What is Self-Neglect?
Safeguarding adults is about protecting those at risk of harm (vulnerable adults) from suffering abuse or neglect.
It is recognised that certain groups of people may be more likely to experience abuse and less able to access services or support to keep themselves safe.
Self-neglect includes situations where a person is declining support with their care needs, hygiene, health or their environment, and this is having a significant impact on their overall well being.
Self-neglect can be a complex and challenging issue to address, because of the need to find the right balance between respecting a person’s autonomy and fulfilling a duty to protect the adult’s health and well-being.
Self-neglect implies there may be an inability or unwillingness or both to attend to ones’ personal care and support needs and impact on well-being and safety. It may manifest in different ways, from lack of self-care to an extent that it threatens personal health and safety by way of, neglecting to care for one’s: personal hygiene, and/or health, and/or surroundings, and/or hoarding.
Self-neglect differs from other safeguarding concerns and forms of neglect as there is no perpetrator of abuse, however, abuse cannot be ruled out as a purpose for becoming self- neglectful.
People may self-neglect and/ or hoard for a variety of reasons, such as:
- unmet care and support needs
- an inability to maintain own self-care and household chores
- chronic use of substances and/or alcohol impacting on their functioning
- having parents who hoarded (a learnt behaviour)
- childhood neglect, trauma or an adverse experience
- the impact of abuse or neglect domestic violence and abuse
- life changing events such as loss of a job, social status or accommodation, bereavement
- the loss of a strongly held value system
- reduced independence due to an accident, trauma, major illness or the onset of frailty.
An intervention or investigation into the reasons for self-neglect is necessary to determine if any form of abuse has taken place. This is not always as easy as it requires the concerned person to develop a rapport with the self-neglecting person and gain their trust in order to ask about their emotions and how they feel about themselves.
Hoarding is the excessive collection and retention of any material to the point that it impedes day to day functioning.
Below is a directory of published safeguarding adult reviews (SARs), by the SAB where learning from self-neglect has been identified. The SAB acknowledge that there are reoccurring themes from local and national learning from SARs that must be addressed. The SAB consider what the obstacles are in implementing recommendations and sustaining improvement and there will be a focus on good practice to promote learning, alongside an emphasis on good quality care principles and the role of effective support and supervision of the workforce to embed learning and inform future practice.
|Name and link
|SAB Partnership that
|Pauline||2023||West of Berkshire|
|Louise||2022||West of Berkshire|
|Ken||2021||West of Berkshire|
|Henry||2020||West of Berkshire|
|Carol||2020||West of Berkshire|
|Paul||2019||West of Berkshire|
|Aubrey||2018||West of Berkshire|
There is a national SAR database, where you can search for SARs where learning in regard to self-neglect has been identified.
Guidance and templates to help staff safeguard individuals who may be at risk from hoarding and self-neglect:
- Self- Neglect and Hoarding Safeguarding Pathway Toolkit has been created to support professionals across the West of Berkshire in their decision making when considering if a safeguarding concern should be raised in response to concerns in regard to vulnerable adults that are or are at risk of self-neglecting and/or hoarding. On completion of the toolkit a total risk score will be obtained and advice on what action should be taken in regard to the total score is provided. There are two example toolkits based on fictious cases Mr. Brown and Mrs. Red, please refer to for best practice examples of completed toolkits.
- Clutter Image Ratings – Used to determine the severity of hoarding in peoples homes. These have been produced as part of a study and are used widely across the world. It is understood that in the UK 2.5-6% homes are effected by hoarding.
- In November 2023, Sue Ross,Assistant Director Safeguarding, Quality, Performance and Practice at Reading Borough Council, delivered a presentation on Hoarding and learning from SARs, a copy of the presentation can be found here.
- On the 18th October 2022, in response to the West of Berkshire Safeguarding Adults Partnership Boards Priority on Self-Neglect, the Boards Independent Chair Professor Keith Brown delivered a session on Self-Neglect and the Mental Capacity Act. The recording of the session can be found here.
- Keith’s story: produced by Birmingham Safeguarding Adults Board, a personal and touching film about hoarding
- In December 2020 the SAB produced a 5 minute briefing on self-neglect.
- In May 2021, West Midlands Regional Adults Safeguarding Leads delivered a webinar on Self-Neglect and the Mental Capacity Act.
- Consent, the NHS have a useful guide on consent to treatment.
- Self-Neglect – Understanding my Story – This is what works – Deborah Barnett
- Lambeth Together have produced a short animation which explains self-neglect and the role everyone plays.
- On the 8th February 2023, Suzy Bray – Emerita of Social Work, University of Sussex and Independent Safeguarding Consultant, delivered a webinar on Identifying and Responding to Self Neglect – Guidance for the Voluntary Care Sector and a copy of the presentation.
- During safeguarding adults week 2022 there was a day focused on self-neglect and the following learning tools was produced:
- Self neglect learning brief.
- A recording of the webinar Self-Neglect – Why do people self-neglect?, presented by Suzy Braye. The webinar provides information and guidance regarding the psychology of self-neglect and how to work with this.
- A recording of the webinar on Hoarding, presented by Jo Cooke from Hoarding Disorders UK. The webinar provides guidance in order to work effectively with individuals who exhibit hoarding behaviours.
- A recording of the webinar on Self-Neglect and Fire Risk, presented by Neil Whitemann from the Royal Berkshire Fire and Rescue Service. The webinar provides information and guidance of how to manage fire risk when working with individuals who may be at risk of fire at their homes due to hoarding behaviours.