What is harm?

Abuse, harm or neglect may be a single or repeated act that causes pain or distress, or it could be a failure to meet your needs or protect you.

There are many different types of harm, including:

  • financial – for example, someone taking your money or valuables without your permission, or pressuring you to change your will or to spend your money in a way you don’t want to
  • physical – hitting or slapping you, not giving you the right medication, restraining you in an inappropriate way, making a room too hot or cold
  • psychological – calling you names, threatening you, humiliating, blaming or controlling you
  • organisational or institutional – a lack of leadership, not enough staff or inadequate care in a hospital or care home
  • discriminatory – unequal treatment because of your age, disability, gender, sexuality, race or religion. It could involve verbal abuse, excluding you or denying you access to support
  • sexual – touching or looking at you inappropriately, assaulting you or making you undress or look at sexual images
  • neglect – when a carer fails to meet your basic needs so you are hungry, cold or in pain
  • self-neglect – when you’re not able to care for your personal hygiene or home to the point that it puts your health and safety at risk.

People responsible for harm are often taking advantage of a special relationship. They could be a friend or family member or a paid care worker. Sometimes harm or neglect happen because the person doesn’t have the right skills for looking after you. Whatever the situation, it is never acceptable. You don’t have to put up with it and it isn’t your fault.

Who is at risk?

Anyone can be at risk of harm. It is no reflection on your intelligence, strength or worth. It can happen anywhere – at home, in a hospital or care home, or a public place.

Some people may be more vulnerable, for example if you:

  • are isolated and have little contact with family or friends
  • have memory problems or difficulty communicating
  • have a disability
  • have mental health issues
  • misuse drugs or alcohol or have a carer who misuses them.

Sometimes the person at risk may be a care worker. Carers can also be at greater risk of harm.

How to get help

If you are experiencing any form of abuse or harm, it's important to speak out to stop it. This may feel difficult but it's the best way to start getting help and support. You could start by talking to your family or friends you trust or speaking to your GP, social worker or local social services.

Many councils have a dedicated team for reporting concerns about abuse, harm or neglect. This might be called a safeguarding team. You can also contact your local council’s adult social care team.

For confidential advice on reporting harm, contact the Hourglass helpline on 0808 808 8141. You can also call our Helpline and arrange to speak to an adviser.

Domestic abuse

Domestic abuse is when someone you live with – a partner, relative or carer – is controlling, threatening or violent.

If you're experiencing domestic abuse, you can get support from the National Domestic Violence Freephone Helpline (in Scotland, contact Scotland’s Domestic Abuse and Forced Marriage Helpline), the Men's Advice Line or the National LGBT+ Domestic Abuse Helpline. If you’re deaf, Signhealth provides help and services in British Sign Language.

Women's Aid also has a directory of local services.

If you think a crime has been committed, you can report it to your local police by calling 101.

If you have been physically hurt or are in an emergency, call 999 for the police or an ambulance.

Ask for ANI codeword scheme

If you’re experiencing domestic abuse and need immediate help, you can ‘ask for ANI’ – pronounced Annie, like the name – in some pharmacies. ANI stands for Action Needed Immediately. Pharmacies that are taking part will display Ask for ANI posters.

The pharmacy will offer you a private space and a phone. They’ll ask if you need support from the police or other domestic abuse support services.

What happens next?

If you report abuse, harm or neglect to your adult social care team, a social worker will work with you to discuss ways to resolve the situation. What happens next depends on:

  • whether you're in danger
  • what you want to happen
  • how much support you need.

If you are still at risk of harm they will start a safeguarding enquiry, which could be a conversation or a more formal course of action involving other agencies.

Your wishes should be taken into account at all stages. If you need help to express your views, you may be able to get support from an independent advocate. In certain situations, you're legally entitled to an advocate.

If the enquiry decides that it's necessary, the adult social care team should put a plan of action in place, stating:

  • how you will be kept safe in future
  • any support, treatment or help you will be given
  • any changes needed to the care you receive
  • any action to be taken against the person who hurt you
  • how you will be supported if you take action to seek justice.

If a crime has been committed or in more serious cases, the police may be involved.

How to stay safe

If you’re worried about being harmed, there are things you can do to reduce the risk.

  • Stay in touch with your friends and neighbours if you can. The more people you’re in contact with, the better. 
  • Go for regular check-ups. You can talk to your GP if you have any concerns. Don’t be afraid to tell your GP – or any other medical professional – if you’re being harmed or neglected. 
  • If you’re finding it difficult to manage in your daily life, ask your council for a free care needs assessment.
  • If you’re caring for someone else and you’re not getting any practical or emotional support, you may both be at risk of harm. Contact carers’ support groups and advice services for help. Our guide Caring for someone has more information about the support available.
  • If there’s a problem with your care services, tell the agency, or the council if they arranged the care. Our factsheet Getting care services at home has more information.

If you’re employing a care worker yourself, ask them for references from previous employers and make sure they’ve had a Disclosure and Barring Service (DBS) check(Disclosure Scotland check in Scotland). This checks to see if they have a criminal record or if there were any other concerns in the past. You can find useful resources to help you employ a care worker on the Carers Trust website.

You may be relying on someone else to do shopping for you or to collect your benefits for example. Ask more than one person to support you if possible, for added protection.  You could also talk to your bank for advice on managing your money.

  • Don’t give anyone your PIN or passwords.
  • If someone is helping you with your shopping, ask for receipts.
  • Keep records and check your statements.
  • Set up direct debits for your bills.
  • Be aware of common scams. See our Scamwise guide for more information. 

If someone is putting pressure on you to change your will, seek legal advice. You might be able to get free initial legal advice through a Law Works legal advice clinic. You can find a solicitor through the Law Society(or Law Society of Scotland in Scotland).

Planning ahead

It’s important to know that someone you trust will make decisions on your behalf if there comes a time when you are unable to do so.

You could set up a lasting power of attorney (LPA), which is a legal document that gives someone you trust the right to make decisions about your money and property and/or your health and welfare. In Scotland, powers of attorney work in the same way but are known by different names.

You must be able to trust your attorney completely. Don’t set up an LPA if you feel under pressure to do so. If someone has forced you to make them an attorney, you can report this to the Office of the Public Guardian (in Scotland, contact the Office of the Public Guardian in Scotland).

You can also set up an advance decision (advance directive in Scotland), which is a way to refuse certain types of treatment or care if there comes a time when you lose mental capacity. It is legally binding and must be followed by the healthcare professionals who are looking after you, unless your circumstances change and the advance decision no longer applies.

If you lose mental capacity and there is no LPA in place, the Court of Protection can appoint a deputy. Deputies are usually relatives or friends but may also be someone like a solicitor or even the local council. Applying to be a deputy is more expensive than setting up an LPA but may offer more protection. In Scotland, this role is called a guardian and is appointed by the sheriff court.

Our guidePlanning for the end of life and our factsheet Managing my affairs if I become ill have more information about setting up an LPA and making an advance decision or advance statement.

Next steps

You will find contact details for your local council on gov.uk/find-your-local-council.

For confidential advice on reporting abuse, harm or neglect, contact Hourglass.

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