1. Background
Adult K was under the care of Mental Health and the Local Authority when a non-fatal fire occurred. The agencies had observed clutter in the home, including dirty dishes, soiled carpets, and discarded cigarette ends on the floor. Following the non-fatal fire, a safeguarding adult concern was raised
2. Theme 1: Self-Neglect
Mental Health and Local Authority reported concerns regarding self-care. Concerns were also raised regarding the home, which had rubbish bags, cigarette ends, unclean dishes, and food boxes.
3. Theme 2: Declining Support
On multiple instances, Adult K was offered assistance with maintaining their home. However, they persistently declined the assistance, indicating they would handle the situation independently.
What to do?
- Be professionally curious – how and what support looks like and how to work collaboratively to achieve the objective.
- Mental Capacity Act (MCA) “unwise decisions” and an appropriate and proportionate response to this to achieve a legitimate aim.
- Consider referral for a Home Fire Safety Check
4. Theme 3: Legal Literacy
Adult K was eligible for Section 117 aftercare (Mental Health Act 1983, as amended in 2007) and was subject to Section 42 of the Safeguarding Act (Care Act 2014).
What do you know?
- Interagency Section 117 Mental Health Act Guidance
- Awareness of Section 117 responsibilities.
- When to undertake a Mental Capacity Assessment.
The Legal Framework:
The Care Act (2014) :
- Section 9 – Assessment of an adult’s care and support
- Section 10 – Carers’ Assessments
- Section 11 – Refusal of assessment
- Section 42 – Enquiry by Local Authority
- Section 44 – Safeguarding Adult Reviews
- Mental Health Act (1983) – Section 117 Aftercare
- Mental Capacity Act 2005 – Code of Practice
5. Theme 4: Safeguarding
The concern of self-neglect and clutter
How?
- To be knowledgeable about the types of abuse and accessible support options.
- To collaborate with the Local Authority to ensure an effective response to safeguarding, including
the capacity to challenge decisions. - To communicate the concerns from your agency.
6. Theme 5: Making Safeguarding Personal
Agencies were aware of Adult K’s desires and wishes, but this did not extend to their protection.
What does this look like?
- Consider the risk and the necessary measures to mitigate it.
- To seek direction when a person is at significant harm and declines interventions.
7. What are my responsibilities?
- Collaborate with partners to find the best method of working with the adult.
- Respect the individual’s viewpoints and work toward their desired outcomes by being person centred.
- Be analytical in order to find underlying factors that will aid in the resolution of the problem.
- Be patient, acquire the individual’s trust, and agree on small steps
8. What to do now……
Read the Adult K Executive Summary Report
- Reflect on this case within team meetings and supervisions
- Use this Learning Briefing in training, where appropriate
- Think about how you can adapt your practice based on this learning
Check the our Local Policies, and Guidance Page for up to date information including:
- High Risk Adults Panel (HRAP)
- Inter-Agency Safeguarding Adults Procedure and Decision Support Guidance
- Making Safeguarding Personal Guidance
- Mental Capacity Act and Deprivation of Liberty Safeguards Policy
- Mental Capacity Act Guidance
- Professional Challenge and Curiosity Learning Briefing
- Self-Neglect and Hoarding Policy and Guidance
- Self-Neglect 7 Minute Guides for Practitioners
Check out these other useful resources and share with your team: