Neglect or acts of omission

Neglect is the ongoing failure to meet an individuals basic and essential needs, either deliberately, or by failing to understand these.

It includes ignoring a person’s needs, or withholding essentials to meet needs, such as medication, food, water, shelter and warmth. This can include acts like not getting enough to eat or ignoring an individuals medical or physical care needs.

Everyone has the right to access the necessities of life, such as food, shelter, clothing, heating, stimulation and activity.

Possible indicators of neglect can include:

• poor environment – dirty or unhygienic
• poor physical condition and/or personal hygiene
• pressure sores or ulcers (Department of Health and Social Care pressure ulcer guidance for professionals)
• malnutrition or unexplained weight loss
• untreated injuries and medical problems
• inconsistent or reluctant contact with medical and social care organisations
• accumulation of untaken medication
• uncharacteristic failure to engage in social interaction
• inappropriate or inadequate clothing

Signs of neglect or acts of omission are not always easy to spot and can be covered up to provide surface level assurance.

Learning from Tom’s Story (West Sussex)

Tom’s powerful personal account of years of control and neglect by his wife and paid carer is an important reminder for health and social care professionals.

Despite multiple interactions with services, Tom’s abuse went undetected for years. It was only after his mother raised concerns in 2020 that safeguarding procedures were triggered. A subsequent Safeguarding Adults Review (SAR) revealed missed opportunities to intervene, a lack of professional curiosity, and insufficient understanding of coercive control in care relationships.

Tom has bravely chosen to share his experience to help others. His story is not just a reflection of personal resilience, but a call for action.

Key learning points include:

• the importance of professional curiosity — asking the right questions and not accepting surface-level explanations
• the need to recognise coercive control in all forms, including within care arrangements
• ensuring that adults at risk are given safe, private opportunities to speak without influence from others

Call to action

• Be curious. Be brave. Be the voice that challenges.
• Early, compassionate intervention can change, and even save, lives!

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