CHW221-Safeguarding People at Risk of Self-Neglect and Hoarding Policy

Registration Number: {{org_field_registration_no}}

Safeguarding People at Risk of Self-Neglect and Hoarding Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} has robust systems in place to identify, assess, and support individuals at risk of self-neglect and hoarding, in compliance with Welsh safeguarding legislation and CIW regulations. This policy outlines clear intervention strategies to safeguard service users while respecting their rights, dignity, and autonomy.

2. Scope

This policy applies to:

All service users who may be at risk of self-neglect or hoarding.
All staff, including care workers, nurses, and management who may come into contact with service users displaying such behaviours.
External agencies, including safeguarding teams, environmental health officers, and CIW inspectors, involved in risk management and intervention.

It covers:

Recognition and assessment of self-neglect and hoarding.
Intervention strategies and support plans.
Legal frameworks and best practice guidance.
Multi-agency collaboration for safeguarding purposes.

3. Legal and Regulatory Compliance

This policy aligns with:

The Social Services and Well-being (Wales) Act 2014, placing a duty on care providers to safeguard vulnerable individuals.
The Regulation and Inspection of Social Care (Wales) Act 2016, ensuring care services provide safe and effective support.
The Mental Capacity Act 2005, guiding decision-making for individuals who may lack capacity due to self-neglect.
The Public Health Act 1936 and 1984, which allows interventions for hoarding that poses a health risk.
The CIW Safeguarding and Well-being Framework, providing guidance on identifying and managing self-neglect.
The Equality Act 2010, ensuring interventions do not discriminate against individuals with disabilities or mental health conditions.

4. Definitions

4.1 Self-Neglect

Self-neglect is the inability or unwillingness of an individual to meet their own personal, health, or environmental needs, leading to a risk of harm. This may include:

Neglecting personal hygiene, leading to infections or skin conditions.
Refusing medication or medical treatment, despite health deterioration.
Failing to eat or drink adequately, leading to malnutrition or dehydration.
Living in unsanitary conditions, posing health and safety risks.

4.2 Hoarding Disorder

Hoarding disorder is a recognised mental health condition where individuals excessively collect and fail to discard items, leading to:

Obstructed living spaces, increasing fire hazards and hygiene concerns.
Inability to maintain daily routines, such as washing, cooking, or sleeping.
Health and safety risks, including rodent infestations and fire hazards.

Hoarding is not the same as collecting; it is a compulsive behaviour that can impact mental well-being and physical safety.

5. Identifying Signs of Self-Neglect and Hoarding

5.1 Early Warning Signs

Staff should be trained to identify the following signs of self-neglect and hoarding:

Persistent refusal of care or assistance.
Unkempt appearance or strong odours.
Unexplained weight loss, dehydration, or physical weakness.
Rooms filled with clutter, excessive waste, or unsanitary conditions.
Reluctance to allow staff into personal spaces.

5.2 Risk Assessment Process

All service users will be assessed upon admission and regularly reviewed for self-neglect and hoarding behaviours. Risk assessments will consider:

Physical and mental health conditions contributing to self-neglect.
Capacity to make informed decisions about their living conditions.
Level of risk posed to the individual and others in the care home.
Fire safety and infection control concerns.

6. Intervention Strategies

6.1 Person-Centred Approach

Interventions must balance risk management with personal choice, ensuring the service user’s rights and dignity are upheld. Key principles include:

Building trust and rapport before making changes.
Engaging service users in discussions about their needs.
Providing support in small, manageable steps.
Encouraging autonomy while ensuring safety.

6.2 Care Planning and Individual Support

If a service user is identified as at risk of self-neglect or hoarding, a multi-disciplinary support plan will be developed, including:

Regular welfare checks and enhanced monitoring.
Involvement of mental health professionals, where necessary.
Nutritional support and hydration monitoring.
Fire safety interventions (e.g., clear escape routes, fire-resistant furnishings).
Support for decluttering, working at a pace the service user is comfortable with.

6.3 Mental Capacity and Safeguarding Referrals

If a service user lacks mental capacity, decisions must be made in their best interests, in line with the Mental Capacity Act 2005.
If there is an immediate safeguarding concern, a safeguarding referral will be made to the Local Authority Safeguarding Team.

7. Multi-Agency Collaboration

Self-neglect and hoarding require a multi-agency approach. {{org_field_name}} will work closely with:

Local Authority Adult Safeguarding Teams.
Environmental Health Officers, if hoarding poses a health risk.
Mental Health Services, for therapeutic support.
Fire and Rescue Services, for home safety assessments.
CIW Inspectors, ensuring regulatory compliance.

8. Fire and Health & Safety Measures

8.1 Fire Risk Reduction

Hoarding increases fire hazards. {{org_field_name}} will:

Conduct fire risk assessments for service users at risk.
Ensure clear escape routes in case of an emergency.
Install additional smoke detectors in high-risk rooms.
Train staff in fire safety interventions for hoarded spaces.

8.2 Infection Control Measures

For cases of severe self-neglect or hoarding, infection control procedures will include:

Regular deep cleaning of living spaces.
Safe disposal of waste and perishable items.
Use of PPE by staff where contamination is a risk.

9. Staff Training and Awareness

All staff must:

Complete mandatory safeguarding training on self-neglect and hoarding.
Understand how to communicate with individuals displaying these behaviours.
Be aware of how to document and escalate concerns appropriately.

10. Documentation and Reporting

All cases of self-neglect and hoarding must be documented accurately. This includes:

Risk assessments and care plans.
Safeguarding referrals, where applicable.
Incident reports, detailing staff interventions and outcomes.
Multi-agency meeting minutes, if external services are involved.

11. Related Policies

This policy should be read alongside:

Safeguarding Adults Policy (CHW13).
Risk Management and Assessment Policy (CHW18).
Infection Prevention and Control Policy (CHW17).
Health and Safety at Work Policy (CHW16).
Fire Safety and Evacuation Policy (CHW20).

12. Policy Review

This policy will be reviewed annually or sooner if legislative changes or operational needs require amendments.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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