Discriminatory abuse

Discriminatory abuse is unequal or unfair treatment of somebody on the basis of a ‘protected characteristic’ – age, disability, gender/gender reassignment, sexual orientation, pregnancy/maternity, race, religion or belief. It may manifest itself as another form of abuse, such as harassment, derogatory remarks or similar treatment. It may also involve denying access, providing substandard access/service or exclusion of somebody on the grounds of a protected characteristic. Discriminatory abuse could be direct – deliberately treating someone less favourably – or indirect – where rules or arrangements are in place for everyone, but which put someone at an unfair disadvantage.

Possible signs of discriminatory abuse include:

• similar indicators to other types of abuse, such as the person appearing withdrawn, isolating, angry, anxious or in fear
• the support offered to someone is different/substandard with no clear rationale or explanation
• the person may raise concerns or complaints about a service not meeting their needs

Case study

Rose has made contact with the Local Authority to complain that her husband George, who visits a dementia day service 3 days a week, is being treated unfairly. She explained that twice a week, the service offers outdoor activities in the garden. As George is in a wheelchair and there are steps down into the garden, it was decided by the service manager that he would stay inside by himself with one care assistant when these activities are taking place. Rose feels that this is unfair as George loves going outside, and he also seems dejected/upset on these days, which suggests he has some awareness of the situation.

Rose explained that she has raised this with the manager of the service, who said that it just wasn’t feasible for George to join in. When Rose suggested using equipment such as a hoist to transfer him, the manager said that they wouldn’t have enough time to do this. Rose then asked whether George’s fees for the day service could therefore be discounted to take into account that he regularly missed out on activities, but the manager said that this would not be possible as he still requires one care assistant to be with him inside during these periods.

This situation was rightly recognised as a safeguarding concern and a referral was made to the safeguarding team. A social worker discussed the situation with Rose in more detail to explore what she wanted to happen in response. Although George was judged to lack mental capacity to make decisions around the safeguarding, the social worker also visited him at home to try to gain his wishes and views. Both Rose and George were very positive about the day service in general – it was clear that they both wanted George to still attend, but that he should be able to access the same activities as everyone else, even if he is in a wheelchair.

The social worker then organised a multi-agency meeting to discuss the concerns with the day service. The Care Quality Commission and the Local Authority’s Commissioning Team (who monitor the overall quality of services provided in the local area) participated in this discussion, along with an OT who already knew George and his mobility needs. The day service manager acknowledged that she could see how the treatment of George amounted to discriminatory abuse, and agreed to make reasonable adjustments to their service to ensure that he could participate fully in all activities on offer. The manager also agreed to share the learning and recommendations from the safeguarding enquiry with her regional manager, in order to ensure that other services were fully complying with equality and human rights legislation.