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Self Neglect & Adult Safeguarding: Responding to Self Neglect & Hoarding during Covid-19

Safeguarding people who self neglect: What Works?

Michael Preston-Shoot
Emeritus Professor of Social Work
University of Bedfordshire 

This session will draw on evidence from the presenter’s research (with David Orr and Suzy Braye OBE) into effective practice in self-neglect;
it will consider:
• the range and scope of self-neglect work nationally
• the challenges experienced in practice
• what goes wrong – findings from safeguarding adult reviews in cases of self-neglect
• what goes right - service users’ and practitioners’ perspectives on approaches that support positive outcomes
• effective interagency working in self-neglect

Michael started his presentation by explaining what we mean by self neglect – “Individuals who neglect themselves and people who hoard. This then impacts on their health”

During his talk Michael shared a video called Keith’s story. During this we learnt – Often someone living like this won’t have access to their bathroom or kitchen due to the hoarding, this then impacts on their wellbeing as they are unable to feed themselves properly or take care of their personal hygiene.

We also learnt that shockingly One third of people who die in house fires are hoarders.

Michael went on to explain that “Self neglect and hoarding is associated with being physically ill, mentally ill, substance misuse and psychosocial factors”


Identification and management of Self Neglect during Covid-19

Wendy Proctor
Designated Nurse Adult Safeguarding
Sunderland Clinical Commissioning Group

• the impact of Covid-19 on Self Neglect
• identification of self neglect
• managing risk and supporting a strengths based way of working to work together to identify meaningful solutions
• managing resistance to engage with services
• our experience 

Wendy began her presentation by saying “Self neglect worries people a lot. It’s a really complex issue”

She went on to say  - “The Care Act brought self neglect into safeguarding in 2014” - “The assumption with capacity is a dangerous assumption – The Mental Health Act must always be considered”

When explaining how to recognise if someone is self neglecting you should look for the following –

“Lack of Self Care”

“Lack of care of ones environment”

“Refusal of services”

Wendy finished by reiterating the importance of questioning Mental Capacity – “It’s so crucial to question mental capacity, making assumptions about capacity can lead to serious problems and must be reviewed all the time”