In the absence of adequate regulation, dishonest, bogus and possible dangerous people may acquire positions of authority in residential homes caring for the elderly, the handicapped, orphans or delinquents. Carers may take advantage of residents in different ways ranging from gratuitous mentally cruelty, through physical (including sexual) abuse, to fraudulent manipulation of an individuals income or social security benefits. Low-paid, untrained workers desperate for employment may carry out nursing tasks without adequate supervision. Malpractice when reported is usually covered up. Those reporting may be penalized as part of that process.
In the UK in 1993 a report on a sample of the 900 children's homes identified the inappropriate use of sanctions and restraints as amounting to abuse in some case. Physical restraint was used too often and too soon, without any attempt at dialogue. Other children were required to help in imposing such restraints. Children were beaten using methods which did not inflict bruising; others were kept in solitary confinement. Sanctions were used in breach of regulations, including restriction or refusal of visits, imposition of distinctive or inappropriate clothing, locking people up, imposition of fines and physical searches. Residents may not be allowed any privacy.