Self-neglect pathway

An assessment using the Multi-Agency Self-Neglect & Hoarding Risk Assessment Guidance Tool [Word Document] should be used and informed by the appropriate pathway for Adults with Care and Support Needs who are self-neglecting.

If the screening scores green (low risk) in all domains, the referring agency should continue with intervention as appropriate and continue to monitor for changes in risk indicators. The agency may still lead and hold multi-agency meeting if they feel it would help with supporting the individual.

If the screening scores amber (medium risk) but no red (high risk) in any domain then the lead agency working with the person for whom there are concerns will ensure a person led assessment and comprehensive risk assessment is carried out. Once the assessments are completed ensure that information is shared, and appropriate support is requested from Adult Social Care via a referral to the Adult Contact Team on 01325 406111.

Adult Social Care will review the referral and provide the appropriate assessment or support.

A lead agency should hold responsibility. A vehicle for coordinating this work will be a multi-agency self-neglect meeting with all relevant parties (and/or carers). There is no prescriptive list of which organisations should be involved. Involvement will be determined by the person’s individual circumstances. The meeting will determine levels of risk and agree a self-neglect support plan. Where there are disagreements about any aspects of the plan, these should be resolved by consultation with a senior manager from the lead agency. Any agency can hold a multi-agency meeting.

Self-neglect support plans will be reviewed every six weeks, to monitor level of risk and continue with multi-agency response.

If the screening scores red (high risk) in any domain, then the lead agency working with the person for whom there are concerns will ensure a person led assessment and comprehensive risk assessment is carried out. Once the assessments are completed a safeguarding referral should be made to the Adult Contact Team 01325 406111.

Adult Social Care (ASC) may speak to the referrer to gather more information and to determine if any adult safeguarding concerns are identified. If adult safeguarding concerns are identified, the concern will be referred to the Adult Safeguarding Team (if no other ASC team is involved at the point of referral) or to the responsible specialist team for S42 enquiry and the Multiagency Safeguarding Adults Procedure will be followed.

If the multi-disciplinary meeting determines higher or lower risk than when first referred, change to and follow the appropriate pathway.

If no safeguarding concerns are identified, ASC will confirm a Lead Agency, a multiagency meeting with the person at the centre and all relevant parties (and/or carers) to determine levels of risk and agree self-neglect support plan.

If High risk continues for an Adult with Mental Capacity or increases following support, or multi-agency engagement is lacking, refer to the Risk Enablement Forum.