By Bruno Ornelas, Head of Service, VOICES

Over the next three years (2019-2022) we will take part in a research project looking at how self-neglect is experienced by people who are homeless, and how this can be addressed through strengthening local adult safeguarding responses.

Along with our colleagues at King’s College London and others, our involvement in this study will be to facilitate Communities of Practice (CoPs) as a theoretically informed approach for aiding reflective practices and embedding a culture of learning and improvement. This includes engaging in participatory and action orientated methods to work collaboratively with Safeguarding Adults Boards across three English local authority areas (including Stoke-on-Trent) to identify positive practices and areas for improvement.

This study is also timely given the concerns raised by government about the adequacy of safeguarding and why there have been so few Safeguarding Adults Reviews (SARs) into the deaths of people who are homeless, and whether learning from these Reviews is being implemented. VOICES collaborated in recent research which looked at themes emerging from SARs where homelessness was a contributing factor. Through this, it was highlighted that self-neglect as being a prominent category of risk that people with needs linked to multiple exclusion homelessness often face, including the challenges of assessments when individuals present with atypical forms of care and support.

Little is known about what constitutes ‘positive practice’ and the services and support that are needed to address self-neglect, particularly where they intersect with substance misuse and other extreme forms of deep social exclusion such as ‘rough sleeping’. Similarly, VOICES Service Coordinators often highlight the challenges and variations in perceptions when homelessness, addiction and self-neglect intertwine and are inextricably linked. Practice challenges often surround the difficulties in reconciling the relationship between autonomy and protection, in particular when the prevailing attitude is somewhat steered unequivocally towards the promotion of choice and independence, often at the expense of the prevention of harm and protection.

We are looking forward to working with our colleagues at the Health and Social Care Workforce unit at King’s College London over the next three years, and hope that this project will make inroads to strengthening adult social care responses to self-neglect and homelessness and ultimately improve outcomes for this marginalised group.

If you would like to find out more then please get in touch with Bruno Ornelas, Head of Service and Safeguarding.