Application across the book’s scenarios
| Scenario | How section 20 could apply |
|---|---|
| Actual care home | A paid worker knowingly leaves a resident without essential medication, continence care, repositioning, nutrition, hydration or emergency assistance, or deliberately humiliates or punishes the resident through care. Provider procedures do not excuse the worker’s own wilful conduct. |
| Sheltered or extra-care housing | The offence may apply to a worker actually providing health or social care, but not automatically to a landlord, concierge or alarm operator outside the statutory care-worker definition. The contract, commissioned task and worker’s role must be proved. |
| Supported living or ordinary home | A domiciliary worker or personal assistant knowingly omits an essential commissioned task. A relative is not brought within section 20 merely because professionals assumed that the relative would provide care. |
| Community activity or transport | A care worker accompanying the person deliberately abandons required support or ignores an emergency need. The conduct must occur in the statutory care relationship; location alone is not decisive. |
| Child removal or family separation | If separation removes informal support, a care worker who knows replacement care is now indispensable and wilfully omits it may commit the offence. The removal itself is not section 20. |
| What would usually be insufficient | A reasonable disagreement about the plan, a single inadvertent mistake, lack of knowledge, inability to act, or conduct by someone who is not within the statutory definition. |
Section 20 of the Criminal Justice and Courts Act 2015 creates a specific offence for a care worker who ill-treats or wilfully neglects a person receiving health care or social care. The prosecution must prove that the defendant and care relationship fall within the statutory definitions and that the conduct was ill-treatment or wilful neglect; a poor outcome, mistake or disputed care assessment is not enough.
How denial of care may satisfy the offence
The offence may be engaged where a paid care worker knows that medication, respiratory support, nutrition, hydration, toileting, turning, supervision or emergency action is required, has the duty and ability to provide it, and deliberately or recklessly fails to do so. Records showing repeated alarms, warnings, falsified visits, punishment or conscious disregard can distinguish wilful neglect from inadvertence.
How child removal may become relevant
Removal is not itself this offence. It may form the factual setting if a care worker knows that separation has removed essential family support and then wilfully leaves the care recipient without replacement care. The victim must still be receiving the health or social care covered by the Act and every element must be proved.
Key evidence
Preserve the job description, provider status, care plan, risk assessment, rota, visit and medication records, contemporaneous warnings, capacity material where relevant, audit trail, injury evidence and proof of the worker’s knowledge and practical ability to act.