Sexual assault of a vulnerable adult is any sexual activity with the person if they:

• lack the capacity to give or withhold consent
• are threatened, coerced or forced to engage in sexual behaviour.

Sexual assault includes:

• non-consensual sexual contact
• exploitative behaviour
• rape and indecent assault
• sexual harassment or sexual interference in any form.

This type of abuse may be instigated by any person, against any other person of any age and of either gender.

Examples of sexual assault include:

• anal or vaginal intercourse without consent
• fingers or objects inserted into vagina or anus without consent
• cunnilingus or fellatio without consent
• masturbation of another person without consent
• non-consensual touching of breasts or genitals
• indecent exposure
• masturbation by a person in the presence of the victim
• voyeurism
• displaying pornographic photography or literature.

Sexual misconduct

Sexual misconduct includes lower-level sexual harassment such as lewd or suggestive comments, teasing or insults with sexual connotations, but which does not necessarily equate to a criminal offence. Sexual misconduct may be categorised as:

1. crossing professional boundaries, which includes sexually explicit comments and other overtly sexual behaviour
2. grooming behaviour.

Crossing professional boundaries can reasonably be construed as involving an inappropriate and overly personal or intimate:

• relationship with
• conduct towards
• focus on

the vulnerable person.

Persistent low-level breaches of professional conduct in this area, or a single serious “crossing of the boundaries” may constitute sexual misconduct, particularly if the vulnerable person’s caregiver either knew, or ought to have known, their behaviour was unwanted.

Behaviour should only be seen as “grooming” where there is evidence of a pattern of conduct by the vulnerable person’s caregiver promoting sexual activity between them and for which there is no other reasonable explanation. The types of behaviours that may lead to such a conclusion include, but are not limited to, the following.

1. Persuading the vulnerable adult they have a “special” relationship, for example by:

• spending inappropriate “special time” with them
• inappropriately giving gifts
• inappropriately showing special favours
• asking for the relationship to be kept “to themselves”.

2. Testing boundaries, for example, by:

• undressing in front of the vulnerable person
• encouraging inappropriate physical contact, even where it is not overtly sexual
• talking about sex
• “accidental” intimate touching.

It is inappropriate to extend a relationship outside of work entangling the vulnerable person into the caregiver’s private life.

Physical assault is non-accidental injury or physical harm to a person by any other person. It includes but is not limited to inflicting pain or any unpleasant sensation, causing harm or injuries by excessive discipline, beating or shaking, bruising, electric shock, lacerations or welts, burns, fractures or dislocation, female genital mutilation and attempted suffocation or strangulation.  This type of abuse can be perpetrated by people known to the vulnerable person, or by strangers.

Examples of physical abuse include:

• hitting, smacking, biting, kicking, pulling limbs, hair or ears
• bending back fingers, bending an arm up behind the back
• dragging, carrying or pushing people who do not want to be moved unless involuntary relocation is part of a behaviour management plan
• roughly handling a person while providing supports such as personal care or transfers
• threatening violence
• bathing in water too hot or too cold.

Unauthorised physical restraint (restrictive practices)

 Restraining or isolating a person for reasons other than medical necessity or the absence of a less-restrictive alternative to prevent self-harm. Restrictive practices include using chemical, physical, mechanical, psycho-social and seclusion mechanisms, or the denial of basic human rights or choices such as freedom of religion, association or movement; or access to property or resources.

Forms of restraint:

Physical: prolonged application on any part of a person’s body to restrict their free movement.

Chemical: inappropriate use of medication to control a person’s behaviour.

Mechanical: inappropriate use of a device to restrict the free movement of a person.

Psycho-social: the use of verbal communications and/or threats of social or material punishment that elicit fear and restrain a person’s behaviour.

Seclusion: confinement in a room or area from which an exit is prevented, or where a person believes they cannot or should not leave a room without permission.

Use of restraints are not considered abuse if they are applied under a properly established behaviour management regime, with adequate approvals and oversight.

Neglect is a failure to provide the basic physical and emotional necessities of life. It can be wilful denial of medication, dental or medical care, therapeutic devices or other physical assistance to a person who requires it because of age, health or disability.  

Neglect can also be a failure to provide adequate shelter, clothing, food, protection and supervision, or to place people at undue risk through unsafe environments or practices and thereby exposing that person to risk of physical, mental or emotional harm. Neglect includes the failure to nurture or provide stimulation needed for the social, intellectual and emotional growth or wellbeing of a vulnerable person.

Neglect may occur when the primary caregiver of a vulnerable person does not provide the essential elements for life described above, or when any person or organisation responsible for providing care or services to a vulnerable person fails to meet this obligation.

Neglect can be a single significant incident where a caregiver fails to fulfil a duty, but is usually the cumulative effect of an ongoing pattern of repeated failures by a caregiver to meet the vulnerable person’s physical or psychological needs.

Examples of neglect include:

• refusing to provide a vulnerable person with food because they have not done what was asked of them
• hurrying or rushing assistance with eating or drinking to fit in with staff timetables rather than vulnerable person’s needs
• withdrawing or denying of privileges, planned outings or personal items that are not designated and planned behaviour management strategies
• depriving the vulnerable person of their right to express their cultural identity, their sexuality or other desires
• failing to ensure adequate food, healthcare support, clothing, medical aid or culturally relevant contexts and supports
• denying use of a device for communication or for expression of needs.

NSW Family and Community Services 2016 Abuse and Neglect Policy for people with a disability identified three types of neglect.

Physical neglect
Failure to provide adequate food, shelter, clothing, protection, supervision, medical and/or dental care, or to place persons at undue risk through unsafe environments or practices. Examples of physical neglect include:

• not supporting the person to maintain hygiene
• not providing adequate medical or dental care
• not maintaining their house
• failing to report hazards
• not completing annual comprehensive health, risk and swallowing assessments.

Emotional neglect
The failure to support and encourage, protect and provide stimulation needed for the social, intellectual and emotional growth or wellbeing of an adult or child. Examples of emotional neglect include:

• ignoring a person
• forced isolation
• depriving a person of their right to express their cultural identity, their sexuality or other desires
• not using a communication device to enable expression of needs or other communication.

Passive neglect:
Failure to provide, or the withholding of, the necessities of life including food, clothing and shelter or medical care. Examples of passive neglect include:

• denial of dental or medical care, therapeutic devices or other physical assistance
• failure to provide proper food, fresh fruit and vegetables.

There are particular classes of neglect that can be committed by a paid caregiver/worker against a vulnerable person.

Supervisory neglect:
An intentional or reckless failure to adequately supervise or support a vulnerable person that results in the death of, or significant harm to, that person; or involves a gross breach of professional standards and has the potential to result in the death of, or significant harm to, the vulnerable person.

Failure to protect from abuse:
Involves an obviously unreasonable failure to respond to information that strongly indicates actual or potential serious abuse of a vulnerable person.

Psychological or emotional abuse includes:

• verbal assaults
• threats of maltreatment
• harassment
• humiliation or intimidation
• failure to interact with a person or to acknowledge that person’s existence.

Psychological abuse may also include denying cultural or religious needs and preferences.  Although any person may initiate psychological abuse towards a vulnerable person, it is likely to come from people on whom the person relies or associates with regularly. The sources could be primary caregivers, family, friends or other service providers.

Examples of psychological or emotional abuse include:

• humiliating a vulnerable person for losing control of their bladder or bowel, or about other private matters
• treating a vulnerable person in ways that deny the person their dignity
• denying the right of the vulnerable person to make their own decisions (where capable)
• preventing a vulnerable person from expressing themselves out of fear of retaliation
• discouraging personalisation of rooms or clothing
• limiting social freedom available to a vulnerable person
• denying cultural needs, such as serving pork to a vulnerable person of the Jewish or Muslim religions
• shouting orders to a vulnerable person
• treating a vulnerable person like a child
• using humiliating names when speaking to a vulnerable person
• removing aids or equipment, for example, wheelchairs or communication devices.

Exposure to domestic violence:
Domestic violence is a range of abusive behaviours perpetrated in the victim’s home by someone well known to them. 

While the potential harm for a vulnerable person being exposed to persistent domestic violence is less than that for a child (whose normative neurological development is put at risk) the vulnerable person’s psychological wellbeing can be severely compromised by having to live in an environment of overwhelming threat and intimidation.

A vulnerable person who is the target for/subject of domestic violence is likely a victim of a criminal offence.

Financial abuse is the improper use of another person’s assets or the use or withholding of another person’s resources. Possible sources of financial abuse are carers, families or guardians who act formally or informally as financial managers and have access to or responsibility for the vulnerable person’s finances and property.

Examples of financial abuse include:

• denying a person access to or control over their money when they have a demonstrated capacity to manage their own finances
• denying a person access to information about their personal finances
• taking a person’s money or other property without their consent (a likely criminal offence)
• forcing changes to wills or other legal documents
• having cheques or credit-card payments forged, or using a person’s personal banking cards without their authorisation
• using a person’s belongings
• improper use of another person’s assets or the use or withholding of another person’s resources.

The NSW Family and Community Services 2016 Abuse and Neglect Policy for people with a disability identifies systemic abuse as a form of harm committed against vulnerable persons and defines it as the failure to recognise, provide or attempt to provide adequate or appropriate services, including services that are appropriate to the person’s age, gender, culture, needs or preferences.

Examples of systemic abuse include:

• service providers arriving late or leaving early (without agreement)
• relevant policies and procedures note being implemented
• people denied the option to make decisions affecting their lives
• unacceptable staff attitudes becoming normalised
• lack of policy awareness and inadequate staff training and education
• service or social isolation
• not identifying and reporting abuse and neglect
• creating dependence on one carer or service for all support
• denying access to a telephone, internet or significant others or a way to independently leave the house

• failure to provide adequate or appropriate services.

Legal or civil abuse:
A particular subset of systemic abuse that involves the denial of access to justice or legal systems that is available to other citizens.  Civil abuse includes:

• denial of access to protection
• no legal support or representation with known reports of abuse.