Corporate Safeguarding Policy

Safeguarding People in Carmarthenshire | Updated November 2023

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Appendix 1 cont'd - Categories and indicators of abuse – Adults at Risk

Categories and indicators of abuse – Adults at Risk

Section 197(1) of the Social Services and Well-being (Wales) Act 2014 provides definitions of ‘abuse’ and ‘neglect’.

Abuse means physical, sexual, psychological, emotional or financial abuse (and includes abuse taking place in any setting, whether in a private dwelling, an institution or any other place).

Neglect means a failure to meet a person’s basic physical, emotional, social or psychological needs, which is likely to result in an impairment of the person’s well-being (for example, an impairment of the person’s health).

The following is a non-exhaustive list of examples for each of the categories of abuse and neglect:

Physical abuse

Hitting, slapping, over or misuse of medication, undue restraint, or inappropriate sanctions.

Types of physical abuse

  • Assault, hitting, slapping, punching, kicking, hair-pulling, biting, pushing
  • Rough handling
  • Scalding and burning
  • Physical punishments
  • Inappropriate or unlawful use of restraint
  • Making someone purposefully uncomfortable (e.g. opening a window and removing blankets)
  • Involuntary isolation or confinement
  • Misuse of medication (e.g. over-sedation)
  • Forcible feeding or withholding food
  • Unauthorised restraint, restricting movement (e.g. tying someone to a chair)

Possible indicators of physical abuse

  • No explanation for injuries or inconsistency with the account of what happened
  • Injuries are inconsistent with the person’s lifestyle
  • Bruising, cuts, welts, burns and/or marks on the body or loss of hair in clumps
  • Frequent injuries
  • Unexplained falls
  • Subdued or changed behaviour in the presence of a particular person
  • Signs of malnutrition
  • Failure to seek medical treatment or frequent changes of GP

Sexual abuse

Rape and sexual assault or sexual acts to which the vulnerable adult has not or could not consent and/or was pressured into consenting.

Indicators of sexual abuse can be both physical and behavioural, including:

  • New emergence of sexually transmitted diseases (STDs)
  • New difficulty sitting or walking
  • Pelvic injury
  • Bruises on inner thighs or around the genital area
  • Anal or genital pain, bleeding, or irritation
  • Bloody, torn, or stained undergarments
  • Extreme agitation
  • Withdrawal from social interactions
  • Panic attacks, or emerging post-traumatic stress disorder (PTSD) symptoms
  • Inappropriate, aggressive, or unusual sexual behaviour
  • Suicide attempts

Psychological abuse

Threats of harm or abandonment, coercive control, humiliation, verbal or racial abuse, isolation or withdrawal from services or supportive networks (coercive control is an act or pattern of acts of assault, threats, humiliation, intimidation, or other abuse that is used to harm, punish or frighten the victim)

Types of psychological or emotional abuse

  • Enforced social isolation – preventing someone accessing services, educational and social opportunities and seeing friends
  • Removing mobility or communication aids or intentionally leaving someone unattended when they need assistance
  • Preventing someone from meeting their religious and cultural needs
  • Preventing the expression of choice and opinion
  • Failure to respect privacy
  • Preventing stimulation, meaningful occupation or activities
  • Intimidation, coercion, harassment, use of threats, humiliation, bullying, swearing or verbal abuse
  • Addressing a person in a patronising or infantilising way
  • Threats of harm or abandonment
  • Cyber bullying

Possible indicators of psychological or emotional abuse

  • An air of silence when a particular person is present
  • Withdrawal or change in the psychological state of the person
  • Insomnia
  • Low self-esteem
  • Uncooperative and aggressive behavior
  • A change of appetite, weight loss/gain
  • Signs of distress: tearfulness, anger
  • Apparent false claims, by someone involved with the person, to attract unnecessary treatment

Neglect

Failure to access medical care or services, negligence in the face of risk-taking, failure to give prescribed medication, failure to assist in personal hygiene or the provision of food, shelter, clothing; emotional neglect. (See also self-neglect)

Types of neglect

  • Failure to provide or allow access to food, shelter, clothing, heating, stimulation and activity, personal or medical care.
  • Providing care in a way that the person dislikes.
  • Failure to administer medication as prescribed Refusal of access to visitors.
  • Not taking account of individuals’ cultural, religious or ethnic needs.
  • Not taking account of educational, social and recreational needs.
  • Ignoring or isolating the person.
  • Preventing the person from making their own decisions.
  • Preventing access to glasses, hearing aids, dentures, etc.
  • Failure to ensure privacy and dignity.

Possible indicators of neglect:

  • Poor environment – dirty or unhygienic.
  • Poor physical condition and/or personal hygiene.
  • Pressure sores or ulcers.
  • Malnutrition or unexplained weight loss.
  • Untreated injuries and medical problems.
  • Inconsistent or reluctant contact with medical and social care organisations.
  • Accumulation of untaken medication.
  • Uncharacteristic failure to engage in social interaction.
  • Inappropriate or inadequate clothing.

Financial abuse

In relation to people who may have needs for care and support and includes:

  • an unexpected change to their will.
  • sudden sale or transfer of the home
  • unusual activity in a bank account
  • sudden inclusion of additional names on a bank account
  • signature does not resemble the person’s normal signature
  • reluctance or anxiety by the person when discussing their financial affairs
  • giving a substantial gift to a carer or other third party
  • a sudden interest by a relative or other third party in the welfare of the person.
  • bills remaining unpaid
  • complaints that personal property is missing
  • a decline in personal appearance that may indicate that diet and personal requirements are being ignored
  • deliberate isolation from friends and family giving another person total control of their decision-making.

Any of the above forms of abuse could be motivated by the personal characteristics of the victim. This may make it a hate crime. These involve a criminal offence perceived by the victim or any other person, to be motivated by hostility or prejudice based on a person’s actual or perceived disability, race, religion and belief, sexual orientation and transgender.

Self-Neglect

Capacity is a highly significant factor in both understanding and intervening in situations of self-neglect.

Self-neglect can happen as a result of an individual's choice of lifestyle, or the person may:

  • be depressed,
  • have poor health,
  • have cognitive (memory or decision making) problems or be physically unable to care for self.

Types of self-neglect

  • Lack of self-care to an extent that it threatens personal health and safety.
  • Neglecting to care for one’s personal hygiene, health or surroundings.
  • Inability to avoid self-harm.
  • Failure to seek help or access services to meet health and social care needs.
  • Inability or unwillingness to manage one’s personal affairs.

Indicators of self-neglect:

  • Very poor personal hygiene.
  • Unkempt appearance.
  • Lack of essential food, clothing or shelter.
  • Malnutrition and/or dehydration.
  • Living in squalid or unsanitary conditions.
  • Neglecting household maintenance.
  • Hoarding.
  • Collecting a large number of animals in inappropriate conditions.
  • Non-compliance with health or care services.
  • Inability or unwillingness to take medication or treat illness or injury.

 

Violence Against Women, Domestic Abuse and Sexual Violence (VAWDASV)
A range of forms of violence are recognised within the term VAWDASV. Many of these terms are used as umbrella terms, and are not mutually exclusive, these include:

Gender-Based Violence (GBV)
Gender based violence constitutes violence that is directed against a person based on gender. It represents a breach of the fundamental right to life, liberty, security, dignity, equality between women and men, non-discrimination and physical and mental integrity (Council of Europe, 2011).

Intimate Partner Violence (IPV)
Intimate partner violence is behaviour by an intimate partner or ex-partner that causes physical, sexual, or psychological harm, including physical aggression, sexual coercion, psychological abuse, economic abuse and controlling behaviours (World Health Organisation, 2017)

Domestic Violence and Abuse (DVA)
The term domestic violence and abuse is used to refer to violence in a domestic setting, including intimate partner violence, but the term can also encompass child to parent violence or abuse of older people or abuse by any member of a family or household.

Sexual Violence and Abuse (SVA)
Sexual violence, sexual assault or harassment involves any sexual act, attempt to obtain a sexual act, or other act directed against a person’s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting (World Health Organisation, 2012b). Sexual violent acts can take place in a range of settings and can include rape within marriage or dating relationships; rape by strangers; sexual abuse of children; forced prostitution or the trafficking of people for the purpose of sexual exploitation and sexual harassment (Krug et al., 2002).

Coercive Control
Coercive control is an act or pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish or frighten the victim. This controlling behaviour is designed to make a person dependent by isolating them from support, exploiting them, depriving them of independence and regulating their everyday behaviour (Women's Aid, 2020b). Coercive control often involves physical violence and sexual coercion and there is evidence that cases involving coercive control are more likely to result in serious harm, including domestic homicide, than cases that involve discrete acts of physical violence (Myhill and Hohl, 2019

Forced Marriage
Forced marriage is where one or both people do not (or in cases of people with some learning disabilities, cannot) consent to the marriage and pressure or abuse is used. It is recognised as a form of violence against women and men, domestic/child abuse, a form of modern slavery, and a serious abuse of human rights.

Child Marriage
In relation to child marriage, any child (under the age of 18) is considered incapable of freely choosing to marry. Complications arise when there is legal entitlement for a child to marry earlier (from 16 years of age) with parental consent, as in the UK.

So called Honour Based Abuse (HBA)
For some communities, the concept of ‘honour’ is deemed to be extremely important, to compromise a family’s ‘honour’ is to bring dishonour and shame and this can have severe consequences. The punishment for bringing dishonour can be emotional abuse, physical abuse, family disownment and in some cases even murder. In most so-called honour-based abuse cases there are multiple perpetrators.

Female Genital Mutilation (FGM)
Female genital mutilation (FGM) involves all procedures that involve partial or total removal of the external female genitalia, other injury to, or alteration of the female genital organs for nonmedical reasons.

Modern Slavery/Human trafficking
Modern slavery is a serious crime that violates human rights. These crimes include holding a person in a position of slavery, servitude forced or compulsory labour, or facilitating their travel with the intention of exploiting them soon after. Victims are forced, threatened, or deceived into situations of subjugation, degradation and control which undermine their personal identity and sense of self. Within this, human trafficking involves the forced exploitation of others, typically for sexual or labour purposes.

Although human trafficking often involves an international cross-border element, it is also possible to be a victim of modern slavery within your own country. It is possible to be a victim even if consent has been given to be moved.

Children cannot give consent to being exploited therefore the element of coercion or deception does not need to be present to prove an offence.

Sexual Harassment
Sexual harassment is defined as unwelcome sexual conduct. This included having received unwanted and or offensive sexually explicit emails or SMS messages, or offensive and/or inappropriate advances on social networking sites

Adolescent Dating Violence (ADV)
Adolescent dating violence (ADV), also called adolescent relationship abuse refers to emotional, physical or sexual abuse of a dating or sexual partner where at least one person is an adolescent.

Hate Crime
A Hate Incident is any incident which the victim, or anyone else, thinks is based on someone’s prejudice towards them because of their race, religion, sexual orientation, disability or because they are transgender.

Further information on Hate Crime (including how to report a hate crime) can be found on the Carmarthenshire Community Safety Partnership website: Hate Crime.