Neglect and Acts of Omission

1. What is Neglect and Acts of Omission?

Neglect and acts of omission occur whenever an individual with responsibility for meeting the needs of an adult at risk does any of the following:

  1. Ignores their medical, emotional or physical care needs;
  2. Fails to provide access to appropriate health, care and support or educational services;
  3. Withholds any of the necessities of life, such as medication, adequate nutrition and heating.

Neglect and acts of omission can be isolated incidents or ongoing ill treatment.

Neglect and acts of omission can happen anywhere and can be unintentional or intentional.

Individuals include informal carers, care homes, domiciliary services, day services, hospitals etc.

If the abuse is taking place in a care setting also see: Allegations against Service Providers (including Organisational Abuse).

2. Indicators of Neglect and Acts of Omission

All the following may be indicators that an adult's needs are being neglected or not met.

The adult:

  1. Is not supported to present themselves the way they would like (for example haircuts, makeup, fingernails and oral hygiene and care);
  2. Is given someone else's clothes to wear;
  3. Has poor personal hygiene or wears dirty clothes;
  4. Is wearing clothing that is unsuitable for the temperature or the environment;
  5. Has lost or gained weight unintentionally;
  6. Does not have access to food and drink in line with their dietary needs;
  7. Has repeated urinary tract infections;
  8. Is not getting care to protect their skin integrity, potentially leading to pressure ulcers;
  9. Does not have opportunities to spend time with other people, either virtually or in person;
  10. Uncharacteristically refuses or is reluctant to engage in social interaction;
  11. Does not have opportunities to do activities that are meaningful to them;
  12. Does not have access to medical and dental care;
  13. Is denied access to communication and independence aids (such as hearing aids) contrary to their care and support plan;
  14. Has not received prescribed medication, or medication has been administered incorrectly (for example, the wrong dose, timing, method, or type of medication);
  15. Does not have access to outdoor space, fresh air and sunlight;
  16. Is not given first aid when needed;
  17. Does not have an agreed care and support plan;
  18. Is not receiving the care in their agreed care and support plan;
  19. Has deteriorating physical or mental health or mental capacity, and there is a lack of response to this from staff;
  20. Lives in a dirty or unhygienic environment;
  21. Has only inconsistent or reluctant contact with external health and social care organisations;
  22. Is not kept safe from everyday hazards or dangerous situations.

3. Wilful Neglect

Under Section 44 of the Mental Capacity Act 2005, any act of wilful neglect is subject to criminal prosecution when the adult lacks capacity to make decisions about their care or treatment and the neglect is carried out intentionally by:

  1. A carer (paid or unpaid);
  2. A Deputy; or
  3. The donee of a Lasting Power of Attorney.

Where it is suspected that the neglect or act of omission meets this criteria, the police must be notified.