Page 20 - TSAB Adult B FINAL (1)

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6.55. It is important to note that there may have been no role for traditional social work input, given Josh
did not want this, but that does not preclude use of Section 42 enquiries as Josh had consented to
this. The social work role should have been to cause others to make enquiries using the most
appropriate professionals to do this based on existing trusted relationships with the support of
internal health safeguarding leads and the Local Authority safeguarding team. The Local Authority
safeguarding role would also have been to coordinate the enquiry and chair any multi agency
meetings. There is currently no local guidance regarding causing others to make enquiries.

6.56. The opportunity to refer could also have come from the frequent attenders meeting had that have
been a more inclusive process. There were social workers who had information that indicated self-
neglect that did not invoke or continue with Section 42 enquiries when Josh refused to engage.

6.57. The TSAB Self Neglect Guidance also has provision for a risk and vulnerability panels where, despite
best efforts, the risk of harm is escalating or continuing.

“The purpose of such panels is to ensure that multi-agency communication
and information sharing takes place on a regular basis and to provide support to practitioners
and their managers in managing the risks involved in the most complex and challenging
cases.” P13

6.58. Some professionals cited not knowing about the guidance and at the time of this review did not know
about the risk and vulnerability panels. Of greater concern is that risk and vulnerability panels were
not known about by those tasked by the Care Act for the responsibility of undertaking Section 42
enquiries in cases of self-neglect. This appears to be because Area B Local Authority Social Work
Teams have not set up the risk and vulnerability panels as required within the guidance. The author
was informed that this would be in place soon.

6.59. There was little understanding of this type of situation being self-neglect by some professionals,
therefore there was little opportunity for other professionals to challenge that this was not being
dealt with under the provisions of the Self Neglect Policy and Guidance. By not drawing together all
professionals to safeguard Josh, there were further missed opportunities to share all knowable
information. Where referrals were made stating the concern was regarding self-neglect, the response
was inadequate with the cited reason that Josh would not engage with the social worker; this did not
lead to a full multi agency safeguarding strategy meeting and safeguarding plan.

6.60. The author would suggest that there are a number of adults with care and support needs, who self-
neglect, may well have capacity and do not engage with services; the Care Act included those very
people to be considered under Section 42 as requiring safeguarding because of the risks of serious
harm to this group of people. It also has to be recognised that intervention with Josh may not have
been ultimately possible if Josh did not agree, but there should have been a comprehensive gathering
of all information to inform a multi-agency risk assessment as required under Section 11 of the Care
Act which identifies that a person with capacity is able to refuse an assessment unless they are at risk
of harm. In this case there was a risk of harm to Josh and information gathering from all involved
agencies could have led to a multi-agency meeting. Risks could also then be escalated within

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