Domestic Abuse Awareness Training for Care and Healthcare Staff

Domestic abuse awareness training teaches care and healthcare staff to recognise the signs of abuse, respond appropriately without investigating or confronting anyone, and know when and how to raise a safeguarding concern. For anyone working in a care home, in a person's own home, or in a healthcare setting, this training matters because staff are frequently the only person from outside a household who sees that person regularly, and abuse is often far broader than physical violence.

Under UK law, the definition of domestic abuse changed significantly with the Domestic Abuse Act 2021, which explicitly recognises coercive control and economic abuse alongside physical violence. This guide sets out what the law says, what staff should look for, and the correct way to respond.

What the Law Says: Domestic Abuse Under the Domestic Abuse Act 2021

The Domestic Abuse Act 2021 introduced the first statutory definition of domestic abuse in England and Wales. Under Section 1 of the Act, behaviour counts as domestic abuse where two people aged 16 or over are "personally connected" to each other, for example as partners, ex-partners, or relatives, and one engages in behaviour that is abusive. The Act defines abusive behaviour as any one, or a combination, of the following: physical or sexual abuse; violent or threatening behaviour; controlling or coercive behaviour; economic abuse; and psychological, emotional or other abuse. The behaviour can be a single incident, or, more commonly, a pattern of conduct that only looks serious when viewed as a whole.

This is the detail that matters most for care and healthcare staff: nowhere in that list does the Act require a visible injury. Controlling or coercive behaviour, such as isolating someone from friends and family, monitoring their movements, or dictating what they can and cannot do, is domestic abuse in law, as is economic abuse, defined as behaviour that substantially affects a person's ability to acquire, use or maintain money, property, goods or services they need. A person can be experiencing serious, sustained domestic abuse while showing no physical marks at all.

Why Care and Healthcare Staff Notice What Others Miss

Staff who visit someone's home, provide personal care, or see a patient regularly are often in a genuinely unique position. For an older person living alone, a disabled adult receiving domiciliary support, or someone whose mobility or health limits their contact with the outside world, a care worker, community nurse or healthcare assistant may be one of very few people who sees them face to face on a regular basis. That close, repeated contact, whether it is checking on medication, helping with washing and dressing, or simply having a conversation during a visit, can reveal things a single GP appointment or phone call never would.

This is also why domestic abuse training sits so closely alongside broader safeguarding training. Staff who understand safeguarding vulnerable adults are better placed to recognise when a concern about a partner, family member, or even another carer needs to be raised through the correct safeguarding route, rather than treated as a private matter between the people involved.

Signs Staff Might Notice

No single sign confirms that domestic abuse is happening, and staff are never expected to diagnose or prove it. A combination of the following, however, should prompt a conversation with a manager or safeguarding lead:

• Injuries that are unexplained, inconsistent with the story given, in places not typically associated with accidental injury, or a pattern of repeated injuries over time.
• A person who seems anxious, fearful, or noticeably different in mood, confidence or communication when a particular partner or family member is present, compared with when they are not.
• Restricted access to money, for example never having cash or a bank card, being unable to explain where their pension or benefits go, or someone else always answering financial questions on their behalf.
• Restricted access to communication, such as a phone that is confiscated or monitored, visits that are cut short or supervised by someone else, or a person who is never left alone with staff.
• Reluctance to accept help or services that would increase their independence, particularly if a partner or family member consistently objects to appointments, equipment or additional support.
• A carer or partner who insists on speaking for the person, answers questions directed at them, or becomes irritated when the person is asked to speak for themselves.

For staff working alone in someone's own home, these signs can be harder to corroborate and easier to miss, because there is no second pair of eyes present. Sound lone-working practice, including how visits are recorded and when concerns are escalated, is covered in more detail in our guide to lone working and domiciliary care risk assessment.

The Correct Response: Listen, Do Not Investigate

The single most important rule in domestic abuse awareness training is this: it is never a staff member's job to investigate, confront the alleged abuser, or gather evidence. Doing so can put the person and the staff member at greater risk, damage the person's trust, and undermine any formal investigation that follows.

The correct response is to:

• Listen without judgement, letting the person speak in their own time and their own words, without pressing for details they have not offered.
• Believe them, and avoid reacting with visible shock or disbelief that could discourage them from saying more.
• Reassure them that they are not to blame and that support is available, without making promises about what will happen next.
• Avoid promising complete confidentiality; explain gently that you have a duty to pass safeguarding concerns to someone who can help.
• Record what was said, in the person's own words where possible, factually and without opinion or interpretation.
• Follow your organisation's safeguarding policy and make a referral through the correct route, usually your safeguarding lead or manager, and, where there is immediate risk, the emergency services.

A calm, non-judgemental, trauma-aware response is central to getting this right. Our guide to trauma-informed care in practice looks in more depth at how to communicate with someone who has experienced abuse or trauma without causing further harm.

Older Adults and Disabled People: A Distinct and Often Hidden Risk

Domestic abuse is not only something that happens between younger partners. According to SafeLives, a UK domestic abuse charity, older victims of domestic abuse typically experience it for far longer before reaching out for help than younger victims, and are more likely to remain living with the person abusing them even after support has been offered. SafeLives' research also found that abuse of older people is more likely than average to come from an adult family member, alongside abuse from intimate partners, and that a substantial proportion of older victims are also living with a disability.

SafeLives has separately highlighted that disabled people can face abuse patterns that go beyond those typically seen in domestic abuse cases generally: an abuser may withhold mobility aids, medication, or communication equipment; exploit a person's isolation or dependence on them for care; or threaten institutionalisation to prevent someone leaving. Crucially, the abuser is not always a partner or family member, it can be a paid or unpaid carer, and professionals do not always think to ask about disability or the caring relationship when a concern is first raised, which means abuse in these situations can be missed or misclassified.

This is exactly why a domestic abuse concern involving an older or disabled person receiving care should be treated as, and routed through, the adult safeguarding process, rather than dismissed as a private "domestic" or "family" matter. For providers regulated in England, this overlaps directly with CQC Regulation 13, safeguarding service users from abuse and improper treatment, which requires providers to have systems in place to prevent abuse, to act without delay on any suspected or alleged abuse, and to ensure staff know how to recognise and report it.

Building This Into Your Organisation's Training

Domestic abuse awareness should not be a one-off session buried in induction and never revisited. It works best as part of a wider programme that also covers general safeguarding, lone working, and a genuine speak-up culture, so that staff who raise a concern, whether about a service user, a colleague, or their own household, know it will be taken seriously. Learnsignal's CPD training courses for care and healthcare staff can be structured around exactly this kind of layered approach, refreshed regularly rather than delivered once and forgotten.

Frequently Asked Questions

Is domestic abuse only physical violence?

No. Under the Domestic Abuse Act 2021, domestic abuse in England and Wales includes physical and sexual abuse, violent or threatening behaviour, controlling or coercive behaviour, economic abuse, and psychological or emotional abuse. A person can be experiencing serious abuse while showing no visible injuries at all.

What should I do if I suspect a service user is being abused by a family member or partner?

Do not investigate or confront anyone involved. Listen to the person without judgement, reassure them they are not to blame, record what was said factually, and report your concern to your manager or safeguarding lead in line with your organisation's safeguarding policy. Where there is immediate danger, contact emergency services.

Can a carer be the person carrying out the abuse?

Yes. SafeLives' research shows that abusers of disabled and older people are sometimes paid or unpaid carers, not only partners or family members. Staff should not assume that because someone provides care, they cannot also be controlling or harming the person they care for.

How does this connect to CQC requirements?

For providers regulated by the CQC in England, Regulation 13 requires systems to prevent abuse, prompt action on any suspicion or allegation, and staff who are trained to recognise and report it, all of which domestic abuse awareness training directly supports.

Recognising domestic abuse and responding correctly is a core safeguarding skill, not a specialist one; every member of care and healthcare staff will, at some point, be the person a service user chooses to tell. Regular, refreshed training that covers the legal definition, the signs to look for, and the correct escalation route gives staff the confidence to respond well when that moment comes.