‘Good social work’, not targets, needed in self-neglect cases

Performance targets and resource pressures could be undermining the “good social work” that is key to improving the lives of people who neglect themselves, finds research published today.

Establishing a positive and collaborative relationship with a person, making regular contact to better understand their life and ongoing, holistic assessments were seen by practitioners as vital in dealing with self-neglect.

However, resources pressures, targets to close cases and workplace environments that failed to support reflective practice all hindered progress.

[See Community Care’s guide to self-neglect cases]

The findings come in a report for the Department of Health based on a review of existing research and workshops with social care and safeguarding practitioners and managers.

“In all the discussions, participants returned to the idea that self-neglect cases required interventions founded on basic social work skills,” said the report.

“[Self-neglect] cases are clasically the ones that should be actively case-managed on an ongoing basis and shouldn’t be this ‘target-assess-review-close’ under the care management process,” said one workshop participant.

However, others warned that 20 years of care management may have deskilled social workers from working in this way, meaning people had to be retrained to do so.

The report said more research was “sorely needed” into effective interventions for self-neglect. It added that practitioners struggled with the complexity of the law in this area and the balance between respecting people’s autonomy and their duty of care.

There were concerns about the adequacy of capacity assessments, with warnings that people found to have capacity to make simple decisions may be assumed to be able to make more complex decisions, potentially putting them at risk.

The 2000 No Secrets guidance on safeguarding does not include self-neglect as a basis for action under adult protection procedures, though the Law Commission’s review of adult care law published this year recommended its inclusion under any reform to safeguarding in next year’s White Paper on social care.

The study, published by the Social Care Institute for Excellence, was carried out by Michael Preston-Shoot of Bedfordshire University and Suzy Braye and David Orr of Sussex University.

For the latest policy and practice on adult safeguarding, attend Community Care’s conference on 2 November in London.

Related articles

Self-neglect cases: how should social workers intervene?

Guide to handling self-neglect cases

Guide to mental capacity assessments

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