There follows a number of nationally recognised categories or types of abuse as defined in the Care Act Statutory Guidance It is important to note, however, that many situations may involve a combination of such categories.

After each category definition is a range of indicators which, if present separately or in clusters, may suggest the possibility of some type of abuse. None of them are conclusive that abuse has taken place but should alert to the possibility of abuse. The lists are not exhaustive but are provided to stimulate thought and awareness as to the possible indicators of abuse.


Physical Abuse

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


Sexual Abuse

Including 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 or sexual acts to which the adult has not consented or was pressured into consenting.


Sexual Exploitation

Including rape, prostitution, sexual photography, subjection to pornography or witnessing sexual acts and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting.


Psychological Abuse

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


Financial or Material Abuse

Including 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, or the misuse or misappropriation of property, possessions or benefits.


Domestic Abuse

Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are, or have been, intimate partners or family members regardless of gender or sexuality. This can encompass, but is not limited to, the following types of abuse:

  • Physical;
  • Sexual;
  • Psychological;
  • Financial;
  • Emotional

Controlling behaviour is a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour.

Coercive behaviour is an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim.

The Government definition, which is not a legal definition, includes so called ‘honour’ based violence, female genital mutilation (FGM) and forced marriage, and is clear that victims are not confined to one gender or ethnic group.

It has been widely understood for some time that coercive control is a core part of domestic violence.  As a result, the inclusion of this in the latest definition highlights the importance of recognising coercive control as a complex pattern of overlapping and repeated abuse perpetrated within a context of power and control.

Without the inclusion of coercive control in the definition of domestic violence and abuse, there may be occasions where domestic violence and abuse could be regarded as an isolated incident.  As a result, it may be unclear to victims what counts as domestic violence and abuse – for example, it may be thought to include physical violence only.  We know that the first incident reported to the police or other agencies is rarely the first incident to occur; often people have been subject to violence and abuse on multiple occasions before they seek help.

“Honour based violence is a crime or incident, which has or may have been committed to protect or defend the honour of the family and/or community.” (Crown Prosecution Service/Association of Chief Police Officers). It is a collection of practices, which are used to control behaviour within families or other social groups to protect perceived cultural and religious beliefs and/or honour. Such violence can occur when perpetrators perceive that a relative has shamed the family and/or community by breaking their honour code.

The Anti-Social Behaviour, Crime & Policing Act 2014 makes it a criminal offence to force someone to marry.  A forced marriage is where one or both people do not (or in cases of people with learning disabilities, cannot) consent to the marriage and pressure or abuse is used.  It is recognised in the UK as a form of violence against women and men, domestic/child abuse and a serious abuse of human rights.  A forced marriage differs from an arranged marriage, in which both parties consent to the assistance of their parents or a third party in identifying a spouse.  Forced marriage can be a particular risk for people with learning difficulties and people lacking capacity.

See also Domestic Abuse Statutory Guidance


Female Genital Mutilation

Female Genital Mutilation (FGM) involves all procedures that include the partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons and is a criminal offence.  FGM is an unacceptable practice for which there is no justification.  The practice is medically unnecessary, extremely painful and has serious health consequences, both at the time when the mutilation is carried out and in later life.

The age at which girls undergo FGM varies enormously according to the community. The procedure may be carried out when the girl is newborn, during childhood or adolescence, just before marriage or during the first pregnancy. FGM constitutes a form of child abuse and violence against women and girls and has severe short-term and long-term physical and psychological consequences. In England, Wales and Northern Ireland, the practice is illegal under the Female Genital Mutilation Act 2003.

FGM Mandatory Duty to Report 2015

Section 5B(11) of the FGM Act 2003 (as inserted by section 74 of the Serious Crime Act 2015) introduces a mandatory reporting duty which requires regulated health and social care professionals and teachers in England and Wales to report ‘known’ cases of FGM in under 18s which they identify in the course of their professional work to the police. The duty applied from 31 October 2015 onwards.


Modern Day Slavery and Human Trafficking

Modern slavery is the term used within the UK and is defined within the Modern Slavery Act 2015.  The Act categorises offences of slavery, servitude and forced or compulsory labour and human trafficking.

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.  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.

There are several broad categories of exploitation linked to human trafficking, including:

  • Sexual exploitation; forced labour; domestic servitude; organ harvesting; child-related crimes such as child sexual exploitation, forced begging, illegal drug cultivation, organised theft, related benefit frauds etc; forced marriage and illegal adoption (if other constituent elements are present).

In the first instance the point of contact for all human trafficking and modern slavery crimes should be the local police force.  If you have information about those who are committing such crimes or where victims are at risk that requires an immediate response, dial 999.  If you hold information that could lead to the identification, discovery and recovery of victims in the UK, you can contact the Modern Slavery Helpline 0800 0121 700. Alternatively you can make calls anonymously to Crimestoppers on 0800 555 111.

If you are an employee or volunteer and you suspect that someone is a victim of modern slavery, and they meet the adult safeguarding threshold, safeguarding adults procedures should be followed.

See also:

SSAB Modern Slavery Guidance

Local Authority Adult National Referral Mechanism Pathway 

Police Transformation Unit Modern Day Slavery Poster

Anti-Slavery Partnership Resources

Government information: Modern Day Slavery.


Discriminatory Abuse

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


Organisational Abuse

Including 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. (See Equalities Act 2010).


Neglect and Acts of Omission

Including 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 includes behaviour such as hoarding.

See also Sunderland’s Self-Neglect Guidance document which also includes in the appendix an at a glance ‘Self-Neglect on a page’ guide, as a quick reference for staff who are dealing with a suspected or confirmed self-neglect case.

The Self-Neglect on a page guide is also available as a separate document.

There is also further Self-Neglect resources on the SSAB website:

Self-Neglect 7-Minute Briefing 1-page summary document

Self-Neglect Good Practice Case Example 7-Minute Briefing.

Self-Neglect Resources: 7-Minute Briefings and What to do about Self-Neglect Animation


Multiple Abuse

The following signs are not attributed to a specific category but could nevertheless indicate the possibility of abuse from one or multiple categories previously stated.

  • Difficulty getting access to the individual;
  • Difficulty in interviewing the person alone;
  • Isolation of the individual;
  • Agency hopping;
  • Repeated visits by the person to a General Practitioner or Accident & Emergency Department for no obvious medical reason or where there is no change in medical condition;
  • Reluctance to seek General Practitioner help;
  • Refusal of support by a known or previously trusted carer;
  • One or more agencies reveal concerns.


Hate Crime

Hate crime is defined as any crime that is perceived by the victim, or any other person, to be racist, homophobic, transphobic or due to a person’s religion, belief, gender identity or disability. It should be noted that this definition is based on the perception of the victim or anyone else and is not reliant on evidence.  Hate crime (and anti-social behaviour) can be reported by the public using the Sunderland City Council on-line form:

Professionals can also use this form if they are concerned that an adult at risk of abuse or neglect whom they are supporting/delivering services to is a victim of hate crime, but are strongly recommended to also raise a formal safeguarding adults concern with the Safeguarding Adults Team.


Mate Crime

Mate crime happens when someone is faking a friendship in order to take advantage of a vulnerable person. Mate crime is committed by someone known to the person. They might have known them for a long time or met recently. A ‘mate’ may be a ‘friend’, family member, supporter, paid staff or another person with a disability.


Extremism, Radicalisation and Prevent

‘Extremism’ is defined in the Prevent Strategy (2011) as vocal or active opposition to fundamental British values, including democracy, the rule of law, individual liberty and mutual respect and tolerance of different faiths and beliefs. Also included in this definition are extremism calls for the death of members of British armed forces, whether in this country or overseas.

‘Radicalisation’ is the process where someone has their vulnerabilities or susceptibilities exploited towards crime or terrorism – most often by a third party, who have their own agenda. Being drawn into terrorism includes not just violent extremism but also non-violent extremism, which can create an atmosphere conducive to terrorism and can popularise views which terrorists exploit.

‘Prevent’ is part of the UK’s counter terrorism strategy, preventing people from becoming involved in terrorism or supporting terrorism.

The current UK definition of ‘terrorism’ is given in the Terrorism Act 2000 (TACT 2000). In summary this defines terrorism as an action that endangers or causes serious violence to a person/people; causes serious damage to property; or seriously interferes or disrupts an electronic system. The use or threat must be designed to influence the government or to intimidate the public and is made for the purpose of advancing a political, religious or ideological cause.

If you have a Prevent concern that an adult is at risk of being radicalised, follow the multi-agency safeguarding concern policies and procedures.

See also Sunderland’s Prevent Referral Map

See also:

Statutory Prevent Duty Guidance

Home Office Prevent training catalogue

Virtual College’s Home Office approved Prevention of Extremism & Radicalisation Training


Abuse of Trust – PiPoT (People/Person in a Position of Trust)

A relationship of trust is one in which one person is in a position of power or influence over the other person because of their work or the nature of their activity. There is a particular concern when abuse is caused by the actions or omissions of someone who is in a position of power or authority and who uses their position to the detriment of the health and well-being of a person at risk, who in many cases could be dependent on their care. There is always a power imbalance in a relationship of trust.  This can also be known as reporting alleged abuse by PiPoT (People/Person in a Position of Trust) and should be reported to the Safeguarding Adults Team.

Always consider other adults and children who may be at risk. For further information regarding Safeguarding Children please refer to: