Safeguarding Adults Services

The "rigorous" implementation of a Care Provider's Care Regime, Practices, Policies and Procedures or Processes that may negatively impact on a persons rights to Independence, Respect, Dignity or Choice

Institutional abuse is the mistreatment of people brought about by poor or inadequate care or support or systematic poor practice that affects the whole care setting.

It occurs when the individual's wishes and needs are sacrificed for the smooth running of a group, service or organisation.

In formal settings institutional abuse is more likely to occur where staff are:

• inadequately trained
• poorly supervised
• not supported by management
• have poor communication skills
• part of a 'closed' culture, for example a care setting where new ideas, visitors, care management or other professional involvement is discouraged
• Institutional abuse can involve more than one abuser and there might also be a number of people experiencing the same abuse e.g. hate crime against particular groups or several family members mistreating a dependent other.
• Failure to respect or support a person or group's right to independence, dignity or choice 
  
• Lack of person centred care planning or a ritualised care routine 
  
• No flexibility in bed times or getting up or deliberately waking someone up 
  
• Inappropriate confinement, restraint or restriction 
  
• Lack of personal clothing or possessions 
  
• Stark living areas, deprived environment or lack of stimulation 
  
• Lack of choice in decoration or other aspects of the environment 
  
• Lack of choice in food or menus or menu planning 
  Unnecessary staff or management involvement in personal finances 
  
• Inappropriate use of nursing or medical procedures, e.g. using un-prescribed medication enemas or catheterization 
  
• Inappropriate use of power or control

Indicators of institutional abuse may include:

• treating adults like children
  
• arbitrary decision making by staff group, service or organisation
  
• strict, regimented or inflexible routines or schedules for daily activities such as meal times, bed / awakening times, bathing / washing, going to the toilet
  
• lack of choice or options for such as food and drink, dress, possessions, daily activities and social activities
  
• lack of privacy, dignity, choice or respect for people as individuals
  
• unsafe or unhygienic environment
  
• lack of provision for dress, diet or religious observance in accordance with an individual's belief or cultural background
  
• withdrawing people from individually valued community or family contact