Organisational or institutional abuse

Organisational abuse occurs when a setting such as a hospital, care home or mental health hospital, or an organisation like a care agency, fail to provide a standard of care and treatment which causes harm to a person. Examples of this include not providing sufficient staff which results in poor quality care, not offering people a choice (for example a choice of food, clothes, or activities), and a lack of dignity and respect (for example not treating people kindly, calling them names or not giving them privacy when they request it).

Organisational abuse is different to neglect in that it is more of a culture throughout the organisation; with lots of people being affected.

Signs and indicators of organisational abuse may include:

• inflexible and non-negotiable systems and routines
• care routines taking priority over individual needs and choices
• lack of consideration of dietary requirements
• people not being given enough food, drink, or support with eating
• name calling; inappropriate ways of addressing people
• lack of adequate physical care, for example, an unkempt appearance
• people being left for long periods without support
• withholding care or medication
• delays in receiving medication or healthcare
• loss of dignity, independence, or respect
• multiple people experiencing the same poor standards of care
• concerns being raised repeatedly but not addressed

People living in care settings should:

• be treated with dignity and respect
• have their preferences and choices listened to
• receive food, drink, medication, and personal care when they need it
• be supported to achieve the best possible quality of life
• feel safe and able to raise concerns

Remember: Organisational abuse is not always deliberate. However, when systems, practices, or staffing arrangements consistently result in people not receiving safe and person-centred care, safeguarding concerns should be raised.