Reports of abuse  at accommodation for the disabled and mentally ill surged 37 per cent to 287 last financial year, up from 209 the previous year.

The cases, reported by "community visitors" who inspect accommodation for the Public Advocate, include a frail, non-verbal elderly person having their leg and knee cap broken in two separate attacks by a staff member in a government-run home, and a mentally ill man being punched in the head at a hospital because he was suspected of smoking in his room.

There were also reports of residents being sexually, physically and emotionally abused by other residents who were inappropriately placed in group homes.

Victoria's Public Advocate Colleen Pearce was particularly concerned about the way the Department of Human Services responded to the case of the broken leg and knee cap.

In her annual report for 2013-14, she said a staff member who saw the abuse called her office's advice line to report it but wanted to remain anonymous for fear of retribution. That person and others were later punished by the government's Department of Human Services for not speaking up earlier.

"It was particularly disappointing to me that when these individuals were finally convinced to report their concerns to DHS management that disciplinary action against these whistleblowers was proposed over their delay in reporting the abuse".

The staff member responsible for the attacks was later charged with criminal offences.

In a separate case, the report said, staff at another home delayed reporting that a worker had kicked, choked and pinned a resident down in front of other staff, because they were intimidated by the perpetrator.

The report said community visitors made 5079 visits last year but Ms Pearce said what they saw was likely to be "only the tip of the iceberg".

The report also revealed:

Ongoing concerns about forceful restraint of mentally ill patients, including the case of a voluntary patient left with a bruised wrist after trying to leave a hospital.

An 18-year-old woman with bipolar disorder said she was sexually assaulted after being admitted to the male section of a hospital psychiatric facility.

Fears of inadequate facilities for disabled people, including one where 23 men shared one shower.

One resident walked out after 16 years. He has not been seen since.  

Ms Pearce said her office was actively promoting zero tolerance of abuse and violence in the sector and she criticised the departments of health and human services for not endorsing a new "Interagency Guideline for Addressing Violence, Neglect and Abuse". This was despite 31 agencies adopting the guidelines to encourage best practice, including all the main Victorian mental health and disability community sector organisations.