The First Hit: a case study of the physical abuse of people with learning disabilities and challenging behaviours in a residential service

This paper describes the circumstances surrounding the physical abuse of persons with learning disabilities and challenging behaviours in a residential service and the general findings of a related inquiry. Evidence is interpreted in relation to wider policy and practice intelligence on the abuse of people with learning disabilities, with lessons for the recognition, reporting and management of abuse identified. The discussion is designed to help those charged with responsibility for the support and protection of people with learning disabilities understand the complex circumstances and conditions which may be associated with an abusive service culture, with the culture of abuse itself examined at four levels. Suggestions for reviewing the development and implementation of adult protection policies and procedures are offered, along with priorities for action and implementation for purchasers and providers.