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Health and Wellbeing
A Health and Well-being Wales Partner

We often think of abuse as being something that happens in people’s own homes. Occasionally, however, abuse can occur in institutions like care homes, nursing homes and hospitals, which are supposed to look after us and care for us when we are ill, or can’t look after ourselves anymore.

Institutional abuse sometimes happens because staff get so used to doing things in a certain way that they don’t realise their actions are abusive, e.g. ignoring someone’s choices or rushing someone so their personal dignity is compromised.

Small, insignificant things are overlooked until the culture becomes one which restricts dignity, privacy, choice, independence and fulfilment.

Examples and indicators of institutional abuse

Institutional abuse can include:

  • failure to respect or support a person or group's right to independence, or choice 
  • lack of person-centred care planning, or a rigid 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
  • unsafe or unhygienic environment
  • lack of choice in decoration or other aspects of the environment 
  • lack of choice in food or menus or menu planning
  • unnecessary involvement in personal finances by staff or management
  • inappropriate use of nursing or medical procedures 
  • inappropriate use of power or control

What should you do if you suspect institutional abuse is occurring?

If you think you've experienced or witnessed an abusive situation, contact your local council’s Social Services Safeguarding Team for help and advice.

You do not have to say who you are, although this may make it more difficult for social services to investigate and protect you or the person being abused.

If you feel nervous about talking to social services, you could ask someone to talk to them on your behalf. This could be a nurse, a carer, an advocate or a friend or relative you trust.

Social services will provide you with the support and advice you need to help you to make any decisions and will help you in taking action to end the abuse and ensure that it doesn't happen again.

What you tell them will be treated sensitively but they may have to tell other people to help them to investigate the concern. 

Last updated: 04/05/2023