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Lewisham Safeguarding Adults Board

Hoarding & Self-neglect

What is Hoarding?

The NHS defines Hoarding Disorder as:

“Where someone acquires an excessive number of items and stores them in a chaotic manner,             usually resulting in unmanageable amounts of clutter”.

It's considered to be a significant problem if:

  • The amount of clutter interferes with everyday living – for example, the person is unable to
    use their kitchen or bathroom and cannot access rooms.
  • The clutter is causing significant distress or negatively affecting the person's quality of
    life or their family's – for example, they become upset if someone tries to clear the clutter
    and their relationships with others suffer.

The clutter image rating clearly illustrates the wide range of clutter in different rooms from clear to extreme.

All professionals working with adults who hoard in Lewisham must utilise the Multi Agency Self-Neglect Policy, Practice Guidance and Procedures and the Lewisham Adult Safeguarding Pathway.

What is self-neglect?

The Care Act 2014 statutory guidance defines self-neglect as:

"A wide range of behaviour neglecting to care for one's personal hygiene, health, or surroundings and includes behaviour such as hoarding."

The term itself can be a barrier to working with the issues as some individuals do not identify with this term or description of their situation. As a result, it is important that practitioners seek to negotiate a common ground to understand the individual’s own description of their lifestyle rather than making possible discriminatory value judgements or assumptions about how it can be defined. In order to prevent self-neglect, it is essential to understand the wider complexity and possible underlying factors, which may present as, or include:

  • Increased incidence of depression and low self-esteem.
  • History of trauma, abuse (including childhood abuse and child sexual exploitation) or bereavement.
  • Physical and mental health issues.
  • Hoarding or no possessions at all.
  • Reclusive or co-dependent, including on pets.
  • Substance misuse.
  • Self-harm.

All professionals working with adults who self-neglect in Lewisham must utilise the Multi Agency Self-Neglect Policy, Practice Guidance and Procedures and the Lewisham Adult Safeguarding Pathway.

lsab logo

LSAB Hoarding and Self-Neglect Briefing

Read our briefing on hoarding and self-neglect.

Image of British Psychological Society logo

The British Psychological Society had produced a short leaflet Understanding Hoarding - When our relationship with
possessions goes wrong.
The leaflet is intended for people with hoarding disorder and their friends and families. 

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GP Hoarding Awareness Leaflet

GP Awareness of Hoarding Disorder is very important. GP's can often be the first professional a person with a Hoarding Disorder discloses their living situation to. 

This GP’s leaflet is a great tool for GP’s to keep on hand and was created by Clouds End CIC and was developed after a Hoarding Awareness Training session with GPs.

If you suspect that an adult you provide healthcare for may be at risk of abuse or neglect please complete the Adult Safeguarding Concern form and return to the Lewisham Adult Gateway as instructed in the form.

Alternatively if you have concerns about the immediate safety of an adult at risk then please contact the Police on 999. 

NHS logo

The NHS has produced information on Hoarding Disorder including:

  • Information on Hoarding disorder
  • Why someone may hoard
  • The difference between hoarding and collecting
  • Signs of a hoarding disorder
  • Why hoarding disorders are a problem
  • What you can do if you suspect someone is hoarding
  • How hoarding disorders are treated

New Training Resource from Safeguarding Adults in Gloucestershire

“Am I YOUR Job?” is a brand new trainer resource (training session plan and video) on Self-Neglect from Safeguarding Adults in Gloucestershire.


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Making Safeguarding Personal in self-neglect workbook

This Making Safeguarding Personal in self-neglect workbook, produced by Research in Practice, draws on evidence from research and Safeguarding Adults Reviews (SAR's) to identify how making safeguarding personal can make a difference to the health, wellbeing and safety of people who are self-neglecting. 

Research in Practice logo

Research in Practice has produced a practice tool Working with people who self-neglect

The tools in this resource focus on different aspects of good practice:

  • understanding self-neglect
  • building a relationship
  • planning and implementing intervention
  • using the legal framework for care, support and protection
  • creating a supportive organisational context.

Learning from London Safeguarding Adult Reviews

Self-neglect is a widespread societal issue that will impact a large number of local residents at a lower-level, and for some this will escalate and may become very serious, including life threatening. 60% of Safeguarding Adults Reviews (SAR) in England, which are the are most serious and high-profile safeguarding cases, involved self-neglect in the recently published 2nd National SAR Analysis, which you can read about here: Lewisham Safeguarding Adults Board - Safeguarding Adults Reviews

Please ensure that you refer to the local policy, guidance, and procedures and embed this into your ways of working. More briefings will follow.

Information for Adults you are working with who hoard

Below you can find a range of resources to support an adult who hoards.

Hoarding Ice-Breaker form image

Hoarding Ice Breaker Form

If clutter, disorganisation or hoarding is affecting your health (mental or physical health) and making you feel anxious, depressed or unwell, then it’s advisable to have a chat with your GP.

If you don’t know what to say or how to start the conversation, then simply download, print off and complete this Ice-Breaker document, and hand it to your GP, Social Worker or any other professional.

They should then start asking all sorts of questions to enable them to start working out what might be causing your symptoms, and discuss some options that will hopefully help make you feel better. There could be a number of different things causing you to feel unwell, so it’s best not to assume there’s just one cause, or just one treatment.

image of POhWER Logo

POhWER provide the Lewisham Advocacy Service to support residents with a variety of issues, where there may be difficulties with communication or understanding information.

Find out more avour the Lewisham Advocay Service Leaflet.

london fire brigade logo

London Fire Brigade offer a service where they can visit an adult at home to provide personalised advice about fire safety. It's totally free, available 24/7, and they even fit free smoke alarms during the visit if you need them. 

Find out more about Home Fire Safety Visits

Image of Community Connections Lewisham Logo

Community Connections Lewisham are able to connect you with groups, activities and services in your local community that can support your health and wellbeing ~ bringing Lewisham to you!

You can phone them on 0330 058 3464, from 9:30am-4pm Monday-Friday (*except Thursdays when our line is open from 2-4pm). You can also get in touch using their online referral form, or visit the Thursday Morning Drop In.

image of Hoarding Support logo

This website provides information, support and advice for people who hoard and their loved ones.

There is also an online community that you can contribute to with your own experiences.

British Red Cross logo

The self-kindness toolkit is packed with activities to support building resilience, coping with stress and worries, and connecting with others.

Inside the self-kindness toolkit:

  • resilience
  • problem solving
  • making decisions confidently 
  • first aid
  • sleep techniques
  • coping with change
  • creative activities
  • connecting with others
  • movement and mindfulness

If you suspect that an adult you work with may be at risk of abuse or neglect please complete the Adult Safeguarding Concern form and return to the Lewisham Adult Gateway as instructed in the form.

Alternatively if you have concerns about the immediate safety of an adult at risk then please contact the Police on 999. 

Lewisham Policy, Procedures and Guidance

All professionals working with adults who self-neglect and hoard in Lewisham must utilise the following policies, procedures and guidance.

Multi Agency Self-Neglect Policy, Practice Guidance and Procedures

Annex 2

Accompanying the Practice Guidance is the Self-Neglect High Risk Panel - Risk Assessment & Action Plan Template.

Lewisham Adult Safeguarding Pathway

Guidance on Improving our Approach to Adult and Family Engagement

Self-Neglect and Hoarding Resources

Learning from Human Stories about Self-neglect - Webinar

Here you can find the slides and handout from the Learning from Human Stories about Self-neglect webinar held by Professor Michael Preston-Shoot.

Here you will find the resources from all of the Self-neglect and Hoarding Training held by the LSAB


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