Learning lessons about self-neglect? An analysis of serious case reviews

Braye, Suzy, Orr, David and Preston-Shoot, Michael (2015) Learning lessons about self-neglect? An analysis of serious case reviews. Journal of Adult Protection, 17 (1). pp. 3-18. ISSN 1466-8203

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Abstract

Purpose
– The purpose of this paper is to report the findings from research into 40 serious case reviews (SCRs) involving adults who self-neglect.

Design/methodology/approach
– The study comprised analysis of 40 SCRs where self-neglect featured. The reviews were found through detailed searching of Local Safeguarding Adult Board (LSAB) web sites and through contacts with Board managers and independent chairs. A four layer analysis is presented of the characteristics of each case and SCR, of the recommendations and of the emerging themes. Learning for service improvement is presented thematically, focusing on the adult and their immediate context, the team around the adult, the organisations around the team and the Local Safeguarding Board around the organisations.

Findings
– There is no one typical presentation of self-neglect; cases vary in terms of age, household composition, lack of self-care, lack of care of one's environment and/or refusal to engage. Recommendations foreground LSABs, adult social care and unspecified agencies, and focus on staff support, procedures and the components of best practice and effective SCRs. Reports emphasise the importance of a person-centred approach, within the context of ongoing assessment of mental capacity and risk, with agencies sharing information and working closely together, supported by management and supervision, and practising within detailed procedural guidance.

Research limitations/implications
– There is no national database of SCRs commissioned by LSABs and currently there is no requirement to publish the outcomes of such inquiries. It may be that there are further SCRs, or other forms of inquiry, that have been commissioned by Boards but not publicised. This limits the learning that has been available for service improvement.

Practical implications
– The paper identifies practice, management and organisational issues that should be considered when working with adults who self-neglect. These cases are often complex and stressful for those involved. The thematic analysis adds to the evidence-base of how best to approach engagement with adults who self-neglect and to engage the multi-agency network in assessing and managing risk and mental capacity.

Originality/value
– The paper offers the first formal evaluation of SCRs that focus on adults who self-neglect. The analysis of the findings and the recommendations from the investigations into the 40 cases adds to the evidence-base for effective practice with adults who self-neglect.

Item Type: Article
Schools and Departments: School of Education and Social Work > Social Work and Social Care
Subjects: H Social Sciences
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0773 Personal health and hygiene Including clothing, bathing, exercise, travel, nutrition, sleep, sex hygiene
Depositing User: Pascale Fanning-Tichborne
Date Deposited: 23 Feb 2015 09:55
Last Modified: 07 Mar 2017 07:47
URI: http://sro.sussex.ac.uk/id/eprint/53039

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Project NameSussex Project NumberFunderFunder Ref
Scoping the issues around self-neglect in social care and allied health and welfare adult servicesG1095Skills for CareUnset