2.1 Describe signs and symptoms associated with the different types of abuse

Course: NVQ Level 4 Diploma In Health And Social Care (RQF)

Unit 12: Understand safeguarding and protection in health and social care settings

LO2: Understand how to respond to suspected or alleged abuse

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2.1 Describe signs and symptoms associated with the following types of abuse: a. physical abuse, b. sexual abuse, c. emotional/psychological abuse, d. financial abuse, e. institutional abuse, f. self-neglect, g. neglect by others, h. discriminatory abuse

There are many forms of abuse that can commonly go undetected. If you are in a caring role, it is important to be able to recognize the signs of abuse and know how to act on the information gained. Abuse can take many forms, which are explained below. The list below highlights the key signs for each type of abuse.

Physical abuse

Definition: Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse. Physical abuse can include:

  • hitting, punching, slapping, kicking, pushing
  • misuse of medication
  • denying access to appropriate health care
  • restraining inappropriately and suffocation

Signs: Physical abuse often comes in many forms, but there are certain signs that can indicate the possibility of physical abuse taking place:

  • injuries that are inconsistent with the explanation given
  • injuries that are not consistent with the person’s age or activity level
  • unexplained and recurrent injuries
  • intentional and avoidable burns, scalds or other injuries to children (indicating physical abuse by a responsible adult)
  • repeated fractures of different ages in infants and young children, which probably indicate non-accidental injury
  • injuries to genital/anal region (indicating sexual abuse)

Sexual abuse

Definition: An incident, or pattern of incidents, of sexual assault, rape and other forms of non-consensual sexual activity. It can include:

  • Unwanted attention such as unwelcome sexual advances
  • touching and groping
  • sexual comments and jokes about a person’s appearance
  • forced prostitution
  • rape (including marital and date rape) and other forms of sexual violence and abuse
  • indecent exposure
  • indecent photography
  • sexual activity with children and young people under the age of consent – including, for example, consensual sex where one person is under 16 or 17 years old

Signs: There are some obvious signs that may indicate the possibility of sexual abuse taking place. These include:

  • changes in behaviour which can be associated with trauma (for example, becoming withdrawn or aggressive)
  • difficulties communicating or relationships breaking down, particularly during puberty or when attending secondary school (which could be due to contact of a sexual nature with older children)
  • unexplained bleeding, discharge or other genital problems
  • fearfulness around the perpetrator of abuse (for example, avoiding someone)
  • recurrent nightmares of sexual activity or of being chased
  • injuries to buttocks or genital area (which may indicate recent sexual assault)

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Emotional/psychological abuse

Definition: Any incident or pattern of incidents of humiliating, degrading or distressing behaviour. This can include:

  • threatening actions or words that appear to put a person in danger
  • name-calling and insults
  • blaming a child for the abuse experienced by another member of the family

Signs: Some signs that may indicate emotional abuse taking place within your setting include:

  • children who seem frightened, worried or highly anxious when entering an area where they know they will meet certain people
  • children who fail to make friends with peers in daycare, school or other settings
  • children who are reluctant to go home from either nursery or school (and which persists)

Financial abuse

Definition: Financial abuse occurs when money, property or other assets are made unavailable, removed or taken away from someone who has limited access to those resources. This can include:

  • taking control of a person’s financial affairs and/or preventing them from gaining access to their own financial information – for example where there is no support available to assist the person with handling these aspects of daily life
  • making debts go up unnecessarily
  • withdrawing small amounts of cash at regular intervals for longer than could be reasonably required (allowing enough time for a cheque to clear)
  • depriving a vulnerable adult of essential living needs such as food and clothing

Signs: The signs that may indicate financial abuse taking place within your setting include:

  • not having enough money for bills or food
  • expenditure appearing very high
  • missing possession or monies
  • poor living condition
  • not being able to pay for food, fuel, or clothing – where this is not explained by a particular event such as illness, bereavement, etc
  • an extreme change in spending patterns (for example, going from living within one’s means to making sizeable unplanned purchases)

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Institutional abuse

Definition: Institutional abuse occurs where the setting fails to meet the needs of an individual and interferes with their freedom. This can include:

  • where there is no reasonable access to activities, support and information
  • restrictions imposed on someone or their freedom of movement within a particular environment (for example, long periods alone in a room)

Signs: Institutional abuse can be indicated by:

  • situations where people appear to be isolated and left alone for long periods of time
  • lack of access to activities, information and communication
  • people with disabilities living in conditions that do not promote their health and well-being (for example, if they are unable to get out and about)
  • unexplained injuries or accidents (particularly where it is an older person)
  • fire risks (such as fluffing up pillows under the bedclothes at night)


Definition: Self-neglect occurs when people fail to carry out the normal and expected activities of daily living. This can include:

  • not keeping themselves clean or allowing their home environment to become dirty and unhygienic
  • withdrawing from social contact and failing to provide adequate food, clothing and shelter for themselves

Signs: As well as providing a service in relation to self-neglect you will need to think about what support would be needed if you come across someone who is at risk of becoming self-neglecting. Some signs that may indicate self-neglect (or risk of) within your setting include:

  • appearing dishevelled – for example, matted hair, unclean clothes or foul-smelling
  • skin problems due to poor hygiene – for example, scabies, sores or even vermin infestation
  • poorly maintained home environment – for example, animal faeces, cigarette butts or dirty dishes in bedroom or bathroom sink
  • not being able to provide basic needs such as food and clothing

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Neglect by others

Definition: Neglect by others occurs when someone is not able to meet their own needs, which are inadequately met by another person. This can include:

  • someone being left alone for long periods of time, with no one checking on them during that time
  • not having appropriate food or clothing – for example, living in extremely cold weather with inadequate clothing, or being consistently dressed inappropriately (for example, nightwear in the day)

Signs: The signs that may indicate neglect by others within your setting include:

  • ill-fitting clothes – for example, trousers with a waistband that goes right around the body
  • people who look unkempt (for example, long nails with dirty cuticles, matted hair)
  • being left in their wheelchair or bed for prolonged periods of time
  • not receiving regular visits from family, friends or professionals – this is particularly important if they are older people and/or people with disabilities
  • old prescription medication not being used

Discriminatory abuse

Definition: Discriminatory abuse occurs when someone is treated less favourably than others, or singled out for unfair treatment. This can include:

  • harassment – such as verbal and non-verbal (physical contact) behaviour which causes distress, alarm and offence to the recipient who feels that the behaviour is based on certain aspects of their identity
  • victimisation – because someone has made a complaint, raised a grievance or otherwise asserted their rights; because they have acted in a way that would be likely to cause criticism from others within the setting about an aspect of care provision or practice

Signs: The signs that may indicate discriminatory abuse within your setting include:

  • people being spoken to harshly
  • prejudice towards people from particular racial groups, religions or cultures
  • people not receiving emergency medication because of incorrect assumptions about their need for it
  • not allowing people to have visitors or take staff-provided transport on outings
  • misusing health care provision (for example, providing inappropriate treatment) – this is always unacceptable if the patient is somebody under your care but can also occur where someone has made a complaint or raised a grievance that you consider has not been fully resolved within the setting

The signs of abuse are often subtle, and it’s important for family members or support staff members (or both) in your life to come forward with any information they may have about possible victimized so we can all work together towards safety!

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