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

Indicators of Organisational Abuse can include:

• inflexible and non-negotiable systems and routines
• lack of consideration of dietary requirements
• name calling; inappropriate ways of addressing people
• lack of adequate physical care, for example, an unkempt appearance
• withholding care or medication

Case study:

Marjorie lives in a busy care home. She has dementia so she is sometimes confused and needs help with lots of aspects of her daily life. The home is frequently short staffed which means Marjorie is often left in bed until 10:30am, even though she is an early riser and would prefer to get up at 6am. Her neighbour in the room next door to her, Fred, can often be heard calling out for help as he is also left until last too as their rooms are at the end of the corridor.

Because of this Marjorie and Fred are only offered porridge as it’s too late for a cooked breakfast which they would both prefer. It’s also quite close to lunchtime by the time they eat breakfast, and they are not offered a later lunch, so after breakfast sometimes they don’t want to each lunch but then they don’t get anything to eat until a cake/biscuit with a cup of tea later on.

Marjorie takes a range of medication but three times this week she has had her medication very late because the nurse in charge hasn’t had time to bring it to her. This has also happened to four other residents on the floor that Marjorie lives on, and it has caused them a range of different side effects.