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Book Full text available online for free

Risk identification and virtual interventions for social workers

Author:
SOCIAL CARE INSTITUTE FOR EXCELLENCE
Publisher:
Social Care Institute for Excellence
Publication year:
2020
Pagination:
17
Place of publication:
London

This quick guide will help social workers and social care practitioners understand how to gather evidence and information, so they are able to identify and assess risks normally gathered through observation. It describes the three stages of the risk assessment process, which include: identifying risks; assessing risks; and managing risks. It then examines the factors that increase the risk of: personal neglect; malnutrition; incontinence or double incontinence; environmental neglect and/or hoarding; carer breakdown; and social isolation. (Edited publisher abstract)

BookDigital Media Full text available online for free

Self-neglect at a glance

Author:
SOCIAL CARE INSTITUTE FOR EXCELLENCE
Publisher:
Social Care Institute for Excellence
Publication year:
2018
Pagination:
6
Place of publication:
London

Self-neglect is an extreme lack of self-care, it is sometimes associated with hoarding and may be a result of other issues such as addictions. This At a glance briefing on self-neglect looks at possible causes of self-neglect, lists relevant legislation, discusses some of the barriers to good practice when working with people who self-neglect, provides suggestions for effective approaches and practical actions to take. The briefing is for practitioners working in the community, including frontline housing officers, social workers, police and health professionals. (Edited publisher abstract)

Book Full text available online for free

Self-neglect policy and practice: key research messages

Authors:
BRAYE Suzy, ORR David, PRESTON-SHOOT Michael
Publisher:
Social Care Institute for Excellence
Publication year:
2015
Pagination:
22
Place of publication:
London

This briefing highlights key findings from research which looked at learning from policies and practices that have produced positive outcomes in self-neglect work. The original research drew on a survey 53 local authorities and a series of in-depth interviews with 20 managers, 42 practitioners in adult social care and in safeguarding, and 29 people who use services. The findings identify factors that make self-neglect services more effective and organisational arrangements that could best help self-neglect work. Interviews of people who use services, practitioners and managers looked at: causes of self-neglect, accepting help, the experience and impact of self-neglect. Five areas which were most frequently identified as making a positive difference to self-neglect in practice were: the importance of relationships, 'finding' the person, legal literacy, creative interventions and effective multi-agency working. It concludes that the heart of self-neglect practice is a balance of knowing the person; being, in showing personal and professional qualities of respect; and doing, in the sense of balancing hands-on and hands-off approaches. The briefing is intended for people who use services, carers, non-specialist workers and the general public. (Edited publisher abstract)

Book Full text available online for free

Self-neglect policy and practice: research messages for managers

Authors:
BRAYE Suzy, ORR David, PRESTON-SHOOT Michael
Publisher:
Social Care Institute for Excellence
Publication year:
2015
Pagination:
37
Place of publication:
London

This briefing highlights key findings for managers from research which looked policies and practices that have produced positive outcomes in self-neglect work. The original research drew on a survey 53 local authorities and a series of in-depth interviews with 20 managers, 42 practitioners in adult social care and in safeguarding, and 29 people who use services. It begins by defining self-neglect and then looks at specific aspects of strategy and governance, including the location of self-neglect within adult safeguarding, the commissioning of reviews, and the development of policies for self neglect. It then looks at operational aspects, focusing on building multi-agency cooperation, configuring effective referral pathways and supporting frontline practice through training and guidance. Four questions for managers to consider when reviewing their organisation's self-neglect policy and practice are also included. Self-neglect practice was found to be more successful where practitioners built good relationships; worked at the individuals pace; were honest about risks and options; made use of creative and flexible interventions; and engaged in effective multi-agency working. Organisational arrangements that best supported self-neglect work included: a clear location for strategic responsibility for self-neglect; a shared understanding between agencies; clear referral routes; training and development for staff working with adults who self-neglect. (Edited publisher abstract)

Book Full text available online for free

Self-neglect policy and practice: research messages for practitioners

Authors:
BRAYE Suzy, ORR David, PRESTON-SHOOT Michael
Publisher:
Social Care Institute for Excellence
Publication year:
2015
Pagination:
28
Place of publication:
London

This briefing highlights key findings for practitioners from research which looked policies and practices that have produced positive outcomes in self-neglect work. The original research drew on a survey 53 local authorities and a series of in-depth interviews with 20 managers, 42 practitioners in adult social care and in safeguarding, and 29 people who use services. Findings from the interviews found that that there was no clear lifestyle patters which led to self-neglect. Factors that were seen as instrumental in supporting good outcomes in self-neglect work included: the importance of relationships; 'finding’ the person through understanding their life history; understanding of legal duties and powers; making use of creative interventions; and effective multi-agency working. The final section looks at the organisational infrastructure for self-neglect work. Key themes were: strong inter-agency strategic ownership; clear referral pathways; reliable data; a range of coherent mechanisms for turning strategic commitments into operational reality.

Book Full text available online for free

Self-neglect policy and practice: building an evidence base for adult social care

Authors:
BRAYE Suzy, ORR David, PRESTON-SHOOT Michael
Publisher:
Social Care Institute for Excellence
Publication year:
2014
Pagination:
222
Place of publication:
London

Using a survey of local authorities in England and interviews with staff and service users, this research investigates current policy and practice in self-neglect in adult social care. A total of 53 out of 152 local authorities responded to the survey (34.9 per cent). Interviews were also completed with 20 managers, 42 practitioners and 29 people who use services across 10 authorities. Key themes emerging from the in-depth interviews were around the areas of creating a strategic and operational infrastructure for self-neglect practice and using approaches that resulted in positive outcomes. Issues discussed include the inter-agency governance regarding policies and protocols (such as LSAB or other mechanism); improved inter-agency training and support; referral pathways and better data collection on self-neglect. Approaches to practice that helped achieve positive outcomes by those involved included the importance of relationship-based and person-centred practice; considering the whole person; an understanding of the Mental Capacity Act 2005; the use of creative interventions; and the value of multi-agency working. (Edited publisher abstract)

BookDigital Media Full text available online for free

Self-neglect and adult safeguarding: findings from research

Authors:
SOCIAL CARE INSTITUTE FOR EXCELLENCE, BRAYE Suzy, et al
Publisher:
Social Care Institute for Excellence
Publication year:
2011
Pagination:
90p., bibliog.
Place of publication:
London

This study, commissioned by the Department of Health, looks at the concept of self-neglect as defined in the literature and interpreted in adult safeguarding practice. The report draws on a systematic review of the literature, workshops with senior managers and practitioners in specialist safeguarding roles, a focus group with adult social care practitioners and interviews with key informants. The main areas of the report cover: how self-neglect is conceptualised; how mental capacity and human rights have an impact on the conceptual framework; the interface between self-neglect and safeguarding; and the nature of professional interventions. The literature identifies wide range of perspectives that inform professionals’ understanding of self-neglect and highlights the tensions between respect for autonomy and a perceived duty to preserve health and wellbeing. Details of the search strategy using are included in the appendices.

Journal article Full text available online for free

'They don't want them to have capacity': multi-agency operationalisation of the Mental Capacity Act 2005 in England with adults who self-neglect

Authors:
ASPINWALL‐ROBERTS Elaine, et al
Journal article citation:
Health and Social Care in the Community, early cite May 2022,
Publisher:
Wiley

The number of adults who self-neglect and thus fall under the aegis of local authority adult safeguarding procedures in England has increased substantially since the introduction of the Care Act 2014. The requirement for collaborative working between agencies dealing with these adults in a safeguarding context is explicit in government policy and legislation. Decisions made by the multiplicity of agencies that may work with people who self-neglect are largely guided by the Mental Capacity Act 2005 (MCA). The overall objective of this research was to develop a clearer understanding of how the range of agencies that might typically be involved in the life of a self-neglecting person work together. This article examines how agencies put the MCA into practice in their work with people who self-neglect, and how they understand their own and others’ roles and responsibilities in so doing. This qualitative study took place in two local authorities in England from 2016 to 2017 and informed a wider action research study which was completed in 2019. Non-probability purposive sampling was used to recruit participants from the professional groups who might typically be involved with self-neglect cases. À total of 245 participants from across 17 different professional groups took part in semi-structured interviews, in a group, paired or individual format, decided by their customary working configuration. Data from the interview transcripts was analysed using thematic analysis. Three key themes in relation to how participants understood the MCA and multi-agency working emerged from the analysis of this data set. These were; a lack of understanding of the MCA by participants and other agencies; a reluctance to engage with MCA assessments; and a perception of manipulation of the MCA by other professionals. This study underlines the importance of the informed application of the MCA in working with people who self-neglect, and an urgent need to consider how this could be enhanced if the service user is not to experience intrusive interventions resulting from professional misinterpretation. (Edited publisher abstract)

Journal article Full text available online for free

Adult safeguarding managers' understandings of self-neglect and hoarding

Authors:
OWEN Jennifer, et al
Journal article citation:
Health and Social Care in the Community, early cite May 2022,
Publisher:
Wiley

Self-neglect and hoarding are behaviours that are hard to define, measure and address. They are more prevalent among older people because of bio-psycho-social factors, which may be exacerbated by advancing age. This paper aims to further understandings of self-neglect and hoarding in England's Care Act 2014 context, drawing on a study involving qualitative interviews with local authority adult safeguarding managers who play an important role in determining interventions with individuals who self-neglect and/or hoard. Online interviews were conducted with adult safeguarding leads and managers from 31 English local authorities in 2021. Interview data were subject to thematic analysis. This paper explores the commonalities and differences in adult safeguarding managers' understandings of the causes and consequences of self-neglect and/or hoarding among older people, which are likely to have tangible impacts on service provision in their local authority, and influencing of wider changes to policies and procedures. Most participants understood these phenomena as caused by a range of bio-psycho-social factors, including chronic physical conditions, bereavement, isolation. A minority took a more clinical or psycho-medical perspective, focusing on mental ill-health, or referred to the social construction of norms of cleanliness and tidiness. Whatever their understanding, by the time such behaviours are brought to the attention of safeguarding professionals a crisis response may be all that is offered. The implications of the findings are that other agencies should be encouraged to provide more early help to older people at risk of self-neglect and/or of developing harmful hoarding behaviours, and that sustained engagement with those affected may help to understand some of the causes of these behaviours to enable effective support or practice interventions. (Edited publisher abstract)

Journal article Full text available online for free

Experiences of adult social work addressing self-neglect during the Covid-19 pandemic

Authors:
MANTHORPE Jill, et al
Journal article citation:
Journal of Social Work, early cite April 2022,
Publisher:
Sage

Summary: Internationally there has been much interest in the impact of the COVID-19 pandemic on the care and support of older people including those with needs arising from self-neglect and/or hoarding. During the pandemic English local authorities' legal duties remained to respond to concerns about harm about people with care and support needs living in the community. This paper reports interviews with 44 participants working for adult safeguarding/adult protective services (APS) in 31 local authorities recruited from all English regions. Interviews took place online in November-December 2020 as the pandemic's second UK wave was emerging. Analytic induction methods were used to develop themes. Findings: Participants reported some of the variations in referrals to their services with more contact being received from community sources concerned about their neighbours' welfare. Participants provided accounts of the local organisation of adult safeguarding services during the pandemic, including in some areas the potential for offering early help to older people at risk of harm from self-neglect or hoarding behaviour. Online inter-agency meetings were positively received but were acknowledged to potentially exclude some older people. Applications: This article reports observations from adult safeguarding practitioners about their services which may be of interest internationally and in renewing services that can sustain public interest in the welfare of their older citizens and in developing early help. The findings reflect those from children's services where online meetings are also predicted to enhance professional communications post-pandemic but similarly need to ensure effective engagement with service users and their families. (Edited publisher abstract)

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