Safeguarding Referral in relation to ‘Organisational Abuse’


This form should be used by professionals or members of the public to raise a safeguarding concern in relation to a service.





Organisational Abuse Enquires


Organisational abuse is defined as, ‘the mistreatment or abuse or neglect of an adult at risk by a regime or individuals within settings and services that adults at risk live in or use, that violate the person’s dignity, resulting in lack of respect for their human rights.’ (Care and Support statutory guidance, 2014ii)






Name and contact details of Service Provider


(This is the name of the Agency/Care Home/Day Service which delivers the service the service users)

Details of Service(s) Delivered








Evidence of Mistreatment, Abuse or Neglect perpetrated by a ‘regime of individuals’: (This section is for you to detail your concerns)









Evidence of impact on service users ‘Personal Dignity’ and /or ‘Human Rights’.













Have you raised your concern with the Service Provider?





If Yes, please provide details:







Is the Service Provider aware you are raising this Organisational Abuse Concern?




Name of person completing this form:


Based at:


Agency & Postal Address




Tel No.


Date form completed



Return to:                                                       


                                                      5th Floor , Britannia House,


Bradford, BD1 1HX

Tel: 01274 43 1077