Neglect and its links to adult social care or safeguarding referrals to SPOC

Guidance-graphic-flaticon

The social work team in safeguarding have produced this brief guidance on how the issue of neglect is defined for purposes of the new single point of contact (SPOC) care pathways which are designed to bring us in line with current social care practice.

This concerns patients who meet Care Act eligibility criteria of having a physical and or mental impairment, disability or illness which prevents them carrying out at least two activities of daily living.

People who neglect themselves often decline help from others; in many cases they do not feel that they need it.

Family or neighbours can sometimes be critical of professionals because they don’t appear to be doing anything to improve the situation of the individual but there are limitations to what others can do if the adult has mental capacity to make their own decisions about how they live.

NEGLECT

Neglect is a form of abuse where the perpetrator, who is responsible for caring for someone who is unable to care for themselves, fails to do so. It can be a result of carelessness, indifference, or unwillingness to provide the care required.

Neglect may include the failure to provide sufficient supervision, nourishment, or medical care, or the failure to fulfill other needs for which the victim cannot provide themselves. These incidents can occur with formal or informal carer’s, in the home or in a organized care setting.

There are some calls crews attend, where neglect is being incorrectly attributed to an informal carer when making a referral to SPOC.

A common scenario encountered is where two adults are in the same household and one is caring for the other, but is failing to meet all the care needs of the other adult. In this scenario, there is no neglect (and no safeguarding), as the carer is attempting to meet the care needs as best they can, but are unable to meet all the needs, in this case the correct SPOC referral pathway is to Adult Social Care for a needs assessment of the cared for person, as there is clearly a need for additional help, if necessary an assessment would also then also be carried out of the carer’s needs by social care.

SELF NEGLECT

Most cases of self neglect will follow the SPOC Adult Social Care referral pathway or GP notification pathway.

In some cases, safeguarding responses may be appropriate rather than a referral for adult social care. However, this does not mean that everyone who self-neglects needs to be safeguarded.

Safeguarding duties will apply where the adult has care and support needs (many people who self-neglect do not), and they are at risk of self-neglect to an extent that the self neglect is life threatening.

Hoarding is now widely considered as a mental health disorder. Hoarding and self-neglect do not always appear together and one does not necessarily cause the other.

A clutter scale of seven or above in relation to hoarding, where there are also care and support needs will be considered a safeguarding, due to it’s impact on of safety of the patient and/or others.

We hope that this provides some useful guidance to you when making referrals to SPOC concerning this subject.

The social work team is normally available for consultation during office hours.

The Social Work Team
Mercedes Macfarlane, Beverley McWilliams and Alan Hay

If you have any questions please contact the team on social.workers@eastamb.nhs.uk.

Published 17th January 2020

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