Purpose - The purpose of this paper is to report the findings from research int 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 datailed 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-contred 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 procedual 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 fprms of inquiry, that have been commissioned by Boards but no 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. There 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 f SCRs that focus on adults who self-neglect. The analysisof 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.