Self-Neglect and Hoarding
A Guide to Safeguarding and Support
A skilled, thorough risk assessment of the behaviours of self-neglect is needed in order to ensure effective care and support is available. This guide offers practical and applicable tools and solutions for all professionals involved in working with people who self-neglect. It includes tips for assessment and decision-making in the support process, and updates following the implementation of the Care Act 2014, which deemed self-neglect a safeguarding matter.
This book is a further step towards building a successful long-term management strategy for self-neglect and hoarding, rather than just a guide focusing on resolving the obvious, outward manifestations. It provides a great example of a 'journey of support' for the affected individual whilst not forgetting the legal obligations and moral duties of professionals. I'm confident, with the toolkit for a patient centred approach outlined in this book, our management of this disorder, with its considerable societal risks, will improve dramatically.
Self-Neglect and Hoarding contains much of the information practitioners will need in working with self-neglect. Barnett's emphasis throughout is on a person-centred approach to this important issue.
Deborah Barnett is a qualified social worker with experience across all aspects of adult services. Deborah has been a member of the Safeguarding Adults Board within her local authority of Durham and runs a successful training and consultancy business, T-ASC (training, Advice, Solutions and Consultancy).
Preface - A Word from the Philosophical
Prevention versus protection
Therapeutic needs assessment versus needs assessment
Individual social work versus individual, family and community social work
Personalised safeguarding versus risk management
Assessment - how much is enough?
Ethics and values
Introduction - An Overview
1. What is Self-Neglect and Hoarding?
Defining self-neglect and hoarding
Is it collecting or is it hoarding?
Attachment to objects
Sorting and organising
Links with other diagnoses
When to consider a referral for diagnosis
2. How Self-Neglect Affects People's lives
Physical and mental health
Families and carers
3. Themes from Adult Serious Case Reviews or Safeguarding Adult Reviews
Ethical decision-making considerations
Care Act compliant enquiries (542)
Risk to others
Mental health and substance misuse
Capacity and consent
Advocacy and representation
Comprehensive and holistic assessment
Compliance and insight
Imposed sanctions, imposed compliance or penalties
Management support and response
Defensible decision making
4. Safeguarding those who Self-Neglect under the Care Act 2014
The safeguarding referral
Eligibility criteria for safeguarding adults
Principles of safeguarding
Information recording and sharing
How the local authority responds
Defensible decision making
The Care Act and information sharing
The Crime and Disorder Act 1998
Case law judgments
Ten steps to information sharing
5. Therapeutic Interventions
Building a rapport
Trauma, abuse, neglect, loss and bereavement
The cycle of change
The beginning of assessment
6. Assessment and Engagement
What is a good assessment?
An example of a safeguarding adult referral and assessment
7. Supporting the Practitioner
Creating social work strategies that are supportive
Social work intervention models
Case loads and austerity
Epilogue: A Final Thought from the Philosophical
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