Families and carers of adults

The Carers (Scotland) Act 2016 came into effect on 1 April 2018 to ensure better and more consistent support for carers so that they can continue to care, if they wish, in better health and to have a life alongside caring.

North Lanarkshire Carers Together and Lanarkshire Carers are agencies who may be able to offer advice and support.

The Adult Support and Protection (Scotland) Act 2007 is a piece of law which aims to protect adults from being harmed. This is because some people may find it more difficult to stop harm from happening to them. The Act calls people in this situation ‘adults at risk’.

The Act defines adults at risk as people aged 16 years or over who:
* are unable to safeguard themselves, their property (their home, the things they own), their rights or other interests;

* are at risk of harm; and

* because they are affected by a disability, mental disorder, illness or physical or mental infirmity, are more vulnerable to being harmed than others who are not so affected.

All three criteria need to be met for someone to be supported under Adult Support and Protection

Harm can take a wide range of forms. It can be intentional – often called abuse. However, harm is often unintentional – and can happen through accident, lack of knowledge, skill or understanding.

Harm can be caused through what is done, or not done- for example where care and support are not provided when they are needed, it can cause harm.

Physical harm

Physical harm occurs when a harmer intentionally or recklessly causes the victim to believe he or she is about to be subjected to violence or is subjected to physical actions that result in distress or injury regardless of the degree of the consequences. Examples include:

• Physical assault e.g. punching, pushing slapping, mishandling, tying down, giving food or medication forcibly or covertly.
• Use of medication other than as prescribed.
• Inappropriate restraint e.g. using bed sides to prevent someone getting out of bed or locking doors to keep people in.

Possible signs:

• unexplained or unusual injuries
• a delay in seeking treatment for injuries or illness
• a sudden increase in confusion
• unexplained deterioration of health or appearance

Psychological & Emotional Harm

Emotional or Psychological harm is caused when conduct leads to fear, loss of self-esteem, loss of dignity, humiliation, feelings of shame, isolation or impotence. This results in mental distress for the adult. Examples include:
• Swearing, shouting, bullying, humiliating.
• Playing on known anxieties
• Manipulation or the prevention of the use of services or facilities, which would aid or enhance life experience.
• Isolation or sensory deprivation.

Possible signs:

• people being anxious or afraid
• misuse of medication, that is, not giving medicines properly
• unexplained changes of behaviour, becoming anxious or withdrawn, fear of another person
• pressure by family or professionals to have someone moved into, or taken out of, care
• hostile or unkind behaviour by a person

Financial harm

Financial harm is caused by the illegal or improper use of the individual’s resources (both financial and property) by another person without their informed consent or through the exercise of undue influence or pressure. Family members, neighbours or acquaintances can sometimes carry out such exploitation, but it can also be done by paid or unpaid carers or volunteers. Examples include:

• Theft or fraud.
• Misuse of money, property or resources e.g. spending an adult at risk’s benefit without their agreement or buying inappropriate goods from which the adult will not benefit
• The removal of objects or items that mean something to the adult. These objects or items can have emotional, monetary, and practical value.

Possible signs:

• unexplained debt, not paying bills for services
• another person using the adult’s possessions, bank account or property without his or her informed consent

Neglect

Neglect entails the failure of responsible individuals to meet the physical, psychological, emotional, and social needs of an individual either intentionally or through omission leading to deterioration in their condition in one or more areas of their wellbeing. Neglect may arise from individual actions or omissions or result from systemic failures in provision by the responsible agency. Examples include:

• Denial of or lack of food, sleep, clothing.
  • Failure to provide for warmth, shelter, medical treatment.
  • Failure to provide for psychological wellbeing.
  • Denial of medication.
  • Failure to respect differences and resulting needs

Possible signs:

• not having their basic needs met, such as adequate food or heating
• not being provided with adequate information about their rights or entitlements, or being misinformed
• the adult at risk not receiving appropriate care, which would protect them from harm

Sexual harm

Sexual harm and abuse occur when a harmer engages in physical acts of penetrative or non-penetrative contact sexual activity or non-physical sexual activity involving visual or auditory exposure to sexually explicit material with a victim who is unable to consent to or refuse such activity. Examples include:
• Rape, indecent assault e.g. inappropriate touching.
• Acts of gross indecency.
• Forcing an adult to observe indecent images or footage.

Possible signs:

• prejudicial actions or remarks to the adult at risk about age, gender, disability, race, colour, sexual or religious orientation
• unexplained changes of behaviour, becoming anxious or withdrawn, fear of another person.

Self-harm

Self-harm is when the individual intentionally damages or injures their body. It’s usually a way of coping with or expressing overwhelming emotional distress. Examples include:
• cutting or burning one’s own skin
• punching or hitting oneself
• poisoning oneself with tablets or liquids, or similar
• Inserting objects into one’s body

Possible signs:

• changes in mood
• being secretive
• avoiding situations where you have to expose your arms or legs
• strange excuses for injuries
• withdrawing from usual activities

Self-neglect

Self-neglect entails the failure of the individual to meet his or her own personal, physical and health needs leading to deterioration in their condition. Self-neglect may arise due to a range of motivational or mental health conditions or a combination of both. Examples include:
• Failure to care for one’s health needs, such as not looking after one’s skin, teeth, feet etc.
• Failing to take prescribed medication
• Failing to recognise or limit behaviour which is putting oneself at risk, such as associating with people exploiting vulnerable adults or indulging in highly risky behaviours
• Failure to care for one’s belongings, such as clothing and property

Possible signs:

• Neglected physical appearance and health
• Social Isolation
• Neglected Living Conditions
• Not feeling able to accept services or support

Hoarding

Self-neglect and Hoarding can often be looked at under the same umbrella term. However, it is important to consider Hoarding as a separate concern and harm type. People who hoard may not be considered self-neglecting and vice versa.

Extreme Hoarding behaviour has been classified as a mental health diagnosis in its own right and can also be linked to other diagnosis. In extreme cases it can lead to some people living in dangerous and/or unhealthy conditions, resulting in a risk of harm.

What is domestic abuse?

Scottish Government states that: Domestic Abuse (as Gender-Based abuse), can be perpetrated by partners or ex-partners and can include physical abuse (assault and physical attack involving a range of behaviour), sexual abuse (acts which degrade and humiliate women and are perpetrated against their will, including rape) and mental and emotional abuse (such as threats, verbal abuse, racial abuse, withholding money and other types of controlling behaviour such as isolation from family or friends).

Domestic Abuse and Adult Support and Protection

Domestic abuse can be physical, sexual, and emotional or psychological and is a pattern of behaviour carried out by the person perpetrating domestic abuse to cause fear and control behaviour of the victim. This pattern of behaviour can include isolation, threats and micromanagement of everyday life and you may hear it being referred to as coercive control.

There are strong similarities within this definition and the definitions of an adult at risk.

It should be made clear that not everyone who experiences domestic abuse that defines an adult at risk.

But many people who experience Domestic Abuse may have additional support and care needs which may also mean that they could be an adult at risk of harm.

Online harm

Whilst there is no legal definition of online abuse, it can be described as a range of behaviours that causes harm or distress to another person. Online abuse includes personal harassment and/or attacks towards an individual or against a group of people (this is also often known as ‘hate speech’).​

To put it more simply, online abuse is any sort of abuse that happens on the internet via any device. It can happen anywhere at any time on mobile phones, games consoles, computers, laptops and tablets.

Police Scotland provide further information and advice on online harm
Examples include:

• Child/Adult Sexual exploitation, abuse & grooming​
• Terrorist content and activity​
• Organised crime​
• Revenge pornography​
• Harassment and stalking – including concerns regarding domestic abuse
• Bullying – sending threats and abusive messaged, creating and sharing images or videos, “flaming”, “trolling”, “doxing” or “outing”​
• Encouraging and assisting self-harm and suicide​
• Incitement and violence
• Sextortion, Romance Fraud and Fraud

Possible signs:

• Increased anxiety, seem distance, upset or angry
• Spending more or less time online
• Disruption of sleep
• Having money for new things
• Spending more time away from home

Because harm can often be linked to someone’s care needs and their inability to protect themselves, harm often happens in a place where a person should feel safest. Harm can happen anywhere including the family home, a hospital ward, care home, day centre, work or a public place.

Anyone can cause an adult to be at risk of harm. Because of the nature of harm, it is not unusual for this to be someone an adult knows well. 

This includes:

• someone who the adult works with
• a relative or friend
• someone supporting the adult, either as a paid or unpaid carer or support
• the adult themselves

Councils have a duty under the Act to make enquiries into an adult’s wellbeing, property or financial affairs, where they know or believe an adult may be at risk of harm.

Reports that an adult may be at risk can come from the community (friend, relative, neighbour, carer) or from another public body such as the police or the NHS. In either case, the relevant social work department is legally required to look into it.

If you phone in to report a concern, your identity will be kept confidential unless you have given permission for it to be passed on.

The Act is about achieving a balance between respecting people’s rights and taking action where necessary to support and protect them.

The Act exists to provide the necessary support to help individuals live their lives as they wish. If the local council is worried about someone, they can visit and speak to the person they are worried about. The council cannot take any action without the consent of the person.

The council must also take account of:

• the wishes and feelings of the adult at risk (past and present); and
• the views of others, such as the adult’s nearest relative or others with an interest in the person’s well-being.

An individual thought to be at risk of harm has the right, as long as there are not concerns that they are under undue pressure, to choose to be part of any adult protection investigation. They can choose not to be interviewed or answer questions.

They also have a right to advocacy support.

You don’t need to wait for yourself or someone else to be at risk of harm to seek support. To receive support early is often the best way to prevent harm from happening.

Please see information  below.