Self Neglect

Screening Tool

ADAPTATION / Adapted by : Jane Timson Head of Safeguarding and Practice Assurance, Rochdale Adult Care
Andy Jones Deputy Head of Neighbourhood Teams, Rochdale Adult Care
Karen McCormick Designated Nurse Safeguarding Adults, HMR CCC
Carl Travis RBSB Development Officer, Safeguarding Boards Business Unit
With kind permission of Torbay Safeguarding Adults Board
VERSION / 1
APPROVAL / Approved by the RBSAB Board / Date 22/2/2018
REVIEW DATE: / Review Scheduled / Date February 2020

Please circle the appropriate rating

Health
Sub-areas / 1 Optimumcare / 2 PersonusesUniversalservices / 3 Referral to Adult Care Prevention Team
0300 303 8886 / 4 Person inneedofsupport fromStatutoryServices / 5 Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
Healthchecksandimmunisation
/ PersonisregisteredwithGP,Dentistetc.and proactiveinscheduledhealthchecks,immunisationanddentalvisits / Personisuptodatewithscheduledhealthchecks,dentalvisitsandimmunisationunlessexceptionalorpracticalproblems.
Plansinplacetoaddressthis. / Socialorpracticaldifficultiespreventthepersonschedulingandkeepinghealthchecks,dentalvisitsandimmunisation / Personneedsa highlevelofpracticalsupport to schedulingandkeepinghealthchecks,dentalvisitsandimmunisation / Evidenceofdeclininghealth– personmaynotregistered withGP, Dentistetc. –repeateduseof999
Disability/chronicillness
/ Allmedicalinterventions/
medicationsare compliedwith. / Anylackofcomplianceisduetopressingpracticalreason.Plansinplace to addressthis. / Socialorpracticaldifficultiespreventthepersoncomplyingwithsomeor allmedicalinterventionsand/or medications. / Personneedsa highlevelofpracticalsupport tocomplywithsomeor allmedicalinterventionsand/ormedications. / Seriouscompliancefailure(medicationnottakenfor noreason),canmislead
– serious risktohealth
Health
1 Optimumcare / 2 PersonusesUniversalservices / 3 Referral to Adult Care Prevention Team
0300 303 8886 / 4 Person inneedofsupport fromStatutoryServices / 5 Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
FollowupAppointments
/ Allappointmentskeptorrearrangedifneeded / Failsoneintwoappointmentsduetodoubtabouttheirusefulness. / Failstokeepappointmentsevenifthereisaclearbenefit.May feeljudgedbyservices. / Needssupport toattendcriticalappointmentsinlinewithhealthneeds / Failsa neededfollowup athirdtimedespitereminders.
Misleadingexplanationsfornotattending. –seecareact
Opinionsought
/ Notonlyonillnessesbutalsoothergenuinehealthmattersthoughtaboutinadvanceandwithsincerity,includingoralhygieneandstate ofteeth. / From professionals/experiencedadultsonmatters ofgenuineandimmediateconcernaboutchildhealth. / On illnessofanyseverity. / Only whenillnessbecomesmoderatelysevere(delayedconsultation). Orfrequentunnecessaryconsultationand/ormedication. / Whenillnessbecomescritical(emergencies) oreventhatignored.
Nutrition
1 Optimumcare / 2 PersonusesUniversalservices / 3 Referral to Adult Care Prevention Team
0300 303 8886 / 4 Person inneedofsupport fromStatutoryServices / 5 Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
QualityandQuantity
/ Awareandplansahead;has excellentqualityfoodanddrink.Andconsumesthe correctadultportions / Provisionofreasonablequalityfood,itmaybeinconsistentbutdoesnotimpactonhealth.Personmaybenefitfromnutritionaladvice. / Provisionofreasonablequalityfood,itmaynotbeavailabledue toSocial,financialorpracticaldifficulties–mayneedadviceonhowto accesscommunity provision / Personmayneedsupport tobeabletoaccess,cookorconsumegoodqualityfood. / Personisverythinorobese,maybedehydrated,doesnoteatenough/eatssignificantlytoomuchtomaintainhealth.
Accessto Specialist services
1 Optimumcare / 2 PersonusesUniversalservices / 3 Referral to Adult Care Prevention Team
0300 303 8886 / 4 Person inneedofsupport fromStatutoryServices / 5 Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
DrugServices
/ Persondoesnotuseanyillicitsubstances.Persondoesnotabuseanyopiatebasedprescribingfrom GPsurgery / Recreationaluse ofcannabis(non-problematic). / Druguseishavinganimpactontheneighbourhoodhoweverthe persondoesnotviewthisasanissue. / Person’sdruguseishavinga negativeimpactontheirhealth. Thepersonhasagreedto receivesupportfromthedrugservice. / Theperson’sdrugmisuseisresultinginrisktoselffromothersand/or thepersonisunabletoprotect self(financialexploitation). Thepersonisunable tomeethis/her ownphysical/psychologicalneeds
AlcoholServices
/ Personabstinentformalcoholordrinkingwithinrecommendedunits / Persondrinkingaboverecommendedunitsper weekonaregularbasisor isengaginginepisodicbingedrinking / Alcoholuseisimpairing thepersonsusualleveloffunctioning(physical,psychological,social) / Personisdrinkingalcoholathazardous/harmfulordependentlevelsandpotentially showingsigns ofwithdrawalsymptoms / Theperson’salcoholmisuseisresultinginrisktoselffromothersand/or thepersonisunabletoprotect self(financialexploitation). Thepersonisunable tomeethis/her ownphysical/psychologicalneeds
Access to specialist services
1 Optimumcare / 2 PersonusesUniversalservices / 3 Referral to Adult Care Prevention Team
0300 303 8886 / 4 Person inneedofsupport fromStatutoryServices / 5 Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
MentalHealthandemotionalwell-being
/ ActivelyengageswithMentalHealthservicesasneeded.Accessessupportfromnon-statutoryservices / Lifestyleand/orfluctuatingmentalhealthissuesmayimpactonabilitytoengagefullyandkeepplanned appointments / Mentalhealthissuesimposingonabilitytomanageselfandregulatemood/interactions / MentalhealthidentifiedasdeterioratedinnatureanddegreetorequireassessmentbyMentalhealthserviceswhichmayinclude a MentalHealthActassessment / Duetomentalhealthdeclinethepersonisatrisk ofselfneglectorabuse(anycategory)andisincreasinglyvulnerable.Mentalhealthissuesmaybeimpactingoncapacity/capacitymaybefluctuatingincreasingvulnerabilityandriskofexploitationfromothers.
SexualHealth
/ Personproactivelymakesappointmentsto havesexualhealthscreeningasneeded. / Personwhomaynotfullyunderstandtheirneedsbutseeksappropriate advicefromprofessionalsortheirsupportnetworks / Personmaynotrecognisetheirneedsorwhere toaccesshelpandadvice / Personneedshelpbutrequiresapersonalsupportpackageinplacetoachievethis,i.e.personalappointment/ workeretc / Personmaynotrecognisetheirneeds,bepreventedfromaccessinghelp,understandthepositionofrisktheyareexposedtoandthe impactofthisontheircurrentandfuturehealth.
Making Decisions
Sub-areas / Optimumcare / PersonusesUniversalservices / Referral to Adult Care Prevention Team
0300 303 8886 / Person inneedofsupport fromStatutoryServices / Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
/ Assumptionofcapacity
Abilitytomakeinformeddecisionswithagoodunderstandingofanyassociatedriskandconsequencestohealth,safetyandwellbeing
(KeyPrinciple1) / Abilitytomakeinformeddecisionsregardingprimaryhealthcareandlifestylechoices
Maymakeunwisedecisions
(Keyprinciple3) / Evidenceofimpairmentordisturbanceinfunctioningofmind
/brain-Couldbetemporaryorpermanent
Mayimpacton,orcausefluctuatingabilitytomakecapacitatedorinformeddecisions
Maynotrecogniseownneedsorassociatedrisksconsequencestotheirpresentation.
Mayresultin anegativeimpactonhealth/well-beingandsafetywithoutanyinsighttopossibleincreasingriskfactors / Requirespersoncentredsupporttohelpthemtounderstandrelevantinformationincludinggreaterexplorationofformatsforcommunication
(Keyprinciple2)
Impairmentordisturbancemaybesignificantenoughtorenderthepersonasunabletomakespecificdecisionsatthetimetheyarerequiredtobemade
MayrequireBestInterestdecisionstobemadeforthem attimes(Keyprinciple4) / Alack ofmentalcapacitytomakedecisionssignificantlyincreasesvulnerabilityandrelianceonothers.
Atgreaterrisk ofneglect/self-neglectabuse/exploitationwithoutappropriatesupportnetworksaroundthem
Reliantonotherstoensurehealth/well-beingandsafetyandforthistobeprovidedinawaythatprotectshumanrightsandpersonaldignity.
(KeyPrinciple5)
Safety Awareness and Practice
Sub-areas / Optimumcare / PersonusesUniversalservices / Referral to Adult Care Prevention Team
0300 303 8886 / Person inneedofsupport fromStatutoryServices / Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
Safety in Living Environment
/ Good awareness of safety issues however remote the risk – and ability to address them / Aware of important safety issues but may need advice from professionals or their support networks to address them. / Lacks awareness and perception except for immediate danger.
Would benefit from Support in identifying and addressing risk. / Has some level of awareness (or not) specialist assessment to support their needs and reduce risks. / The person is living or forced to live in conditions they are placing themselves and others at direct risk of harm i.e.
Hoarding, Slavery, unsafe use of electrical/gas equipment etc.
On-line safety
/ Uses the internet safely, aware of on- line risk and reports concerns appropriately. / Awareness of general internet safety but may need advice from professionals or their support networks on practical safety (e.g. privacy settings) and behavioural safety (e.g. online reputation). / Person may be unaware of the risks they are exposed to and with support may be able to access existing service within the community / Bespoke package of care required to ensure person is safe. (i.e.
Community safety) / Person who (whether they use the internet or not) is vulnerable and is being targeted for exploitation, crime and harm on line.
Safety Awareness and Practice
Sub-areas / Optimumcare / PersonusesUniversalservices / Referral to Adult Care Prevention Team
0300 303 8886 / Person inneedofsupport fromStatutoryServices / Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
Road Safety
/ Good awareness and practice in road safety. / Needs support to understand risks and road safety i.e.
Person with learning disability, cycling proficiency etc. but has support / Lack of understanding of impact of external factors impact on road safety. i.e. drugs and alcohol, mental health / Needs assessment
i.e. visual impairment, physical disability etc. / Needs safeguarding
i.e. running into traffic, dangerous driving etc
Use of safety equipment
/ Has appropriately and specialist equipment in place which is regularly maintained and in working order. The person is competent in using the equipment. / Has appropriately and specialist equipment in place which is regularly maintained and in working order. The person has support to use the equipment. / The person may need support to maintain their safety and well- being but may not be aware of the options available to them. / The person needs an assessment by a specialist to ensure that the correct equipment is available to meet there needs / The person has all the appropriate equipment / assessed/provided but is non-compliant in its use – putting themselves or others at risk of harm
Shelter
Sub-areas / Optimumcare / PersonusesUniversalservices / Referral to Adult Care Prevention Team
0300 303 8886 / Person inneedofsupport fromStatutoryServices / Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
a.Accessto Shelter
/ Personmaintainstheirownhousingneedsunaided. / Personmaintainstheirownhousingneedswithsupportfromuniversalservicesor theirsupportnetworks / PersonneedssupportwithHousingbutisnotawareofdoesnotunderstandtheirentitlementorwhere to accesssupport – andneedsinformationandadvice / Personwhoneedssupport toaccessHousingoraccommodationservices / PersonhasexhaustedallHousingoptions,isintentionallyhomelessorverytoohigh riskto place–whichmayexposethem toadditionalrisksoftargetingorforced exploitation.
Conditionofaccommodation

If applicable – see also the Hoarding Toolkit at / Essential and additional fixtures and fittings, good heating, shower and bath facilities. / All essential fixtures and fittings i.e. bathing, toileting and kitchen aids / Accommodation shows signs of disrepair/minor neglect – may need support to address the issues / Adults need specialist support to maintain housing or accommodation. / Adults dangerously exposed to environmental risks
Clothing
Sub-areas / Optimumcare / Optimum Care / PersonusesUniversalservices / Referral to Adult Care Prevention Team
0300 303 8886 / Person inneedofsupport fromStatutoryServices / Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
Appropriateclothing
/ Thepersonhadagoodrangeofclothesthatoffertherightprotectioninallweathersandknowswhentowearthem. / Thepersonhasarangeofclothesthatoffertherightprotectioninallweathersandhassupportfromtheirsupportnetworktowearthemappropriately. / Thepersonmaynothaveaccesstoweatherspecificclothingandmayneedsupporttoaccessclothingonaninfrequentorregularbasis. / Thepersondoesnothaveclean,appropriateoradequateclothingandwouldrequireadditionalsupporttoaccessandensuretheycanmaintainsuchitems / Inappropriatefittingclothesleadingtoexposure(criminaloffence)
Personal Hygiene
Sub-areas / Optimumcare / Optimum Care / PersonusesUniversalservices / Referral to Adult Care Prevention Team
0300 303 8886 / Person inneedofsupport fromStatutoryServices / Person tobereferredforS42Safeguardingenquiry / Not applicable or not known
Personalhygiene

/ Thepersonisabletomaintaintheirownpersonalhygieneandpresentation. / Thepersonisabletomaintaintheirownphysicalhygieneandpresentationwithsupportfrom theirsupportnetwork. / Thepersonmaylackanawarenessoftheirhygieneanditsimpactonthem;and/orlackaccesstofacilitiestoaddresstheirhygieneneeds. / Personneedsadditionalprofessionalsupporttomaintaintheirhygiene to preventdeterioration. / Thepersonisunabletomaintaintheirownphysicalhygieneandpresentationandwillnotengagewithsupport,whichishavingsignificantdetrimentalimpactontheirphysicalandpsychologicalhealth.
Managing Money
Sub-areas / Optimumcare / Person uses Universal services / Referral to Adult Care Prevention Team
0300 303 8886 / Person in need of support from Statutory Services / Person to be referred for S42 Safeguarding enquiry / Not applicable or not known
/ Personhasaccessto salary orbenefitsisawareofrisksandcanmanage themindependentlyfortheirownneeds / Personhasaccesstosalaryorbenefitsandcanmanage themwithsupportfrom theirsupportnetwork.Toensurethattheyarebeingusedtomaintaintheirindividualneeds / Thepersonmay nothaveaccesstomoneyeitherbecausetheyarenotclaimingthebenefitstheyareentitled.Orhavedebtsorother issueswhichfundsareprioritisedfor,whichtheymayneedsupport tosortout. / ThispersonmayneedsupportunderthementalcapacityAct tomanagetheirfinances,or throughanAppointeetomanagetheirbenefits / Thepersonmay nothaveaccesstomoneyeitherbecausetheirsalaryisbeingwith-heldor theyaresubject to Mate/HateCrime,or theyareexploitedfinanciallyinanother way(includingon-line/postaltargeting).
Food Preparation
Sub-areas / Optimumcare / Person uses Universal services / Referral to Adult Care Prevention Team
0300 303 8886 / Person in need of support from Statutory Services / Person to be referred for S42 Safeguarding enquiry / Not applicable or not known
FoodPreparation
/ Fullyself-motivatedto prepareandawareofdietaryneedsi.e.diabetics. / Personhasappropriatesupportfrom their supportnetworktoensurethattheycanprepare/accessfood. / FoodPreparationinfrequentandinconsistent. / Personmayadditionalsupport topreparemealsinlinewiththeir dietaryneedsi.e.diabetics. / Thepersondoesnoteatappropriatefoodsregularlydespitesupportbeingprovided or dieticians advice.MayneedreferraltoGPorMentalHealthservices
Carer Support
Sub-areas / Optimumcare / Person uses Universal services / Referral to Adult Care Prevention Team
0300 303 8886 / Person in need of support from Statutory Services / Person to be referred for S42 Safeguarding enquiry / Not applicable or not known
Relationshipwithcarers- choiceandcontrol / Personsupportedwithformalandinformalcarers,thisisself-managedandthe personis awareofpotentialrisks. / Personsupportedbytheirsupportnetworksandmaintaingoodrelationshipswiththemfreefromabuse / Supportfrominformalcarersisambivalentanddoesnotaddresstheperson’sneeds–needssupporttoaddressthis;ornocarersupportcurrentlyinplace. / Relationshipwithpaidcarer breakingdown,the personneedssupport toaddressthis. / Significant concerns raised on how the carer speaks to or physically responds to the person raising concerns of abuse or exploitation.
CommunityEngagement
Sub-areas / Optimumcare / Person uses Universal services / Referral to Adult Care Prevention Team
0300 303 8886 / Person in need of support from Statutory Services / Person to be referred for S42 Safeguarding enquiry / Not applicable or not known
Accessto CommunitySocialisation
/ Personjoinspositivegroups/activitiesoftheirchoosingintheircommunity or is happy with their current social arrangements / Personjoinspositivegroups/activitiesoftheirchoosingintheircommunityandissupportedtodothisbytheirsupportnetworks / Thepersonmaybepartofasocialgrouporactivitywhichiscohesivebutthismaynotbeapositiveactivity
i.e.drugculture,streetworking,orcrime. / Socialexclusion.Personwillneedsupport.
Also consider potential radicalisation -ReferraltoChannelProcess / Thepersonisstigmatisedanddiscriminatedagainstandthereforeisexcludedfromorfeelsunabletoaccesscommunityactivities.
Gaining employmentoraccessing education / If appropriate, personisengagedinemployment,educationorvolunteering / Personisengagedinemployment,educationorvolunteeringandissupportedtodothisbytheirsupportnetworks / Personisnotengagedinemployment,educationorvolunteeringandnotawareoftheopportunitiesavailabletothem. / Personisnotengagedinemployment,educationorvolunteeringandwouldneedprofessionalsupporttobeabletoaccess. / Personissuspectedofbeingrecruitedintocrimeormodernslavery
Possibleoutcomes / PersonmaintainsownwelfarewithappropriateuseofUniversalServices / Personmanagestheirneedsinthecommunity withhelpfrom their circleofsupport / Askpersonforconsent torefer toAdult Care Prevention Team (contact details on back cover) / Make areferraltoAdult Care (contact details on back cover)for anassessmentofneed / Make areferraltoAdult Care for an assessment of need for multi-agency safeguarding response

ScreeningAnalysis/Outcomes

The Self NeglectAssessmentTool will help you to provide clear, concise and relevant information to aid future planning for the person screened. It isanticipated that this be a short summary of the key issues.

Name,dateofbirthandcontactdetailsofPersonScreened
Situation
  • NameofPersoncompletingtoolandContactdetails
  • Relationshiptothepersonscreened
  • Theissuesthathavegreatesteffectontheperson

Background
  • Whatisthepersonnormallylike:
StayingHealthy
Beingsafe
LivingWell
Assessment
  • Howhavetheychangedfromtheirnormal
  • Howquicklyhavetheychanged
  • Iamworriedabout….

Recommendations (if required)
  • Ithinktheproblemis…
  • IsthereanythingI(the practitioner) shoulddo?
  • WhatwouldhappentothepersonifIdonothing?
  • Recordanddocumentanyintervention/conversations
Includedate/time,whoyouspoketoandtheoutcomeofthecall/referral
Other comments