Taking action on safeguarding concerns

Examples: hitting, kicking, smacking, slapping, hair-pulling, pushing, rough handling, scalding or burning, inappropriate use of restraint, misuse of medication (e.g. over-sedation), genital mutilation, forced feeding or deliberate withholding of food, forced confinement or isolation, making someone deliberately physically uncomfortable (e.g. removing jumper and opening a window to make them cold).

Possible signs of physical abuse: unexplained injuries; injuries that are inconsistent with an account of what happened; injuries that are inconsistent with the person’s lifestyle; injuries not followed up/ignored; frequent changes of GP; changes in weight or appearance; insomnia; changes in behaviour such as becoming withdrawn, anxious or angry; changes in behaviour around a particular person or in particular situations.

Examples: rape, attempted rape, sexual assault, indecent exposure, sexual photography, inappropriate looking or touching, forcing someone to look at pornography or witness sexual acts, sexual teasing, harassment or innuendo, pressuring someone to consent to sexual acts, or carrying out sexual acts when someone cannot consent

Possible signs of sexual abuse: bruising; signs of sexually transmitted infections such as pain, itching, bleeding or discharge; unusual difficulty walking or sitting; new incontinence not related to any medical diagnosis; reluctance or fear of receiving help with personal care; unusual changes in sexual behaviour or attitude; unusual changes in sexually explicit language; insomnia; changes in behaviour such as becoming withdrawn, anxious or angry; changes in behaviour around a particular person or in particular situations.

Sextortion is a term used to describe sexual extortion that has a financial motivation. Criminals befriend people through dating apps and social media, and start a relationship quickly. They pressure the person into sending intimate photos and videos, and then blackmail them by threatening to post these online. Get more support from Stop Non-Consensual Intimate Image Abuse (NCII).

Example: removing walking stick or frame, removing communication aids, intentionally leaving someone unattended when they need assistance, control, threats, belittling, intimidation, humiliation, over-protection, coercion, harassment, cyber bullying, restricting personal choice or opinion, refusing to respect privacy, deprivation of contact/refusing visitors, verbal abuse, or the use of infantilising language

Possible signs of emotional abuse: low self-esteem and self-depreciating language; tearfulness; changes in weight or appearance; insomnia; changes in behaviour such as becoming withdrawn, anxious or angry; changes in behaviour around a particular person or in particular situations.

Examples: not allowing someone access to their own money or possessions, using their money or possessions for the wrong purposes (e.g. unauthorised use of a car; moving into someone’s home without agreement), pressuring someone into spending their money in a certain way (e.g. take out a loan, sign a will, hand over inheritance), fraud, scamming (e.g. telephone, online, on the doorstep), rogue traders.

Possible signs of financial and material abuse: signs of unpaid bills, credit card debt, insufficient food in the house, repeated and unnecessary repairs on a house; gradually withdrawing or becoming more isolated from friends/family; personal possessions missing; unexplained lack of money; unexplained withdrawals from bank account; person managing the affairs fails to provide receipts or evidence of spending and/or is evasive when discussing finances.

Examples: not providing or allowing access to food, heating, clothing, appropriate housing, personal care (including shaving, hair cuts, nail care, menstruation and menopause), medical care (including routine check-ups – dentist appointments, eye tests, annual health checks at the GP, access to routine screening programmes), social life and stimulating activity (the local authority has a duty to provide this – everybody needs social connections and activities that interest and stimulate them). Not appropriately maintaining any of these needs.

Possible signs of neglect: changes in weight; untreated injuries or health conditions; inadequate clothing (for example, no coat in winter); pressure sores; poorly maintained environment; poor personal hygiene.

This is a lack of self-care so extreme that it affects personal health and safety. Examples of self-neglect include hoarding, not maintaining living space, ignoring health needs such as having appropriate food and heating, not attending to personal hygiene, not accessing appropriate medical care when needed.

Possible signs of self-neglect: living in dirty conditions, neglecting house hold maintenance, very poor personal hygiene, lack of appropriate food, heating and clothing, hoarding.

Hoarding can also be a sign of a mental health issue. For more information about hoarding, visit Mind.org.uk.

Please note: Self-neglect is specifically recognised as a type of abuse in England and Scotland. In Wales and Northern Ireland, it is likely that self-neglect would be reviewed on a case-by-case basis.

Examples: exploitation, human trafficking, forced labour, debt bondage – being coerced into debt then ‘working’ to repay that when they will never realistically be able to, forced domestic servitude.

Possible signs of modern slavery: living in overcrowded and unkempt conditions; isolation and lack of contact with community; appearing malnourished or withdrawn; unkempt clothing and poor personal hygiene; always accompanied by another person they seem fearful of; lack of personal documents or identification; fear of authorities and unwillingness to disclose information.

The Modern Slavery Helpline offer advice and support on modern slavery 24 hours a day, 7 days a week on 08000 121 700. You can find modern slavery training and awareness raising resources here.

This is any type of abuse (e.g. emotional, financial, physical or other types listed above) which happens within an intimate personal relationship or family setting. Domestic abuse often includes control, coercion and threatening behaviour.

Examples of control, coercion and threatening behaviour: isolating a person from their wider friends/family; monitoring their time; monitoring their phone/online communications; dictating everyday movements e.g. where a person can go/who they can see/what they can wear; name-calling/putting a person down; gaslighting (repeatedly undermining or questioning a person’s reality); any kind of threat or intimidation either physically or verbally.

Forced marriage is a type of domestic abuse where a person is pressured, coerced or forced to marry, or they don’t have the capacity to consent to marry. Forced marriage is illegal in the UK. The Forced Marriage Unit has a helpline (020 7008 0151) to provide advice and support for relatives of people who are victims of forced marriages

Female Genital Mutilation (FGM) is a type of domestic abuse where a female’s genitals are forcibly cut or removed for non-medical reasons. FGM may be carried out when the person is a new born baby, a child or teenager, before marriage, or during pregnancy. FGM is illegal in the UK. It is also illegal to take someone from the UK to another country, to perform FGM. Click here for more information and advice on FGM. You can take free training developed by the Home Office on recognising and preventing FGM.

This is any type of abuse (e.g. emotional, financial, physical or other types listed above) that is carried out on the basis or perceived basis of a particular characteristic, such as age, gender, disability, religion, sexual orientation, race.

Examples of discriminatory abuse: refusing to dress someone in preferred religious clothing because it takes longer; excluding a person from an activity on the basis of their gender; not providing a reasonable adjustment to a disabled person accessing a service; derogatory remarks about a person’s choice of food that represents their culture; not offering someone a service on the assumption that they won’t need or want it due to their age.

This can be any type of abuse (e.g. emotional, financial, physical or other types listed above) and repeated poor practice that happens within an organisation, however it typically refers to denying an individual their choice and autonomy. This might be a specific care setting, such as a hospital or care home, but it can also refer to a person’s own home where care is provided by a team.

Examples: inappropriate use of power, inappropriate restrictions or confinements, lack of choice in environmental aspects (e.g. food, heating, lighting, decoration), lack of personal possessions, lack of choice in routine (e.g. having no flexibility in eating/sleeping schedule).

Possible signs of institutional abuse: overcrowding; unhygienic environment; discouraging visits from friends/family; being forced to go to bed at a certain time simply because it meets the needs of the staff/environment; not being offered a choice of hot drink or being told that hot drinks are only available at set times.

Hate crime is a term used to describe any incident or crime that is motivated by hostility or prejudice towards a person because of a particular characteristic (such as disability, race, religions, sexual orientation, transgender identity).

Hate crime is a criminal offence in the UK and can be reported to the police.

You can also:

• Report anti-Muslim attacks to Tell MAMA (Measuring Anti-Muslim Attacks) – an independent and confidential support service for those who face anti-Muslim hatred and prejudice across the UK
• Report racism or hate crime to On Your Side – a charity for anybody in the UK who identifies as part of an East or Southeast Asian community, including people with mixed heritage

Find out more about hate crime here.

Mate crime is when someone befriends a person in order to exploit or abuse them. Mate crime can involve many of the types of abuse listed above (e.g. financial/material, physical, emotional, sexual). Mate crime may start online or over social media, or in a person’s own home. Find out more about mate crime here.

Cuckooing is a term often related to mate crime, and refers to when someone takes over or stays in a person’s home, despite the person not wanting this. Gangs often do this to create a base for dealing and storing drugs and weapons. Signs of cuckooing may include: frequent visitors at unsociable hours, changes in daily routine, unusual smells coming from the property, suspicious or unfamiliar vehicles outside, inside the property there may be signs of drugs or weapons being hidden.

County lines is a term used to describe gangs involved in importing drugs using dedicated mobile phone lines. Gangs enlist a ‘middle man’ to build a network people (usually adults at risk, and children) who will move drugs for them, between towns and cities in the UK. They do this through befriending, threats, intimidate, coercive control and violence. Cuckooing is often a feature in a county lines operation. Find out more about cuckooing and county lines here.

Sextortion is a term used to describe sexual extortion that has a financial motivation. Criminals befriend people through dating apps and social media, and start a relationship quickly. They pressure the person into sending intimate photos and videos, and then blackmail them by threatening to post these online. Get more support from Stop Non-Consensual Intimate Image Abuse (NCII).

Online harm is when someone uses the internet (e.g. apps, social media, websites, messages) to cause physical or psychological harm to a person. This may include hate or mate crime, or cyberbullying (intimidating, threatening or offensive messages). Read about mate crime above.

More information:

• Metropolitan police – I’m being harassed by someone on social media. What can I do?
• Gov.uk – Understanding and reporting online harms on your online platform
• Talkback is a charity working with autistic and learning disabled people. They have free online training on cyber bullying, cyber fraud and cyber security
• Get Safe Online provide clear and unbiased information about online safety
• The Online Safety Act 2023 puts a range of duties on organisations and social media companies, making them more responsible for the safety of their users
• The National Cyber Security Centre information, guidance and blog posts
  

A scam is a deceptive act, usually for financial gain. It might take place on a person’s doorstep, by post, over the phone, by email or social media. Scams are fraud and this is a crime. In England, Wales and Northern Ireland contact Action Fraud on 0300 123 2040 for more advice or to report. In Scotland, contact the police on 101. Read more on reporting fraud.

More information:

• Take Five is a national campaign providing clear information about preventing email, phone and online fraud, especially where the criminal impersonates another organisation
• Stop! Think Fraud: Protecting yourself from doorstep, postal and phone scams
• Think Jessica is a charity raising awareness of the dangers and implications of scams
  

It is important to be aware of radicalisation. This is the process of a person adopting extreme views (e.g. religious, political or social) which can result in them carrying out acts of terrorism. A person may be targeted by extremist groups, and groomed and recruited over a period of time. The government has released guidance (‘Prevent Duty’) for authorities in England, Wales and Scotland on preventing radicalisation and countering terrorism. You can take free online training in Prevent here. There is no equivalent guidance in Northern Ireland.

• If your brother or sister is able to keep their own records, talk to them about how best to keep track of what is happening and how to store these notes or photos privately.
• Keep notes about the date and time of any incidents, who was involved and where it happened. Take photos if relevant and make copies of any useful documents such as care plans.
• Keep a record too of your brother or sister’s moods and behaviour – they may show specific reactions to a member of staff for example, or there may be a change in behaviour over a period of time that may have worried you.
• This may help you build a case if you need to and also firm up your evidence if you are worried about whether your concerns are real or not.
  

In some cases – for example, if your concern is about a particular member of staff within a care home setting or a hospital – you (or your brother/sister) may feel able to discuss the concerns with someone you both trust within the management team in the first instance, as they may take the appropriate safeguarding action.

If your brother or sister has a key professional such as a learning disability nurse, you can raise the concerns this way too. It is the responsibility of all staff working with disabled people to recognise concerns and report poor practice or safeguarding issues.

However, if this isn’t relevant for your situation, you should report your concerns to the local authority in which your brother or sister lives.

Who to contact:

• In England and Wales, contact the local authority and ask to speak with the Adult Safeguarding Team.
• In Northern Ireland, contact the Adult Protection Gateway Service based in your local Health and Social Care Trust.
• In Scotland, contact the Adult Protection or Care team in your local council.
  

• If the response you receive after raising your concern is unsatisfactory or if you feel it hasn’t been taken seriously, you can raise it as a formal complaint. Each local authority and service has a formal complaints procedure which they should have in writing or on their website which you can follow.
• Read our guide on Making a complaint and follow the steps
  

• In most cases issues can be resolved through taking issues directly to service providers within the local authority or getting their support to change a situation for your brother or sister. However, there are some situations where the abuse or neglect may be so serious that it has caused serious injury, trauma or in rare cases, the death of a disabled person. In these situations more legal expertise needs to be sought.
• You can contact a solicitor for more advice. There are some lawyers who specialise in human rights law or community care law for example who can guide you through the process.
• Remember there may be time restrictions in taking a case to court, so if a case is serious you may want to get legal advice as soon as possible.
  

“My disabled sister employs a personal assistant (PA) herself using direct payments, and I support her with this. As we directly employ the PA, we don’t have an agency or organisation to turn to. I’m worried about some of the PA’s behaviour. I’m concerned that if I raise the issue with the PA, or sack them, they could fight back alleging unfair dismissal. We’re slowly building evidence, but it’s really hard leaving my sister in the sole care of someone that I’ve got growing doubts about.” – Adult sibling

This is not an easy situation to be in, particularly if you’re concerned that your sister is potentially at risk of abuse. You just want your sister to live a safe and happy life and that’s not a lot to ask. Being a sibling can be complex and challenging – you’re not alone.

You’re right to keep building evidence:

• If your sister is able to keep her own records, talk to her about how best to keep track of what is happening and how to store these notes or photos privately.
• Keep notes about the date and time of any incidents, who was involved and where it happened. Take photos if relevant and make copies of any useful documents such as care plans.

You and your sister may have some difficult decision making. For example, whether to deal with a situation informally with a chat over a cuppa or whether to give a formal written warning. Does the situation warrant suspending the person while there is an investigation into what might have happened?

It may also help to seek further support and advice:

• Skills for Care – employing personal assistants and sorting out problems
• Disability Rights UK – personal budgets helpline (includes advice on direct payments and employing PAs)
• You may be able to access other HR support and advice through your local authority

This is a stressful situation for you as a sibling, and it can really help to meet others who just ‘get’ what sibling life is like. Find out more about our sibling support groups and join here. Chat with other siblings online on our private Facebook community here.