Assessment

Self-neglect is a complex issue that can pose a challenge to professionals. It is crucial to consider how to begin engagement with the person at the beginning of any assessment. Sensitive and comprehensive assessment is important when identifying the person's capabilities and level of risk.

When undertaking the assessment, the professional should be cautious not to accept the first, and potentially superficial response given, rather than exploring more deeply how a person understands and could act on their situation.

It is important to look further and tease out the possible significance of personal values, past traumas and social networks. This may require more than one visit.

The Care Act

Section 11 of the Care Act provides local authorities with the legal right to conduct an assessment of someone assessed as having capacity to refuse an assessment when person is subject to a Section 42 enquiry.

This piece of legislation supports information gathering and multi-agency responses where a concern relates to self-neglect and a person is refusing to engage with the assessment process.

Questions to ask yourself

Does the person have mental capacity in relation to specific decisions about self-care and, or acceptance of care and support?

How might the person's life history, family or social relations be interconnected with the self-neglect?

Are there links between the self-neglect and health or disability?

Is the self-neglect a recent change or a long-standing pattern?

What is the person's view of the self-neglect?

Is alcohol consumption or drug use related to the self-neglect?

Is the self-neglect intentional or not?

What strengths does the person have - what is he or she managing well and how might this be built on?

Remember: Practitioners should avoid the suggestion that self-neglect, including that linked to chronic alcohol use, is a lifestyle choice.