Buckinghamshire Partnerships

Organisational or Institutional Abuse

Organisational or Institutional Abuse

What is Organisational or Institutional abuse?


Organisational or Institutional abuse is the mistreatment of people brought about by poor or inadequate care or support, or systematic poor practice that affects the whole care setting. It occurs when the individual's wishes and needs are sacrificed for the smooth running of a group, service or organisation.

Why does it happen?
In formal settings organisational or institutional abuse is more likely to occur where staff are:

  • inadequately trained
  • poorly supervised
  • not supported by management
  • have poor communication skills
  • part of a 'closed' culture, for example a care setting where new ideas, visitors, care management or other professional involvement is discouraged

Organisational or institutional abuse can involve more than one abuser, and there might also be a number of people experiencing the same abuse e.g. hate crime against particular groups or several family members mistreating a dependent other.

Examples of Organisational or Institutional abuse
These may include:

  • failure to respect or support a person or group's right to independence, dignity or choice 
  • lack of person centred care planning or a ritualised care routine 
  • no flexibility in bed times or getting up or deliberately waking someone up 
  • inappropriate confinement, restraint or restriction 
  • lack of personal clothing or possessions 
  • stark living areas, deprived environment or lack of stimulation 
  • lack of choice in decoration or other aspects of the environment 
  • lack of choice in food or menus or menu planning
  • unnecessary involvement in personal finances by staff or management
  • inappropriate use of nursing or medical procedures, e.g. using un-prescribed medication enemas or catheterization 
  • inappropriate use of power or control

Indicators of Organisational or Institutional abuse
These may include:

  • treating adults like children
  • arbitrary decision making by staff group, service or organisation
  • strict, regimented or inflexible routines or schedules for daily activities such as meal times, bed / awakening times, bathing / washing, going to the toilet
  • lack of choice or options with food and drink, dress, possessions, daily and social activities
  • lack of privacy, dignity, choice or respect for people as individuals
  • unsafe or unhygienic environment
  • lack of provision for dress, diet or religious observance in accordance with an individual's belief or cultural background.

What can you do to support someone who is a victim of Organisational abuse?

if you believe that someone may be a victim of Organisational abuse then you can do the following;-

  • If you are a member of staff in the Organisation that is abusing the person, you can speak to your line manager or use your organisations Whistleblowing policy.
  • You can contact the Care Quality Commission 
  • You can make a referal to the Safeguarding Adults Team based at the MASH.

As with all forms of abuse you should talk to the indiviudal on whose behalf you are making the referral to obtain their consent. However if the person lacks the mental capacity to make a decision regarding their care and treatment or you believe other people may also be victims of the abuse, then you MUST refer to Adult Safeguarding on the number below. 

Agencies that can help are:

  • Police                               999 or 101
  • MASH                               0800 137 915
  • Care Quality Commission 0300 061 6161

What is Buckinghamshire Safeguarding Adults Board doing about Organisational abuse?

Buckinghamshire Safeguarding Adults Board has been considering abuse in care home. In March 2017 the Board held a Board meeting themed around abuse in care homes. Since then the Board has undertaken an audit to look at issues of abuse in care homes and the Board will continue to raise awareness of organisational abuse in its new Business Strategy in 2018 - 2020.