New Self-Neglect and Hoarding Multi-Agency Procedure and Practice Guidance (June 2024)
Self-neglect features in a significant number of national and local Safeguarding Adult Reviews (SARs), highlighting the fact that self-neglect is a complex area for intervention as issues of capacity, lifestyle and choice are often involved which requires the judgement of individual practitioners about what is an acceptable way of living and the degree of risk some lifestyle choices pose to the individual.
This procedure and guidance was developed following learning highlighted through a number of Learning Lesson Reviews undertaken by Darlington Safeguarding Partnership in 2022 to 2023. With agreement to develop practice guidance and include examples of positive, flexible and creative approaches to support practitioners in engaging with people who are self-neglecting to help understand the barriers organisations pose for those who consistently refuse support, including Mental Capacity Act guidance and establish a multi-agency risk escalation meeting to manage those complex cases.
Introduction
This Procedure and Practice Guidance was produced and endorsed by the Darlington Safeguarding Partnership in June 2024 within the context of the duties set out in paragraph 14.2 of the Care Act (2014) Care and Support Statutory Guidance.
Under Section 42 of the Care Act 2014 safeguarding duties apply to an adult who meets the following criteria:
- has needs for care and support (whether or not the local authority is meeting any of those needs) and:
- is experiencing, or at risk of abuse or neglect and;
- as a result of those care and support needs, is unable to protect themselves from either the risk of, or the experience of abuse or neglect.
An adult who meets the above criteria is referred to as an ‘adult at risk’. Safeguarding duties also apply to family carers experiencing intentional or unintentional harm from the adult they are supporting or from professionals and organisations they are in contact with.
The guidance is intended to provide a framework for working with an adult at risk in Darlington who self-neglects. The purpose is to identify self-neglect, reduce the associated risks; and wherever possible, prevent serious injury or death of adults at risk who appear to be self-neglecting.
Aim of Multi-Agency Practice Guidance and Process
This policy and procedural guidance work towards reducing the risk; and wherever possible prevent the serious injury or death of an adult at risk who may appear to self-neglect by:
- providing a framework for ensuring adults at risk are empowered as far as possible, to understand the implications of their actions and/or behaviours
- promoting a shared, multi-agency understanding and recognition of the issues, including those involved in working with adults at risk who self-neglect
- providing a mechanism for ensuring there is effective multi-agency working and practice; and concerns receive appropriate prioritisation
- ensuring that all agencies and organisations uphold their duties of care
- ensuring a proportionate response to the level of risk to self and others.
This is achieved through:
- promoting a person-centred approach which supports the right of the adult at risk to be treated with respect and dignity; and to be in control of, and as far as possible, to lead an independent life.
- aiding recognition of situations of self-neglect.
- increasing knowledge and awareness of the different powers and duties provided by legislation, their relevance to the particular situation and adults at risk’ needs. This includes the extent and limitations of the ‘duty of care’ of professionals.
- promoting adherence to a standard of reasonable care whilst carrying out duties required within a professional role, in order to avoid foreseeable harm.
- promoting a proportionate approach to risk assessment and management.
- clarifying different agency and practitioner responsibilities and in so doing, promoting transparency, accountability, evidence of decision-making processes, actions taken and:
- promoting an appropriate level of intervention through a multi-agency approach.
This guidance does not include issues of risk associated with deliberate self-harm by an adult at risk. If self-harm appears to have occurred due to an act of neglect or inaction by another individual or service, consideration should be given to raising a safeguarding adults concern with Adult Social Care.
You will find a range of information and resources below to support you in your role.