Self-Neglect and Hoarding


There are many reasons why people may neglect themselves.  Self-Neglect covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. When an adult who may have needs for care and support appears to be at risk of self-neglect, and may be refusing care and support or whose self-neglecting behaviours pose a risk to others, it can be difficult for practitioners or concerned carers, friends/family members, to understand how statutory duties and legal powers could be applied to improve the Adult’s situation. The Care Act s42 Safeguarding triage should be considered and applied where necessary. We are using today as an opportunity to share good practice guidance and local pathways to seek support.

What is Self Neglect?

The Care Act Guidance advises that ‘self-neglect’ covers a wide range of behaviour including neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. Research literature states the term ‘self-neglect’ is commonly used to refer to:

  • Lack of self-care: in personal hygiene, in adhering to daily needs, in refusal of essential care or necessary medical treatment.
  • Lack of care of the living environment: hoarding, squalor and infestation.

Hampshire and IOW 4LSAB Multi-Agency Safeguarding Adults Policy provides guidance on responding to self-neglect and persistent welfare concerns here:

 Guidance on responding to self-neglect and persistent welfare concerns 

The 4LSAB One Minute Guide to Self-Neglect helps recognise possible signs of self-neglect and provides contacts for the pan-Hampshire area.

Responding to Self-Neglect Video – Lambeth Safeguarding Adults Board

The Lambeth SAB has produced the video below on how to respond to self-neglect.

Self-Neglect SARs

The Hampshire Safeguarding Adults Board published earlier this year an independent thematic Safeguarding Adults Review (SAR) into the circumstances surrounding six individual cases of Self Neglect which resulted in the deaths of those involved. The learning from this review can be found here:  Self-Neglect Thematic Review (March 2022)

A presentation on Good Practice in Self Neglect (using SAR learning and research evidence to inform practice) by Suzy Braye, Emerita Professor of Social Work, can be viewed here: Self-Neglect Presentation 13-01-22

4LSAB Self-Neglect Learning Briefing

This document highlights learning from a number of Safeguarding Adult Reviews (SARs) that involved self-neglect as a central theme.

4LSAB Self-Neglect Learning Briefing


‘Hoarding is the excessive collection and retention of any material to the point that living space is not able to be used for its intended purpose.’ The World Health Organisation say hoarding is characterised by an ‘accumulation of possessions due to excessive acquisition of – or difficulty discarding – possessions, regardless of their actual value.  Hoarding disorder is a persistent difficulty in discarding or parting with possessions. A person with a hoarding disorder may experience distress at the thought of disposing of the items or simply be unable, either physically or through other health related factors, dispose of items despite an acknowledgment that changes need to be made. They will have an excessive accumulation of items, regardless of actual financial value. We are using today as an opportunity to share good practice guidance and local pathways to seek support.

4LSAB Multi-agency Hoarding Guidance

The 4LSAB Multi-Agency Hoarding Guidance sets out a framework for collaborative multi-agency working across Hampshire using a ‘person centred solution’ based model to support those demonstrating hoarding behaviours.

The purpose of this guidance is to support providers, practitioners, and other professionals to identify when to raise concerns regarding poor self care or lack of care for living conditions, identify agencies who can provide support and set out what they may expect by way of a response and encourage and support defensible decision making in accordance with our duty of care. This guidance should be read in conjunction with the Hampshire 4LSAB Multi-Agency Safeguarding Policy. The document is available here: 4LSAB Multi-Agency Hoarding Guidance 2022

Safe and Well

Hampshire Fire Service Safe and Well is a Home Fire Safety visit that’s tailored to an individual’s needs, relating to their health and lifestyle choices.  This is available to people with vulnerabilities that may indicate that they are at more risk of harm from fire.  This visit is free of charge and will include a customer-made information pack, installation of new fire alarms and a check of existing fire alarms, issue of fire retardant bedding, furniture throws and nightwear and, if appropriate, a referral to other services for a professional assessment.  To find out more visit the Hampshire Fire Service Safe and Well webpage.

Important telephone numbers

If you are worried about an adult, please telephone Southampton Adult Social Care: 023 8083 3003 or call the Police: 101 or in an emergency dial 999