The Care and support statutory guidance identifies ten types of abuse. These are:

Physical abuse
Domestic violence or abuse
Sexual abuse
Psychological or emotional abuse
Financial or material abuse
Modern slavery
Discriminatory abuse
Organisational or institutional abuse
Neglect or acts of omission
Self-neglect

[Please click on the link to the source of this definition above (https://www.scie.org.uk/safeguarding/adults/introduction/types-and-indicators-of-abuse) for full definitions and indicators of each type of abuse. Alternatively this information is available in the glossary definition of each category.]

The Mental Capacity Act (MCA) provides a non-exhaustive checklist of factors that decision-makers must work through in deciding what is in a person's best interests. Some of the factors to take into consideration are:

- Do not discriminate. Do not make assumptions about someone's best interests merely on the basis of the person's age or appearance, condition or any aspect their behaviour.
- Take into account all relevant circumstances
- If faced with a particularly difficult or contentious decision, it is recommended that practitioners adopt a 'balance sheet' approach
- Will the person regain capacity? If so, can the decision wait?
- Involve the individual as fully as possible
- Take into account the individual's past and present wishes and feelings, and any beliefs and values likely to have a bearing on the decision
- Consult as far and as widely as possible.

Again, it is vital that you record your best interests decision. Not only is this good professional practice, but given the evidence-based approach required by the MCA, you will have an objective record should your decision or decision-making processes later be challenged.

For more detailed information you should refer to the Mental Capacity Act Code of Practice.

Eligibility to be a best interests assessor is described in the DoLS Regulations.

Best interests assessors are the lynchpin on which the entire edifice of DoLS rests, and they have a range of duties that fall to them within the operation of the Safeguards.

Best interests assessors are often the main assessors though a mental health assessor may also assess capacity. They are responsible for ascertaining that the person is 18 or older (the age assessment, now generally incorporated as part of the best interests assessment). They are solely responsible for assessing whether there are any lawful decision-makers who object to what is proposed (the ‘no refusals’ assessment). If qualified also as Approved Mental Health Professionals under the Mental Health Act 1983 (as amended), they are able to carry out the eligibility assessment, to decide whether this person’s rights should be protected by the use of the MHA or the MCA, via the Safeguards.

Most significantly, they must carry out two vital tasks: they are responsible for deciding whether a restrictive situation is authorised by Sections 5 and 6 of the MCA, or whether it amounts to a deprivation of the person’s liberty. If they conclude, given all evidence and scrutiny of the concrete situation of the person, and in the light of current case law, that the person is deprived of their liberty, they must assess holistically whether the restrictions are in the person’s best interests, and proportionate to the risk and seriousness of harm to that person without the proposed restrictions. They must keep abreast of developments in case law to carry out these tasks correctly.

It is the role of the best interests assessor to:

- suggest any conditions that might reduce the need for ongoing deprivation of liberty, or lessen the impact of the deprivation on the relevant person
- frame any conditions so that they apply to such matters that the managing authority can control (rather than general care planning)
- discuss any conditions in advance of setting them with the managing authority, to ensure that the managing authority can comply
- suggest a maximum length for which authorisation can be granted – this can be for up to a year, although many supervisory bodies are reluctant to authorise for such a long period (however, an authoriser can shorten the period from that suggested by the best interests assessor, but cannot lengthen it).

"Care and support" is the term used to describe the help some individuals need to live as well as possible with an impairment, illness or disability.

Care and support options should not see an individual as a passive recipient of a service, but an active participant of the development of care and support based on the outcomes that matter to them and within the context of their individual skills, ambitions and priorities.

Care and support is not a service delivered to an individual but a network of support which seeks to actively promote individual wellbeing and independence and does not wait to respond until an individual has reached crisis point.

Care and support is not something which is facilitated by the local authority alone but incorporates opportunities from other sources such as the individual themselves, friends and families, the local community and social networks, universal services, private and voluntary organisations.

Each of the following functions under the Care Act 2014 describes the help which individuals can expect from the local authority to enable them to live as well as possible with an impairment, illness or disability.

- Promoting individual wellbeing [Care Act, Section 1]
- Providing information and advice [Section 4]
- Preventing needs for care and support [Section 2]
- Promoting integration of care and support with health services etc. [Section 3]
- Promoting diversity and quality in provision of services [Section 5]
- Co-operating [Sections 6-7]
- Assessing needs [Sections 9-13]
- Care and support planning [Section 25]
- Personal budgets [Section 26]
- Direct payments [Sections 31-33]
- Transition for children to adult care and support [Sections 58-66]
- Independent advocacy [Sections 67-68]
- Discharge of hospital patients with care and support needs [Section 74]
- After-care under the Mental Health Act 1983 [Section 75]
- Prisoners and persons in approved premises [Section 76]
- Safeguarding adults at risk of abuse or neglect [Sections 42-47]

A collection of resources that define what the digital capabilities are, while providing examples and tools to help social workers be confident using digital technology and data to support their increasingly complex role.

Types of discriminatory abuse

- Unequal treatment based on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex or sexual orientation (known as 'protected characteristics' under the Equality Act 2010)
- Verbal abuse, derogatory remarks or inappropriate use of language related to a protected characteristic Denying access to communication aids, not allowing access to an interpreter, signer or lip-reader Harassment or deliberate exclusion on the grounds of a protected characteristic
- Denying basic rights to healthcare, education, employment and criminal justice relating to a protected characteristic
- Substandard service provision relating to a protected characteristic

Types of domestic violence or abuse

Domestic violence or abuse can be characterised by any of the indicators of abuse outlined in this briefing relating to:
psychological
physical
sexual
financial
emotional.

Eligibility outcomes for adults with care and support needs - Managing and maintaining nutrition - Maintaining personal hygiene - Managing toilet needs - Being appropriately clothed - Being able to make use of the home safely - Maintaining a habitable home environment - Developing and maintaining family or other personal relationships - Accessing and engaging in work, training, education or volunteering - Making use of necessary facilities or services in the local community, including public transport, and recreational facilities or services - Carrying out any caring responsibilities the adult has for a child. Eligibility outcomes for carers with support needs: - Carrying out any caring responsibilities the carer has for a child - Providing care to other persons for whom the carer provides care - Maintaining a habitable home environment in the carer's home, whether or not this is also the home of the adult needing care - Managing and maintaining nutrition - Developing and maintaining family or other personal relationships - Engaging in work, training, education or volunteering - Making use of necessary facilities or services in the local community, including recreational facilities or services - Engaging in recreational activities.

Types of psychological or emotional abuse

Enforced social isolation - preventing someone accessing services, educational and social opportunities and seeing friends
Removing mobility or communication aids or intentionally leaving someone unattended when they need assistance
Preventing someone from meeting their religious and cultural needs
Preventing the expression of choice and opinion
Failure to respect privacy
Preventing stimulation, meaningful occupation or activities
Intimidation, coercion, harassment, use of threats, humiliation, bullying, swearing or verbal abuse
Addressing a person in a patronising or infantilising way
Threats of harm or abandonment
Cyber bullying

Types of financial or material abuse

Theft of money or possessions
Fraud, scamming
Preventing a person from accessing their own money, benefits or assets
Employees taking a loan from a person using the service
Undue pressure, duress, threat or undue influence put on the person in connection with loans, wills, property, inheritance or financial transactions
Arranging less care than is needed to save money to maximise inheritance
Denying assistance to manage/monitor financial affairs
Denying assistance to access benefits
Misuse of personal allowance in a care home
Misuse of benefits or direct payments in a family home
Someone moving into a person's home and living rent free without agreement or under duress
False representation, using another person's bank account, cards or documents
Exploitation of a person's money or assets, e.g. unauthorised use of a car
Misuse of a power of attorney, deputy, appointeeship or other legal authority
Rogue trading - e.g. unnecessary or overpriced property repairs and failure to carry out agreed repairs or poor workmanship

The Mental Capacity Act 2005 introduced the role of the independent mental capacity advocate (IMCA).

IMCAs are a legal safeguard for people who lack the capacity to make specific important decisions: including making decisions about where they live and about serious medical treatment options. IMCAs are mainly instructed to represent people where there is no one independent of services, such as a family member or friend, who is able to represent the person.

Types of organisational or institutional abuse:
Discouraging visits or the involvement of relatives or friends
Run-down or overcrowded establishment
Authoritarian management or rigid regimes
Lack of leadership and supervision
Insufficient staff or high turnover resulting in poor quality care
Abusive and disrespectful attitudes towards people using the service
Inappropriate use of restraints
Lack of respect for dignity and privacy
Failure to manage residents with abusive behaviour
Not providing adequate food and drink, or assistance with eating
Not offering choice or promoting independence
Misuse of medication
Failure to provide care with dentures, spectacles or hearing aids
Not taking account of individuals' cultural, religious or ethnic needs
Failure to respond to abuse appropriately
Interference with personal correspondence or communication
Failure to respond to complaints

Types of financial or material abuse

Theft of money or possessions
Fraud, scamming
Preventing a person from accessing their own money, benefits or assets
Employees taking a loan from a person using the service
Undue pressure, duress, threat or undue influence put on the person in connection with loans, wills, property, inheritance or financial transactions
Arranging less care than is needed to save money to maximise inheritance
Denying assistance to manage/monitor financial affairs
Denying assistance to access benefits
Misuse of personal allowance in a care home
Misuse of benefits or direct payments in a family home
Someone moving into a person's home and living rent free without agreement or under duress
False representation, using another person's bank account, cards or documents
Exploitation of a person's money or assets, e.g. unauthorised use of a car
Misuse of a power of attorney, deputy, appointeeship or other legal authority
Rogue trading - e.g. unnecessary or overpriced property repairs and failure to carry out agreed repairs or poor workmanship

The Deprivation of Liberty Safeguards (DoLS) can only apply to people who are in a care home or hospital. This includes where there are plans to move a person to a care home or hospital where they may be deprived of their liberty. The care home or hospital is called the managing authority in the DoLS.

The MCA (Mental Capacity Act) Directory has been developed to provide a single space for the sharing of useful information and tools to aid the implementation of the Mental Capacity Act and Deprivation of Liberty Safeguards. Here you will find publications, videos, and academic research that professionals across Health and Social Care may find useful in their day to day practice.

Types of modern slavery:

Human trafficking
Forced labour
Domestic servitude
Sexual exploitation, such as escort work, prostitution and pornography
Debt bondage - being forced to work to pay off debts that realistically they never will be able to

Types of neglect and acts of omission:

Failure to provide or allow access to food, shelter, clothing, heating, stimulation and activity, personal or medical care
Providing care in a way that the person dislikes
Failure to administer medication as prescribed
Refusal of access to visitors
Not taking account of individuals' cultural, religious or ethnic needs
Not taking account of educational, social and recreational needs
Ignoring or isolating the person
Preventing the person from making their own decisions
Preventing access to glasses, hearing aids, dentures, etc.
Failure to ensure privacy and dignity

Types of organisational or institutional abuse:

Discouraging visits or the involvement of relatives or friends
Run-down or overcrowded establishment
Authoritarian management or rigid regimes
Lack of leadership and supervision
Insufficient staff or high turnover resulting in poor quality care
Abusive and disrespectful attitudes towards people using the service
Inappropriate use of restraints
Lack of respect for dignity and privacy
Failure to manage residents with abusive behaviour
Not providing adequate food and drink, or assistance with eating
Not offering choice or promoting independence
Misuse of medication
Failure to provide care with dentures, spectacles or hearing aids
Not taking account of individuals' cultural, religious or ethnic needs
Failure to respond to abuse appropriately
Interference with personal correspondence or communication
Failure to respond to complaints

Types of physical abuse

Assault, hitting, slapping, punching, kicking, hair-pulling, biting, pushing
Rough handling
Scalding and burning
Physical punishments
Inappropriate or unlawful use of restraint
Making someone purposefully uncomfortable (e.g. opening a window and removing blankets)
Involuntary isolation or confinement
Misuse of medication (e.g. over-sedation)
Forcible feeding or withholding food
Unauthorised restraint, restricting movement (e.g. tying someone to a chair)

Types of psychological or emotional abuse

Enforced social isolation - preventing someone accessing services, educational and social opportunities and seeing friends
Removing mobility or communication aids or intentionally leaving someone unattended when they need assistance
Preventing someone from meeting their religious and cultural needs
Preventing the expression of choice and opinion
Failure to respect privacy
Preventing stimulation, meaningful occupation or activities
Intimidation, coercion, harassment, use of threats, humiliation, bullying, swearing or verbal abuse
Addressing a person in a patronising or infantilising way
Threats of harm or abandonment
Cyber bullying

The Care and support statutory guidance identifies ten types of abuse. These are:

Physical abuse
Domestic violence or abuse
Sexual abuse
Psychological or emotional abuse
Financial or material abuse
Modern slavery
Discriminatory abuse
Organisational or institutional abuse
Neglect or acts of omission
Self-neglect

[Please click on the link to the source of this definition above (https://www.scie.org.uk/safeguarding/adults/introduction/types-and-indicators-of-abuse) for full definitions and indicators of each type of abuse. Alternatively this information is available in the glossary definition of each category.]

Types of self-neglect:

Lack of self-care to an extent that it threatens personal health and safety
Neglecting to care for one's personal hygiene, health or surroundings
Inability to avoid self-harm
Failure to seek help or access services to meet health and social care needs
Inability or unwillingness to manage one's personal affairs

Types of sexual abuse

Rape, attempted rape or sexual assault
Inappropriate touch anywhere
Non-consensual masturbation of either or both persons
Non-consensual sexual penetration or attempted penetration of the vagina, anus or mouth
Any sexual activity that the person lacks the capacity to consent to
Inappropriate looking, sexual teasing or innuendo or sexual harassment
Sexual photography or forced use of pornography or witnessing of sexual acts
Indecent exposure

A given situation could have a 'significant impact' on one individual but not on another. Therefore, professional judgement and analysis of the information gathered in the assessment are crucial to establishing whether there is indeed 'significant impact' on the individual's wellbeing. The following are examples of what 'significant impact' could mean: - Significant impact could be a consequence of a single effect: this means that the inability to achieve two or more outcomes affects at least one of the areas of wellbeing in a significant way. - Significant impact could be a consequence of a cumulative effect: this means that the individual may have needs across several of the eligibility outcomes, perhaps at a relatively low level, but as these needs affect the individual in various areas of their life, the overall impact on the individual is significant. - Significant impact could be a consequence of a domino effect: this means that currently the individual may have needs in relation to few eligibility outcomes, but it can be anticipated that in the near future other outcomes will be affected, causing a significant impact on the individual's wellbeing.

This guide summarises the process and the key elements to consider in relation to using a strengths-based approach. It should be read in conjunction with the Care and Support (Assessment) Regulations 2014 and Chapter 6 of the statutory guidance.

Prevention services based on a strengths-based approach support an individual’s independence, resilience, ability to make choices and wellbeing.

This guide will be updated and links to further good practice will be added when available.

The Deprivation of Liberty Safeguards (DoLS) can only apply to people who are in a care home or hospital. This includes where there are plans to move a person to a care home or hospital where they may be deprived of their liberty. The care home or hospital is called the managing authority in the DoLS. Where a managing authority thinks it needs to deprive someone of their liberty they have to ask for this to be authorised by a supervisory body. They can do this up to 28 days in advance of when they plan to deprive the person of their liberty.

For care homes and hospitals the supervisory body is the local authority where the person is ordinarily resident. Usually this will be the local authority where the care home is located unless the person is funded by a different local authority.

The '3 conversations' model is an innovative approach to needs assessment and care planning. It focuses primarily on people's strengths and community assets. It supports frontline professionals to have three distinct and specific conversations.

The first conversation is designed to explore people's needs and connect them to personal, family and community sources of support that may be available.

The second, client-led, conversation seeks to assess levels of risk and any crisis contingencies that may be needed, and how to address these.

The third and final conversation focuses on long-term outcomes and planning, built around what a good life looks like to the user, and how best to mobilise the resources needed (including personal budgets), and the personal and community assets available.

For further information, visit the Partners 4 Change website.

A person may need to be deprived of their liberty before the supervisory body can respond to a request for a standard authorisation. In these situations the managing authority can use an urgent authorisation. Urgent authorisations are granted by the managing authority itself. There is a form that they have to complete and send to the supervisory body.

The managing authority can deprive a person of their liberty for up to seven days using an urgent authorisation. It can only be extended (for up to a further seven days) if the supervisory body agrees to a request made by the managing authority to do this.

When using an urgent authorisation the managing authority must also make a request for a standard authorisation. The managing authority must have a reasonable belief that a standard authorisation would be granted if using an urgent authorisation.

Before granting an urgent authorisation, the managing authority should try to speak to the family, friends and carers of the person. Their knowledge of the person could mean that deprivation of liberty can be avoided. The managing authority should make a record of their efforts to consult others.