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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

On (not) learning from self-neglect safeguarding adult reviews

Author:
PRESTON-SHOOT Michael
Journal article citation:
Journal of Adult Protection, 23(4), 2021, pp.206-224.
Publisher:
Emerald

Purpose: The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis. It also explores whether lessons are being learned from the findings and recommendations of an increasing number of reviews on self-neglect cases. Design/methodology/approach: Further published reviews are added to the core data set, mainly drawn from the websites of safeguarding adults boards (SABs). Thematic analysis is updated using the domains used previously. The domains and the thematic analysis are grounded in the evidence-based model of good practice, reported in this journal previously. Findings Familiar findings emerge from the thematic analysis and reinforce the evidence-base of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners working with such cases. Multiple exclusion homelessness and alcohol misuse are prominent. Some SABs are having to return to further cases of self-neglect to review, inviting scrutiny of what is (not) being learned from earlier findings and recommendations. Research limitations/implications The national database of reviews commissioned by SABs remains incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. National Health Service Digital annual data sets do not enable the identification of reviews by types of abuse and neglect. However, the first national analysis of SARs has found self-neglect to be the most prominent type of abuse and/or neglect reviewed. Drawing together the findings builds on what is known about the components of effective practice, and effective policy and organisational arrangements for practice. Practical implications: Answering the question “why” remains a significant challenge for SARs. The findings confirm the relevance of the evidence-base for effective practice but SARs are limited in their analysis of what enables and what obstructs the components of best practice. Greater explicit use of research and other published SARs might assist with answering the “why” question. Greater scrutiny is needed of the impact of the national legal, policy and financial context within which adult safeguarding is situated. Originality/value: The paper extends the thematic analysis of available reviews that focus on study with adults who self-neglect, further reinforcing the evidence base for practice. Propositions are explored, concerned with whether learning is being maximised from the process of case review. (Edited publisher abstract)

Book Full text available online for free

Social care responses to self-neglect among older people: an evidence review of what works in practice

Authors:
MARTINEAU Stephen, et al
Publisher:
NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London
Publication year:
2021
Pagination:
48
Place of publication:
London

A review of the English-language research literature (published 2015-20), which focuses on adult social care responses to self-neglect among older people. The report also examines the law and policy context in England provided by the Care Act 2014 and the Mental Capacity Act 2005. The literature generally presents the building of good relationships between practitioners and people who self-neglect as the primary ‘intervention’. This is likely to involve a sustained engagement on the part of practitioners in order to build rapport and trust. The literature suggests that more concrete interventions work better if they take place against the backdrop of these trusting relationships. There is a potential interplay between negotiated and imposed interventions. These might involve, for example, making the person’s environment safe, or supporting the person managing their bills, through to statutory enforced action. It is also common for the literature under review to place a high value on multi-agency working because of the complexity self-neglect often involves. Researchers highlight the wide array of agencies that may be engaged and warn of the barriers to good practice, such as lack of joined-up systems (silo working), an ignorance of others’ roles, and the lack of a shared language around self-neglect. A recurring theme in the literature is the difficulty practitioners face in cases where the person has mental capacity with respect to the relevant decisions but is reluctant to alter behaviour that appears to be placing them at risk of harm. The value placed on the autonomy of the individual in these circumstances may be viewed in the light of recent debates on the nature of autonomy and the degree to which the concept should be approached in relational rather than narrowly individualistic terms. (Edited publisher abstract)

Journal article Full text available online for free

Care ethics for supported decision-making. A narrative policy analysis regarding social work in cases of dementia and self-neglect

Author:
THELIN Angelika
Journal article citation:
Ethics and Social Welfare, 15(2), 2021, pp.167-184.
Publisher:
Taylor and Francis
Place of publication:
Abingdon

Sweden has been held up as one of the most advanced states when it comes to legal realisation of human rights for older persons with dementia, and there are national policies that propose how welfare professionals are to fulfil these rights. However, previous research has repeatedly shown that care managers in Sweden make decisions that leave these persons and their families without suitable interventions, which is especially problematic in cases of self-neglect (an inability to care for oneself combined with resistance to receiving care from others) when basic living standards for health and well-being are jeopardised. This problem is increasing around the world as dementia becomes more common, but there has been little national or international research on policies affecting this matter. This article examines how national policies in Sweden guide care managers to work ethically in cases of self-neglect among older persons with dementia. Through a policy narrative approach, the findings specify care ethical standards that aim to support decision-making abilities in such cases. The discussion dwells on how weaknesses in the identified narrative, in the context of dementia-associated self-neglect, can explain why these standards seem to have little impact on practice. (Edited publisher abstract)

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