Opening the “too difficult box": strengthening adult safeguarding responses to homelessness and self-neglect

Introduction

The Care Act 2014 for the first time told councils what to do to help people keep safe from abuse or neglect. Workers from different agencies can disagree about what is the best way to help someone, and this can sometimes lead to poor care where the person is harmed or dies. Safeguarding Adults Boards (SAB) are expected to look into this and try to find out what went wrong through a Safeguarding Adults Review (SAR).

Little is known about what constitutes ‘positive practice’ and the services and support that are needed to address this problem. Concerns have been raised by government about the adequacy of safeguarding, and why there have been so few Safeguarding Adult Reviews into the deaths of homeless people. There are also concerns that learning from these Reviews is not being implemented.

Objectives

The overall aim of this study is to explore how self-neglect is experienced by people who are homeless, and how this can be addressed though strengthening local adult safeguarding responses.

Methods

This study involves:

• a literature review to identify common themes around the subjects of safeguarding, self-neglect and homelessness
• case studies across three different local authorities in England which will follow what happens to 30 people who are homeless and who the council knows about because of concerns about self-neglect over three month through interviews and encounters with homeless people
• interviews with  at least 20 workers about their experiences
• a range of modelling exercises to examine underlying economic reasons for the lack of Safeguarding Adult Reviews.

This study will try out a special approach called a ‘Community of Practice’ (CoP) which may help Adult Safeguarding Boards to make changes that are needed to help people who are homeless be safe. The researchers will feed back the practice learning from workers and people with lived experience and will work with the CoPs to co-produce guidance.