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What is abuse and neglect?

Abuse is action that harms another person in some way.

Abuse of adults with care and support needs is where someone in a position of trust hurts, harms or causes someone distress. Abuse is unacceptable; everyone has the right to be treated with dignity and respect and to live free of abuse or mistreatment, whether they live on their own, live with others, live in a care/nursing care home, attend a day centre or are in hospital.

Types of abuse may be one-off or multiple incidents. Repeated instances of poor care may be an indication of more serious problems and of what we now describe as organisational abuse.

Abuse can occur in any relationship and may result in significant harm, or exploitation.

The person responsible for the abuse is very often well known to the person being abused and could be a spouse; partner; son; daughter; relative; friend; carer or neighbour; a paid carer or volunteer; a health worker; social care or other worker; another resident or service user; an occasional visitor or someone who is providing a service. It can be caused by a person deliberately intending to harm or neglect, failing to take the right action or through their ignorance.  It can involve one or a number of people. Abuse is not always intentional but it causes harm and so needs to be stopped.

Further information is available in the ‘Safeguarding adults: multi-agency policy and procedure for the West Midlands’ 

What Is Safeguarding?

Safeguarding is about making people aware of their rights, protecting them and preventing abuse; this used to be known as Adult Protection.

Who Does Adult Safeguarding Apply To?

The Care Act 2014 places a duty on local authorities to look into adult safeguarding concerns in relation to an adult (18 years and over) who:

Has needs for care and support (whether or not the local authority is meeting such needs), these adults may for example be:

  • Frail due to ill health, physical disability or cognitive impairment, or a combination of these.
  • Have a learning disability
  • Have a physical disability and/or a sensory impairment
  • Have mental ill health or needs arising from dementia.
  • Have a long-term illness/condition
  • Users of substances or alcohol, where decision making ability may have been affected.


  • Is experiencing, or at risk of, abuse or neglect;


  • As a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.


  • assault,
  • hitting,
  • slapping,
  • pushing,
  • misuse of medication,
  • restraint or inappropriate physical sanctions.


  • psychological,
  • physical,
  • sexual,
  • financial,
  • emotional abuse,
  • so called ‘honour’ based violence.

Sandwell has  signed up to the West Midlands Domestic Violence and Abuse Standards, aimed at improving services, more information can be found at Sandwell – Domestic Abuse.

Or, for help and support, contact Black Country Women’s Aid 24 hour helpline on 0121 552 6448 call the free 24-hour National Domestic Violence Helpline on 0808 2000 247. ALWAYS CALL 999 in an EMERGENCY


  • rape,
  • indecent exposure,
  • sexual harassment,
  • inappropriate looking or touching,
  • sexual teasing or innuendo,
  • sexual photography,
  • subjection to pornography or witnessing sexual acts,
  • indecent exposure and sexual assault
  • sexual acts to which the adult has not consented or was pressured into consenting.


  • emotional abuse,
  • threats of harm or abandonment,
  • deprivation of contact,
  • humiliation,
  • blaming,
  • controlling,
  • intimidation,
  • coercion,
  • harassment,
  • verbal abuse,
  • cyber bullying,
  • isolation,
  • unreasonable and unjustified withdrawal of services or supportive networks.


  • theft,
  • fraud,
  • internet scamming,
  • coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, other misuse or misappropriation of property, possessions or benefits. More information about scamming can be found here: Sandwell Scam Awareness

Modern slavery refers to situations where individuals are coerced, deceived, or controlled by others to work under exploitative conditions. It encompasses a range of abusive practices, including forced labour in industries like agriculture, construction, and manufacturing, as well as the trafficking of men, women, and children for purposes of sexual exploitation, forced begging, or forced marriage. Modern slavery represents a grave violation of human rights and stands in stark contrast to the principles of freedom, equality, and dignity.

Modern slavery manifests in numerous forms, each inflicting immense suffering on its victims. These include:

Sexual exploitation: victims may be forced into prostitution, pornography or lap dancing for little or no pay. They may be deprived of their freedom of movement and subjected to threats and violence.

Labour exploitation: a victim is made to work with little or no pay and may face violence or threats. If they are foreign nationals, their passports may be confiscated by their exploiters and they may be made to live in terrible conditions and under constant threat.

Forced criminality: victims can be forced to participate in a range of illegal activities including pick pocketing, shop lifting, cannabis cultivation, county lines exploitation and other activities. The Modern Slavery Act provides for a defence for victims who have been forced into criminality.

Domestic servitude: victims work in a household where they may be ill-treated, humiliated, subjected to exhausting hours, forced to work and live under unbearable conditions or forced to work for little or no pay. In some cases, forced marriage can lead to domestic servitude.

Organ harvesting: victims are trafficked for their internal organs (typically kidneys or the liver) to be harvested for transplant. 

Forced marriage: where people are forced into marriage for a range of reasons including exploiting the rights conferred on them by citizenship or for domestic servitude.

Financial exploitation: for example, benefit fraud, where benefits are falsely claimed by perpetrators on behalf of their workers; bank accounts being opened in a victim’s name but used by perpetrators; or workers’ wages being paid directly into the exploiters own bank accounts by companies who think they are paying a worker individually.

Further information on modern slavery can be found here

Click here for information on how to report modern slavery concerns.

Modern Slavery Helpline (24 hrs): 0800 0121 700



  • forms of harassment, slurs or similar treatment because of race, gender and gender identity, age, disability, sexual orientation or religion.


  • neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home.
  • This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation


  • ignoring medical, emotional or physical care needs,
  • failure to provide access to appropriate health, care and support or educational services,
  • the withholding of the necessities of life, such as medication, adequate nutrition and heating

This covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and can include behaviour such as hoarding. Self–neglect can be quite complex in nature and is often managed in different ways to the abuse or neglect of others. People who self-neglect may be helped by care management teams and other professionals working together. It is important that people who self-neglect can be helped to understand long and short term risks, and ways of minimising those risks. Sandwell has adopted regional self- neglect guidance which can be found here – Sandwell Self-neglect Guidance

Sandwell has also produced a Hoarding Framework.

Birmingham Safeguarding Adults Board have also produced this short film about hoarding:

Where does abuse happen?

Abuse can happen at any time and almost anywhere, for example:

  • In someone’s own home
  • In the home of a carer, friend, neighbour or other acquaintance
  • At a day centre
  • In a care home
  • In hospital or other health setting
  • At work
  • At college
  • In a public place

Who might be an abuser?

Abusers may not be easy to identify and can be:

  • A current or previous partner,
  • A relative or friend or acquaintance
  • A volunteer
  • A paid member of staff or professional, including those who may work in a position of trust
  • Another service user
  • A neighbour
  • A carer
  • A stranger
Support Organisation Contact Details
Action on Elder Abuse Helpline – 0808 808 8141
Care Quality Commission
General Enquiries – 03000 616 161
Forced Marriage Unit
(at the Foreign Office)
Phone – 020 788 0151
Dignity In Care
Hate Crime/True Vision
Office of the Public Guardian Phone – 0300 456 0300
Email –