Institutional abuse relates to abuse within an institution. The word institution relates to an organisation, specifically a health organisation e.g. nursing home or care home. Institutional abuse is a failure to meet the requirements health care professional is meant to in order to care for a vulnerable adult appropriately. A system of power (nursing home/care home) should abide by all safeguarding legislations. This may include neglect, neglect, and causing physical injury. Training of staff, supervision or record keeping is a form of institutional abuse. By not keeping records on service users, it means staff members may not be up to date with current illnesses of the service users. For example, they may continuously feed a service users food that they are now allergic to or have a reaction to, this is a form of abuse as the institution should be aware of their service user’s requirements. Clinical guidelines 

Possible signs of institutional abuse:

https://www.rbsab.org/the-public/what-is-abuse/institutional-abuse.aspx 

Case Study 

Neglect stemming from "institutionalised abuse" at a care home directly contributed to the deaths of five of its elderly residents after ample warning signs were ignored or missed by managers and watchdogs, a coroner has ruled.

In a devastating verdict delivered hours after Health Secretary Jeremy Hunt conceded that "something is badly wrong" with the care system, West Sussex coroner Penelope Schofield there had been mismanagement "from the top down" at the Orchid View home run by the defunct provider Southern Cross.

Relatives said the findings meant the Crown Prosecution Service should review a decision not to bring charges against five people who were arrested - some on suspicion of manslaughter by gross negligence - following the death of one resident, 77-year-old Jean Halfpenny, who received an overdose of the blood-thinning drug Warfarin. Prosecutors had previously ruled there was insufficient evidence to proceed against any staff member. Ms Schofield said she was satisfied that Mrs Halfpenny had been overdosed and then her medical records destroyed after it became clear she required hospital treatment. Meera Read, a manager of the home in Copthorne, near Crawley, denied she had looked at the documents for Mrs Halfpenny and falsified new ones after saying: "Shit, we can't send her to hospital with those. They will shut us down."

Here is an example of institutional abuse. The members of staff firstly accidently overdosed the service user and destroyed her documents displaying the correct amount. Instead of abiding by safeguarding and admitting to a mistake they refused to take her to hospital with the correct documents exampling her requirements blood thinning. This lead to her death, if she had been taken to hospital with correct documents and not false ones she may have lived. The nursing home chose to not provide the care they had promised and took matters into their own hands causing institutional abuse. 

http://www.independent.co.uk/news/uk/home-news/britains-cruellest-care-home-institutional-abuse-contributed-to-deaths-of-five-pensioners-8889770.html 

Discrimination is acting on judgements about people whether negatively or positively and treating people differently, usually because they are members of a particular social group. An example of discrimination would be treating a same-sex couple differently to a heterosexual couple because of a homophobic opinion.

Case study 

Miss Read is in her twenties, has Down’s syndrome and a moderate learning disability. She is from a travelling background and now lives in 24-hour supported accommodation and attends a local day centre. Miss Read reported to the Day Centre Manager that two students in the cookery class had called her “nasty names about her being a traveller”. Miss Read stated this had happened two weeks ago and she had not slept properly since. She said she was frightened of the students because during the lunch break they had sung a song saying “people like you should go back to your own country” and you are “scroungers”. The manager discussed the concerns with Miss Read, and explained that she had a duty to inform Adult Social Care (ASC) as the comments being made were of an abusive nature. Miss Read agreed to this but said she just wanted the “nasty names and singing to stop”. 

This is an example discriminitory abuse as they are giving abuse to this individual based on her culture. Cultural discrimination affects people’s cultures which includes their chosen religion or their language and background. These groups of people may be affected and treated unequally in society because of stereotypes, prejudice or discrimination. Offensive cultural discriminatory terms such as 'traveller' and 'scroungers' is a form of verbal discriminatory abuse. This can, as we see above, have effect on a persons emotions as miss read is frightened of the students, this may make her feel as though she does not want to return to the day centre. The individual has also noted she is not sleeping properly as a result of the abuse. The students are also teasing miss read by singing hateful songs to her which will upset her as they are abusing her as a result of her culture.  

 http://www.eastsussexsab.org.uk/wp-content/uploads/2016/11/Case-Example-Dicriminatory-Abuse.pdf