Self-neglect

All individuals have the right to take risks and to live their life as they choose. These rights will be respected and weighed when considering duties and responsibilities towards them. They will not be overridden, other than where it is clear that the consequence would be seriously detrimental to their, or another person’s health and wellbeing and where it is lawful to do so. Staff will also consider the rights:

• to privacy and information sharing under the Data Protection Act, weighed against the level of risk; and
• of others who may be affected

Staff working with individuals who self-neglect should consider the support other agencies could provide, including:

• District Council
• Housing and Environmental Services
• Mental Health Services.  Discuss with their GP if you are concerned that the person is:
  • suffering from mental ill-health, or
  • their mental health is impacting on decision making

Consider if a referral to mental health services is appropriate.

• Health Services. If the individual is registered with a GP you must contact them to advise on the current health of the patient. The GP will also be able to advise on other health professionals involved with the patient and ensure they are involved in the multi-agency plan.
• Lincolnshire Police will respond to urgent cases where life may be at risk. Our officers will work with partners to agree suitable safeguarding strategies for all individuals concerned. We are committed to sharing information with our partners to identify those in need of support.
• Fire and Rescue Services. If you identify any risks relating to fire, refer to Lincolnshire Fire and Rescue Services. Complete the referral form.
  If the patient does not consent, but you consider them to be at high risk, or believe the risk to others is high risk, telephone 01476 565441 and discuss your concerns with the community fire safety team. Consent should always be sought where possible.  Non-consent should not prevent a referral.  You can refer for staff safety and public safety.
• Wellbeing service
• Neighbourhood working or team
• Voluntary services
• Ambulance services do not case-hold, however they often attend people who self-neglect and can provide additional information on how a person is managing. Ambulance services also have frequent caller teams and safeguarding teams who may be able to support in attendance at multi-agency meetings to support the individual moving forward.
• Children safeguarding
• Adult safeguarding

If required, refer to the LSAB professional resolution and escalation policy.

If the individual you are working with is homeless:

• refer to the Lincolnshire homelessnes strategy
• contact the relevant district council

At the heart of self-neglect is a complex interaction of knowing, being and doing:

Knowing:

Understanding the whole person, their history, its significance to their current situation, along with their knowledge that underpins professional practice.

Being:

Being on the journey with the patient. Showing professional qualities of respect, empathy, honesty, reliability, integrity and staying alongside.

Doing:

In the sense of balancing hands-on and hands-off approaches.  Ever seeking the tiny opportunity for consent doing the small things.  These then may lead to negotiations for the bigger things. It also includes referrals to others that can help.

Improvements to health, wellbeing and home conditions can be achieved by spending time building relationships and gaining trust. When people are persuaded to accept help, some research has shown that they rarely go back to their old lifestyle.  This sometimes means receiving help over a long period. This may include:

• treatment for medical or mental health conditions or addictions
• or practical help with de-cluttering and deep cleaning someone's home