Page 19 - TSAB Adult B FINAL (1)

This document was classified as: OFFICIAL

of self-neglect by the referrers. The author would suggest that it may have been a better approach for
the adult safeguarding social worker to take a more lead role in a Section 42 Enquiry albeit that Josh
was in hospital.

6.48. There was much mention of a social worker when Josh was an inpatient on the mental health ward.
During the review, it was ascertained that this role was allocated to that unit albeit still employed by
the Local Authority. It appears that this was as a result of issues in the transfer of staff from integrated
mental health and social work teams to individual services from the Local Authority and health.

6.49. Information gathered in this review indicates that there was a lot of very good work undertaken by
this social worker and that there was a good relationship with Josh. The information of any
assessment undertaken by this social worker was not known to the Local Authority team as this is not
recorded on Local Authority systems. As this social worker is not employed in a role that undertakes
statutory duties, assessment of need under the Care Act (Section 9) was not undertaken. There was
no recorded communication between this social worker and the other social workers who were
involved. The input of that social worker is not included in the report received from the Local
Authority for this review but is included in the mental health report.

6.50. The information in the above few paragraphs indicates some concerns for how the safeguarding
system regarding self-neglect was understood and applied in this case. The Care Act (2014) is very
clear, a person with care and support needs is entitled to be safeguarded whether or not the Local
Authority is meeting those needs. Josh therefore did meet the criteria for safeguarding support.

6.51. TSAB’s self-neglect policy states clearly in its definition of self-neglect, that it covers a wide range of
behaviours including neglecting one’s health. Adults can self-neglect through:

“Refusal of services that could mitigate the risk to safety and well-being (e.g. lack of engagement
with health and/or social care staff and other services/agencies)” p.8

6.52. The guidance that supports this policy has a specific section on substance misuse and self-neglect. The
guidance also reminds staff not to overlook people if they have capacity, are making unwise decisions
and withdrawing from services if they to be at significant risk of serious harm.

6.53. It can be seen that these elements of self-neglect fitted Josh completely. Josh was rightly subject to a
Section 42 enquiry under a category of self-neglect. This should have been clearly explained to Josh by
someone he trusted, and his wishes and feelings ascertained. Josh had consented to the safeguarding
referral but did not want intervention from a social worker.

6.54. Although the Care Act places a duty on Local Authorities to undertake safeguarding enquiries, there is
also provision to cause others to make enquiries. The refusal of Josh to engage with a social worker
did not necessarily mean that he did not want safeguarding support. There were opportunities for
health staff to have a greater role in the Section 42 enquiries given that the self-neglect was largely
regarding health issues. Information gathered, alongside Josh’s wishes should then have resulted in a
safeguarding meeting attended by all of those involved. This would have led to a more robust
safeguarding enquiry with clear outcomes that were shared to all partners.

19