Duty of Care in cases of self-neglect

Safeguarding adults at risk of harm often creates a tension for professionals between promoting an adult’s autonomy and their duty to try to protect them from harm. All professionals working with adults at risk should be aware of their duty of care in cases of self-neglect or hoarding, even when the individual has been assessed to have mental capacity in relation to the relevant decisions. Respect for autonomy and self-determination must always be balanced against the duty of care and promotion of dignity and wellbeing. The duty of care can be summarised as the obligation to exercise a level of care towards an individual, as is reasonable in all circumstances, by taking into account the potential harm that may reasonably be caused to that individual or their property. It means supporting an individual to achieve their chosen outcomes while maximising safety as far as practicable.

Darlington Safeguarding Partnership has a duty to ensure that partner agencies protect Darlington residents from foreseeable harm with consideration being given to others who may also be at risk, at which point an individual’s autonomy may potentially be overridden in the public interest. The overall aim is not to be bureaucratic or paternalistic, but to empower individuals to take control of shaping their own lives wherever possible and lead the pace of intervention.

Respect for autonomy does not mean abandonment. Working with self-neglecting adults often requires persistence over a long period rather than time-limited involvement.

This policy requires that all cases of self-neglect and hoarding assessed as high risk and open to Adult Social Care will not be closed prior to multi-agency agreement and a clear record of all protective measures and shared decision making should be kept.