take many forms. The Care Act guidance for England lists physical abuse, domestic abuse, sexual abuse, psychological abuse, financial or material abuse, modern slavery, discriminatory abuse, organisational abuse, neglect and acts of omission, and self-neglect. Types can and often do overlap.

For care staff, neglect and acts of omission are particularly important because they can directly damage health and dignity. Examples include missed or delayed care, poor continence support, leaving people hungry or thirsty, failing to get medical help, not using aids correctly, inadequate pressure area care, missed medicines support, preventable infections, unsafe moving and handling, and not responding to pain or deterioration.

Organisational abuse matters in residential settings because systems and culture can cause harm as much as individuals can. A home can become unsafe through weak leadership, poor staffing, rushed care, lack of privacy, unlawful restraint, missing records, ignored complaints, or a culture where disrespectful practice is normalised.

Discriminatory abuse occurs when someone is treated unfairly or denied appropriate support because of disability, race, religion, age, sex, sexual orientation, gender identity, language, or another protected characteristic. In care homes this may affect everyday things such as choices, communication, food, intimacy, activities, visiting, or how seriously concerns are investigated.

Examples staff may encounter

• Physical abuse: hitting, rough handling, misuse of medication, inappropriate restraint, or injury caused by another resident.
• Psychological abuse: threats, humiliation, bullying, intimidation, isolation, controlling behaviour, or repeated shouting.
• Sexual abuse: unwanted touching, sexualised language, coercion, assault, or sexual activity without valid consent.
• Financial abuse: theft, pressure around money, misuse of benefits, missing valuables, scams, or misuse of personal allowance.
• Self-neglect: severe neglect of personal care, health, environment, or safety, which may still require a safeguarding response.

Abuse is not limited to visible injury. Financial misuse, discriminatory practice, neglect, and normalised shortcuts can all seriously harm dignity and safety.