Self-neglect

A person living in a way that puts their health, safety, or wellbeing at risk.

Non-reportable concerns

Examples of isolated incidents where no other similar concerns have been identified and that do not need to be reported as a safeguarding concern include:

• Poor self-care causing some concern, but no signs of impact or distress.
• Property neglected but all essential services/appliances work.
• Risks can be managed by current professional oversight or universal services.
• The person is not at risk of losing their home, tenancy, or placement within the community.
• Evidence of hoarding with concerns about its impact on health/safety.
• No access to social care support.
• Occasional non-attendance at meetings, such as health appointments.

Concerns requiring consultation

More serious incidents will require internal consultation, through relevant organisational policies and procedures and senior leadership as well as potentially through the Sussex Safeguarding Adults Policy and Procedures and other organisations being made aware.

Actions that should be considered to reduce risk include:

• Consideration for advocacy services.
• Consideration for whether a Mental Capacity Act assessment is required.
• Professionals are advised to follow self-neglect guidance and convene a multi-agency meeting to discuss ongoing risk and intervention prior to a Multi-Agency Risk Management (MARM) referral if appropriate.
• Referral to Environmental Health services.
• Review of health care or treatment plan.
• Consider whether a referral to Children’s Services may be appropriate, if there is substance use and/or environmental concerns.

Examples that require external consultation with the relevant Adult Social Care department, and may lead to a safeguarding referral needing to be submitted, include:

• Failing to engage with health and social care professionals.
• Indication of lack of insight into self-neglect.
• Lack of essential amenities/food provision.
• Refusing medical treatment, care or equipment that will impact health and wellbeing.
• Property or environment shows signs of neglect with evidence of unsanitary conditions, clutter, hoarding that are potentially damaging to health and wellbeing.
• Where animals in property are impacting on the environment with a risk to health.

Reportable concerns

Serious incidents need to be formally raised as a safeguarding concern with the local authority Adult Social Care department. Consideration should also be given as to whether the police or other emergency services need to be contacted. Professional curiosity is important and a Think Family approach if children or other adults may be impacted.

In these cases, it is important that you consider additional actions to contacting the local authority. These include:

• RAISE SAFEGUARDING CONCERN
• If there is an indication a criminal act has occurred, the police must be consulted.
• Immediate safety plans must be implemented.
• Consider whether a referral to Children’s Services may be appropriate, if there is substance use and/or environmental concerns.

Examples of reportable concerns include:

• The person is living in squalid or unsanitary conditions that mean life is in danger without intervention.
• Extensive structural deterioration/damage in the property causing risk to life including fire or gas leaks.
• Lack of self-care and/or refusal of health/medical treatment resulting in a significant impact on health and wellbeing (i.e., malnutrition and potential risk to life).
• High level of clutter/hoarding leading to access being obstructed within a property and fire hazards.
• Behaviours such as substance use that pose risk to self and/or others, including when addiction leads to the neglect of other factors such as eating or accessing medical treatment, or the physical risks of substance withdrawal.
• The individual is not able to accept any support or future arrangements to improve the situation.