Organisational abuse
There are different types of adult abuse, some of which are also criminal offences. See below for more information about adult abuse, however please also note that evidence of one indicator should not be taken on its own as proof that abuse is happening. The list of indicators is not exhaustive, there are other indicators that do not appear here, and individuals may be subject to more than one type of abuse at the same time.
Types of organisational or institutional abuse
- Discouraging visits or the involvement of relatives or friends
- Run-down or overcrowded establishment
- Authoritarian management or rigid regimes
- Lack of leadership and supervision
- Insufficient staff or high turnover resulting in poor quality care
- Abusive and disrespectful attitudes towards people using the service
- Inappropriate use of restraints
- Lack of respect for dignity and privacy
- Failure to manage residents with abusive behaviour
- Not providing adequate food and drink, or assistance with eating
- Not offering choice or promoting independence
- Misuse of medication
- Failure to provide care with dentures, spectacles or hearing aids
- Not taking account of individuals’ cultural, religious or ethnic needs
- Failure to respond to abuse appropriately
- Interference with personal correspondence or communication
- Failure to respond to complaints
Possible indicators of organisational or institutional abuse
- Lack of flexibility and choice for people using the service
- Inadequate staffing levels
- People being hungry or dehydrated
- Poor standards of care
- Lack of personal clothing and possessions and communal use of personal items
- Lack of adequate procedures
- Poor record-keeping and missing documents
- Absence of visitors
- Few social, recreational and educational activities
- Public discussion of personal matters
- Unnecessary exposure during bathing or using the toilet
- Absence of individual care plans
- Lack of management overview and support
Real life example of organisational abuse
In June this year, in the UK two carers appeared in court accused of abusing an elderly Alzheimer’s patient resident in a care home. The workers were only brought to justice after the family were concerned about their mother’s constant crying and unexplained bruises on their mother’s wrists, and installed a secret camera in her bedroom. Carers were filmed dragging the frail and terrified, 71 year old victim out of bed by her wrists, refusing the diabetic OAP food and drink and ignoring her pleas to use the toilet.
In 2016 the BBC programme Panorama aired an expose of care home abuse after footage was recorded by three reporters - one posed as a resident, the other two got jobs there. The Panorama undercover filming shows one nurse saying she will give morphine to a resident "to shut her up" - an event described by an independent expert as "horrifying". The care home was immediately closed but the programme exposed the organisational abuse individuals may be subject to by abusive staff.