This is one of the most ‘obvious’ types of abuse, that often people think of in relation to safeguarding adults or children. Physical abuse is the non-accidental use of force that causes (or could cause) injury, pain or impairment.

So, what can it look like?

• Assault, hitting, slapping, punching, kicking, hair-pulling, biting, pushing
• Rough handling
• Scalding and burning
• Physical punishments
• Inappropriate or unlawful use of restraint; restricting movement (e.g. tying someone to a chair)
• Making someone purposefully uncomfortable (e.g. opening a window and removing blankets)
• Involuntary isolation or confinement
• Misuse of medication (e.g. over-sedation)
• Forcible feeding or withholding food

How might you recognise it?

• Bruising, cuts, welts, burns and/or marks on the body or loss of hair in clumps
• Unexplained fractures
• No explanation for injuries or inconsistency with the account of what happened
• Injuries are at odds with the person’s lifestyle (e.g. something looks like a cigarette burn but they don’t smoke)
• Injuries are in unusual places e.g. inside of arms or legs
• Frequent injuries
• Unexplained falls
• Subdued or changed behaviour in the presence of a particular person
• Unusual weight loss, or other signs of malnutrition
• Untreated medical problems or frequent changes of GP

Remember that some people may bruise more easily than others, if they are on blood thinners for example, or if they have problems with mobility and fall regularly or bump into things in the house. People that need equipment to help them move, especially hoists or stand aids, are at a higher relative risk of bruising or injury.

Accidents can happen too. Not every injury or fall will be a safeguarding concern. But it is important to check that abuse or neglect has not been a factor; ask the questions, be curious.