Neglect or actions of omission
Neglect is the ongoing failure to meet an individuals basic and essential needs, either deliberately, or by failing to understand these.
It includes ignoring a person’s needs, or withholding essentials to meet needs, such as medication, food, water, shelter and warmth. This can include acts like not getting enough to eat or ignoring an individuals medical or physical care needs.
Everyone has the right to access the necessities of life, such as food, shelter, clothing, heating, stimulation and activity.
Self-Neglect
Self-neglect can take many different forms and may be the result of complex physical, mental, psychological and environmental factors; it can affect both adults with and without the mental capacity to understand the consequences of the way they live their life.
Wolverhampton Safeguarding Together Partnership have developed an Adult Neglect Strategy, this is aims to:
• Prevent neglect of a person by an individual or organisation, it is not about self-neglect
• Outline our commitment to enhancing awareness and understanding of neglect
• Identify when neglect occurs
• Support effective safeguarding responses to promote the safety and wellbeing of adults at risk
We recognise that addressing adult neglect requires a multi-agency approach that extends beyond the confines of a single agency or organisation. The strategy emphasises the importance of working in partnership, where everyone involved understands their role and responsibilities in safeguarding adults.
Sometimes it can be difficult differentiating between poor care and neglect. It is important that concerns are addressed to prevent future harm. Incidents of poor care should be addressed through training, supervision, contract monitoring and improvement plans, and review of staffing sufficiency etc. Poor care does not need to trigger the safeguarding process. Safeguarding interventions should be reserved for neglect, which is different to poor care because of the severity of associated risks and chronicity. Distinguishing between poor care and neglect help safeguarding professionals to focus their time and energy where it is most needed.
Examples of Poor Care:
• A one-off medication error (although this could of course have had serious consequences)
• An isolated incident of under-staffing, resulting in a person’s incontinence pad being unchanged all day
• Poor quality, unappetising food
• An isolated incident of a missed visit by a care worker from a home care provider
“This can include neglect and poor care practice within an institution or specific care setting such as a hospital or care home or in relation to care provided in a person’s own home. This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice because of the structure, policies, processes and practices within an organisation” (Care Act Statutory Guidance).
Organisational abuse may also be identified because of a cluster of safeguarding concerns about a number of adults with care and support needs being supported by the same care provider. However, several allegations of abuse within a care environment do not necessarily always constitute organisational abuse. It is imperative that such situations are not dealt with in isolation as repeated instances of neglect or poor practice may be an indication of a more serious concern. The Adult MASH should be contacted to discuss further.
Organisational abuse may include:
• Inappropriate use of power or control
• Inappropriate confinement, restraint, or restriction
• Lack of choice – in food, in decoration, in lighting and heating, and in other environmental aspects
• Lack of personal clothing or possessions
• No flexibility of schedule, particularly with bedtimes
• Financial abuse
• Physical or verbal abuse
• An unsafe, unhygienic or overcrowded environment
• A strict or inflexible routine
• Lack of privacy, dignity, and respect for people as individuals
• Withdrawing people from community or family contacts
• No choice offered with food, drink, dress or activities
• No respect or provisions for religion, belief, or cultural backgrounds
• Treating adults like children, including arbitrary decision-making
Self-neglect can be challenging for practitioners to address, because of the need to find the right balance between respecting an adult’s autonomy and fulfilling a duty to protect the adult’s health and wellbeing.
Indicators of Self-Neglect:
