Taking action on safeguarding concerns
As a sibling of a disabled adult you might be worried about the quality of care or support your brother or sister is receiving. Your brother or sister might have directly told you something worrying, or you might have noticed changes in their mood or behaviour. Sometimes these concerns are very serious and you may think there is some level of abuse or neglect.
Abuse or neglect can happen anywhere, and by anyone. It might happen within the family home, at a day service, volunteer centre, workplace or residential home. For siblings, these are very tough issues to face. You might be living a long way from your brother or sister or may suspect that a family member is the one who might be responsible for causing harm. Whatever the situation, it is important that you speak up about your concerns.
What is safeguarding?
“Safeguarding” is a term that is used to mean the protection of people who might have difficulty protecting themselves. This might be a person who needs care and support, as a result of a disability or long-standing illness. Safeguarding is about making sure that everyone can live their lives safely without the risk of abuse or neglect.
What is abuse?
“Abuse” means to treat someone badly. Different types of abuse and possible signs of abuse are described below in more detail.
Types of abuse
This list is not exhaustive – you may come across other types of mistreatment. It’s important to remember that several types of abuse can happen at once. The possible signs of abuse that are listed below are not necessarily hard evidence that abuse is happening, but they are an indication that further investigation needs to take place. If you have concerns – you must talk to someone about them.
Examples: hitting, kicking, smacking, slapping, hair-pulling, pushing, rough handling, scalding or burning, inappropriate use of restraint, misuse of medication (e.g. over-sedation), genital mutilation, forced feeding or deliberate withholding of food, forced confinement or isolation, making someone deliberately physically uncomfortable (e.g. removing jumper and opening a window).
Possible signs of physical abuse: unexplained injuries; injuries that are inconsistent with an account of what happened; injuries that are inconsistent with the person’s lifestyle; injuries not followed up/ignored; frequent changes of GP; changes in weight or appearance; insomnia; changes in behaviour such as becoming withdrawn, anxious or angry; changes in behaviour around a particular person or in particular situations.
Examples: rape, attempted rape, sexual assault, indecent exposure, sexual photography, inappropriate looking or touching, forcing someone to look at pornography or witness sexual acts, sexual teasing, harassment or innuendo, pressuring someone to consent to sexual acts, or carrying out sexual acts when someone cannot consent
Possible signs of sexual abuse: bruising; signs of sexually transmitted infections such as pain, itching, bleeding or discharge; unusual difficulty walking or sitting; new incontinence not related to any medical diagnosis; reluctance or fear of receiving help with personal care; unusual changes in sexual behaviour or attitude; unusual changes in sexually explicit language; insomnia; changes in behaviour such as becoming withdrawn, anxious or angry; changes in behaviour around a particular person or in particular situations.
Example: removing walking stick or frame, removing communication aids, intentionally leaving someone unattended when they need assistance, control, threats, belittling, intimidation, humiliation, over-protection, coercion, harassment, cyber bullying, restricting personal choice or opinion, refusing to respect privacy, deprivation of contact/refusing visitors, verbal abuse, or the use of infantilising language
Possible signs of emotional abuse: low self-esteem and self-depreciating language; tearfulness; changes in weight or appearance; insomnia; changes in behaviour such as becoming withdrawn, anxious or angry; changes in behaviour around a particular person or in particular situations.
Financial and material abuse
Examples: not allowing someone access to their own money or possessions, using their money or possessions for the wrong purposes (e.g. unauthorised use of a car; moving into someone’s home without agreement), pressuring someone into spending their money in a certain way (e.g. take out a loan, sign a will, hand over inheritance), fraud, scamming (e.g. telephone, online, on the doorstep), rogue traders.
Possible signs of financial and material abuse: signs of unpaid bills, credit card debt, insufficient food in the house, repeated and unnecessary repairs on a house; personal possessions missing; unexplained lack of money; unexplained withdrawals from bank account; person managing the affairs fails to provide receipts or evidence of spending and/or is evasive when discussing finances.
Examples: not providing or allowing access to food, heating, clothing, appropriate housing, personal care, medical care, social life and stimulating activity. Not appropriately maintaining any of these needs.
Possible signs of neglect: changes in weight; untreated injuries or health conditions; inadequate clothing (for example, no coat in winter); pressure sores; poorly maintained environment; poor personal hygiene.
This is a lack of self-care so extreme that it affects personal health and safety. Examples of self-neglect include hoarding, not maintaining living space, ignoring health needs such as having appropriate food and heating, not attending to personal hygiene, not accessing appropriate medical care when needed.
Possible signs of self-neglect: living in dirty conditions, neglecting house hold maintenance, very poor personal hygiene, lack of appropriate food, heating and clothing, hoarding.
Please note: Self-neglect is specifically recognised as a type of abuse in England and Scotland. In Wales and Northern Ireland, it is likely that self-neglect would be reviewed on a case-by-case basis.
Examples: exploitation, human trafficking, forced labour, debt bondage – being coerced into debt then ‘working’ to repay that when they will never realistically be able to, forced domestic servitude.
Possible signs of modern slavery: living in overcrowded and unkempt conditions; isolation and lack of contact with community; appearing malnourished or withdrawn; unkempt clothing and poor personal hygiene; always accompanied by another person they seem fearful of; lack of personal documents or identification; fear of authorities and unwillingness to disclose information.
This is any type of abuse which happens within an intimate personal relationship or family setting. Domestic abuse often includes control, coercion and threatening behaviour. Forced marriage is a type of domestic abuse where a person is pressured, coerced or forced to marry, or they don’t have the capacity to consent to marry. Forced marriage is a crime in the UK.
This is any type of abuse that is carried out on the basis or perceived basis of a particular characteristic, such as age, gender, disability, religion, sexual orientation, race.
This is any type of abuse and repeated poor practice that happens within an organisation.
It is also important to be aware of radicalisation. This is the process of an individual adopting extreme views, whether religious, political or social. This can result in a person carrying out acts of terrorism. Individuals may be targeted by extremist groups, and groomed and recruited over a period of time. The government has released guidance (‘Prevent Duty’) for authorities in England, Wales and Scotland on preventing radicalisation and countering terrorism. There is no equivalent guidance in Northern Ireland.
What should I do if I think my disabled brother or sister is being abused?
If your brother or sister is in immediate danger report this to the police straight away.
If there is no immediate danger we recommend that you take the following actions:
- Keep notes about the date and time of any incidents, who was involved and where it happened. Take photos if relevant and make copies of any useful documents such as care plans.
- Keep a record too of your brother or sister’s moods and behaviour – they may show specific reactions to a member of staff for example, or there may be a change in behaviour over a period of time that may have worried you.
- This may help you build a case if you need to and also firm up your evidence if you are worried about whether your concerns are real or not.
Report to the local authority
- If there is no immediate danger, then you should report your concerns to the local authority in which your brother or sister lives.
- In England and Wales each local authority has an Adult Safeguarding Team that investigates these issues.
- In Northern Ireland you should contact the Adult Protection Gateway Service based in your local Health and Social Care Trust.
- In Scotland you should contact the Adult Protection or Care team in your local council. For more information visit Act Against Harm.
- If your brother or sister has a social worker or other key professional such as a residential service manager or learning disability nurse, you can raise the concerns this way too. It is the responsibility of all staff working with disabled people to recognise concerns and report poor practice or safeguarding issues.
Making a formal complaint
- If the response you receive after raising your concern is unsatisfactory or if you feel it hasn’t been taken seriously, you can raise it as a formal complaint. Each local authority and service has a formal complaints procedure which they should have in writing or on their website which you can follow.
- Read our guide on making a complaint What to do if your disabled brother or sister doesn’t receive the care that they should
Taking legal action
- In most cases issues can be resolved through taking issues directly to service providers within the local authority or getting their support to change a situation for your brother or sister. However, there are some situations where the abuse or neglect may be so serious that it has caused serious injury, trauma or in rare cases, the death of a disabled person. In these situations more legal expertise needs to be sought.
- You can contact a solicitor for more advice. There are some lawyers who specialise in human rights law or community care law for example who can guide you through the process.
- Remember there may be time restrictions in taking a case to court, so if a case is serious you may want to get legal advice as soon as possible.
Getting further information and advice
You can get further information and advice from the following organisations:
- Ann Craft Trust supports organisations to protect adults at risk and can advise family members on taking safeguarding action
- The Challenging Behaviour Foundation supports families of people with severe learning disabilities who display challenging behaviour and can advise on issues about inappropriate restraint or restrictive practices
- Inquest investigates the deaths of vulnerable people in state care (in England and Wales), including those of people with a learning disability or autism in NHS run institutions
- The Forced Marriage Unit has a helpline (020 7008 0151) to provide advice and support for relatives of people who are victims of forced marriages
- The Modern Slavery Helpline offer advice and support on modern slavery 24 hours a day, 7 days a week on 08000 121 700
Helping your brother or sister
If your brother or sister has experienced neglect or abuse, they may need some expert help and support to overcome the trauma and stress they have experienced. Seeing your brother or sister receive this support may help you too.
- Your brother or sister’s GP may be able to refer them for counselling or they may be able to self-refer depending on what is available in their area
- If your brother or sister has a learning disability or mental health team they may be able to suggest a service they could be referred to or if necessary, bring in some expert therapeutic support from outside the area
- The charity Respond supports adults with learning disabilities and/or autism who have experienced abuse or trauma
My brother was abused by a member of staff in the residential service he lives in. Luckily he is verbal and was able to report the abuse and it was taken very seriously by the management of the home. The member of staff was removed and appropriate action was taken. But what was hard for me was the aftermath, my brother was just so angry and upset. He has a learning disability and just couldn’t understand why this had happened to him. Working with the staff where he lives, we managed to find some counselling from a service in another county. He also went on a body awareness course for people with learning disabilities. This really helped to improve his confidence and helped him slowly to move on from what had happened. Karen, adult sibling
Support for you
As a sibling you may be a key support for your brother or sister through this very difficult time and it is important that you look after yourself too. You may need to talk to other adult siblings or someone at Sibs about your experiences. You may need to see a counsellor in your own right to help you cope with what has happened.