Warwickshire Safeguarding Adults Board will be publishing a series of 'Spotlight Features' each month, to highlight specific topics. This will include news articles, events, campaigns and information on certain safeguarding subjects. The links below provide in-depth information for practitioners and the community at large across Warwickshire. The aim of which is to heighten awareness and understanding of Safeguarding.

 

March 2018 - Hoarding & Self-Neglect

The Warwickshire Safeguarding Adults Board would like to put a spotlight on Hoarding and Self-Neglect. We have put together some information, and news articles to help raise awareness.

You often hear about hoarding disorders on such reality television programmes such as “Obsessive Compulsive Hoarding” or “Hoarders: Buried Alive” which can often highlight a group of cleaners showing disgust and horror as they enter the Hoarders property, then hiring a skip and a van and removing all clutter whilst arguing and belittling the hoarder. WSAB would like to highlight that Hoarding and Self-Neglect is a mental health disorder, and cannot simply be solved by someone coming in and giving their house a good clean. It requires care, attention and most of all patience. It needs teamwork to help get to the root cause of the hoarding or self-neglect, to find solutions and methods on overcoming their issues. We are hoping with the information provided in this Spotlight Feature that it will help increase better understanding and empathy towards this mental health disorder in and around Warwickshire, and to acknowledge the complexities involved when overcoming such a disorder.

 


We recommend to follow the advice given by NHS England, which is when someone is facing a Hoarding or Self-Neglect concern is to encourage said person to visit their GP as their first port of call. If they are not yet comfortable to do so, perhaps consider contacting a helpline such as:

  • Hoarding UK - 020 3239 1600
  • Anxiety UK - 08444 775 774
  • OCD UK - 0845 120 3778

Further information and support will be found in the below points.

 


The West Midlands ‘Adult Self-Neglect Best Practice Guidance’ says:
There is not a universally accepted definition of self-neglect. However the following is commonly used and a good starting point:
Self-neglect is defined as ‘the inability (intentional or unintentional) to maintain a socially and culturally accepted standard of self-care with the potential for serious consequences to the health and well-being of the self-neglecters and perhaps even to their community.’
(Gibbons, S. 2006. ‘Primary care assessment of older people with self-care challenges.’ Journal of Nurse Practitioners, 323-328.)

The Care Act statutory guidance 2014 defines self-neglect as;
"self-neglect - this covers a wide range of behaviour neglecting to care for one's personal hygiene, health or surroundings and includes behaviour such as hoarding"

 

  • Living in very unclean, sometimes verminous, circumstances, such as living with a toilet completely blocked with faeces, not disposing of rubbish;
  • Neglecting household maintenance, and therefore creating hazards;
  • Obsessive hoarding creating potential mobility and fire hazards;
  • Animal collecting with potential of insanitary conditions and neglect of animals' needs;
  • Failing to provide care for him/herself in such a way that his/her health or physical well-being may decline precipitously;
  • Poor diet and nutrition, evidenced by for instance by little or no fresh food or mouldy food in the fridge;
  • Failure to maintain social contact;
  • Failure to manage finances;
  • Declining or refusing prescribed medication and/or other community healthcare support – for example, in relation to the presence of mental disorder (including the relapse of major psychiatric features, or a deterioration due to dementia) or to chiropody issues;
  • Refusing to allow access to health and/or social care staff in relation to personal hygiene and care – for example, in relation to single or double incontinence, the poor healing of sores;
  • Refusing to allow access to other organisations with an interest in the property, for example, staff working for utility companies (water, gas electricity); and
  • Being unwilling to attend appointments with relevant staff, such as social care, healthcare or allied staff.

It is important to understand that poor environmental and personal hygiene may not necessarily always be as a result of self-neglect. It could arise as a result of cognitive impairment, poor eyesight, functional and financial constraints. In addition, many people, particularly older people, who self-neglect may lack the ability and/or confidence to come forward to ask for help, and may also lack others who can advocate or speak for them. They may then refuse help or support when offered or receive services that do not actually adequately meet their needs.

 


Yes it is. A self-neglect characteristic can be; “Obsessive hoarding creating potential mobility and fire hazards”.

 

According to OCD UK there is believed to be three categories of hoarding:

  • 'Prevention of harm' hoarding – Prevention of bad things happening, common to other forms of OCD, where a person will fear that harm will occur if they throw things away. For example refuse collectors will be injured by sharp edges of discarded cans or glass objects, or that someone may be contaminated from a discarded item.
  • 'Deprivation hoarding' – Where a person feels that they may need the object later, sometimes because of previous experience of deprivation. For example, after the Second World War many people across Europe had few possessions, and so everything became valuable and reusable.
  • 'Emotional' Hoarding – For some people hoarding becomes emotional, where perhaps, because of past traumatic experiences with people, they believe objects hold a special emotional significance. For example, where a loved teddy bear can be trusted more than people, a person can develop relationships with objects rather than people.

 

The following case study is extracted from the West Midlands ‘Adult Self-Neglect Best Practice Guidance’:

"Ms S is a 63 year old woman with mild learning disability. She has always lived with and was cared for by her parents until they both died over the last 5 years. She now lives alone in the former parental home. The house is in disrepair with no windows at the back of the house. The kitchen floor is always wet from the rain. The house is dirty. The house is cluttered with possessions such that it is difficult to walk through the house. Ms S is incontinent, her legs are ulcerated and weeping. Ms S has recently refused to let her sister into her house, but does still allow her GP to come into her house.

The Local Authority received a concern about risk of harm through self-neglect. The GP feels Mr S’s capacity to understand the risks may be in question. The Local Authority decided there is reasonable cause to suspect Mrs S meets the criteria for s42 enquiry under the Care Act because there is reasonable cause to suspect that Mrs S has needs for care and support, is at risk of self-neglect, and there is reasonable cause to suspect Ms S is unable to protect herself from self-neglect or the risk of it.
The enquiries agreed were for the GP- as the person who knows Ms S best- to work with Ms S to understand what her views and wishes are about her care and support needs and to encourage her to accept input and assessment from the Local Authority, and for the Local Authority to undertake a needs assessment."


The Birmingham Safeguarding Adults Board has produced a film to raise awareness of hoarding and to guide professionals on what kinds of interventions seem to work the best so that the people affected (both the person who hoards and other people whose lives this impacts upon) get the support that they need. See below:


Ceci Garrett is the founder and Executive Director of Lightening the Load, a ministry that works to connect those in the Spokane area of the USA with resources and hope as they unclutter their homes, lives, and relationships. Her work to raise awareness about the effects hoarding disorder has on the family and the community stems from her personal experiences growing up with a hoarding parent. Here she is giving a talk about how Hoarding is a mental health issue at TEDx:


This video was produced in support of the Chief Fire Officers Association's UK Hoarding Awareness Week back in 2014, but all information is just as relevant and as important today.

 

NHS services give the following advice:

  • If you think a family member or someone you know has a hoarding disorder, try to persuade them to come with you to see a GP.
  • This may not be easy, as someone who hoards might not think they need help. Try to be sensitive about the issue and emphasise your concerns for their health and wellbeing.
  • Reassure them that nobody is going to go into their home and throw everything out. You're just going to have a chat with the doctor about their hoarding to see what can be done and what support is available to empower them to begin the process of decluttering.
  • Your GP may be able to refer you to your local community mental health team, which might have a therapist who's familiar with issues such as OCD and hoarding. If you have difficulties accessing therapy, the charity OCD-UK may be able to help.
  • It's generally not a good idea to get extra storage space or call in the council or environmental health to clear the rubbish away. This won't solve the problem and the clutter often quickly builds up again.

 

Please note most of these courses are aimed at professionals based in the Safeguarding sector, click on the associated links for more information:

SCIE Courses:
SCIE Adults self-neglect course
https://www.scie.org.uk/training/safeguarding/adults-self-neglect

Safeguarding adults training for managers and newly appointed safeguarding leads
· 13 April 2018, London - book now
· 16 May 2018, London - book now

 

Clouds End CIC

Clouds End is a Community Interest Company (CIC) based in the UK. They work with people who suffer from hoarding disorder or chronic disorganisation. They have in-house training, as well as e-learning available, to have a look at what they have available, and the services they provide, go to their website by clicking here. 

 

Hoarding UK

The UK National Charity for people impacted by hoarding behaviours will be hosting the ‘National Hoarding Conference’ on 14th May 2018 at the Emirates Stadium in London. “National Hoarding Conference 2018 – Improving Person-Centred Outcomes is an event for people, nationwide, who are affected by hoarding behaviour and the professional services who support them. This conference is being held as a precursor to an International Conference in UK in 2019. The theme in 2018 is ‘Partnership Working’.” for more information go to their website by clicking here.

 

 

 

 


Previous spotlight themes:


ITNOTOK 2018

Week commencing 5th February is Sexual Abuse and Sexual Violence Awareness Week in the UK. The Warwickshire Safeguarding Adults Board would like to take this opportunity to put a spotlight on the issue of Sexual Abuse and Sexual Violence against adults with care and support needs. We have put together some information, news articles and a list of upcoming events in relation to the topic, to help expand understanding and raise awareness.

What is meant by sexual abuse and sexual violence?

It includes rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting. It includes penetration of any sort, incest and situations where the person causing harm touches the abused person’s body (e.g. breasts, buttocks, genital area), exposes his or her genitals (possibly encouraging the abused person to touch them) or coerces the abused person into participating in or looking at pornographic videos or photographs. Denial of a sexual life to consenting adults is also considered abusive practice. 
Any sexual relationship that develops between adults where one is in a position of trust, power or authority in relation to the other (e.g. day centre worker/social worker/residential worker/health worker etc.) constitutes sexual abuse.

 

Why are the Warwickshire Safeguarding Adults Board putting a spotlight on it?

The #metoo campaign is a hot topic in the media at the moment, and with it being Sexual Abuse and Sexual Violence Awareness week in February, the WSAB want to take this opportunity to highlight sexual abuse and sexual violence against adults, particularly those adults with care and support needs and older people (which is rarely reported in today’s media).

 

Possible signs/indicators of an adult (particularly an adult with care and support needs) who is being sexually abused:

  • Adult has urinary tract infections, vaginal infections or sexually transmitted diseases that are not otherwise explained;
  • Adult appears unusually subdued, withdrawn or has poor concentration;
  • Adult exhibits significant changes in sexual behaviour or outlook;
  • Adult experiences pain, itching or bleeding in the genital/anal area;
  • Adult’s underclothing is torn, stained or bloody;
  • A woman who lacks the mental capacity to consent to sexual intercourse becomes pregnant;
  • Sexual exploitation.

 

What help is out there for adults in Warwickshire who have gone through sexual abuse/violence?

If you are reporting sexual abuse or sexual violence against yourself or that of another adult, there are many ways to do this, have a look at the list below to see what would be preferable to your circumstance:

  • Call 999 to report a rape or attempted sexual assault, as soon as possible after the crime. If the offence has recently happened:
    • keep the clothes you were wearing and don’t wash them - the police may need them as evidence for the investigation
    • try not to shower as there may be evidence which the police can use.
  • If you don’t want to report it to the police - You can go to a Sexual Assault Referral Centre (SARC) such as the Blue Sky Centre in Nuneaton, which provides people who have experienced rape or sexual assault with support and advice to assist in their recovery. Find one nearest to your location by clicking here
  • Alternatively, you can contact the following support organisations:
    • Rape Crisis - Rape Crisis England & Wales is a feminist organisation that exists to promote the needs and rights of women and girls who have experienced sexual violence, to improve services to them and to work towards the elimination of sexual violence. 
    • Victim Support - Victim Support (VS) is the independent charity for people affected by crime and traumatic events in England and Wales. Its specialist teams provide individual, independent, emotional and practical help to enable people to cope and recover from the effects of crime. 
    • RoSA - RoSA is an independent charity offering free confidential support for anyone who has experienced the trauma of rape, sexual abuse or sexual violence. We work throughout the county of Warwickshire supporting women, men, young people and children from age 5. Its support is also offered to family members, partners and carers. 
    • Safeline - Safeline is a specialised charity working to prevent sexual abuse* and to support those affected in their recovery. This includes working with people whose mental health issues (manifesting for example as self-harming) suggest that they may be vulnerable to abuse. 
    • Refuge Warwickshire - If you are experiencing domestic violence in Warwickshire, Refuge-Warwickshire Domestic Violence Service can support you and your children to keep safe. Refuge-Warwickshire Domestic Violence Service is a county-wide service which provides support to women, men and children experiencing domestic violence in Warwickshire. 

 

What events or training is there in regards to sexual abuse and sexual violence?

The Survivors Trust (TST) is a UK-wide Charity that is the national umbrella agency for specialist organisations who give support to survivors of rape, sexual violence and childhood sexual abuse throughout the UK and Ireland. They have kindly sent us a list of their upcoming training workshops for 2018, click here to download. 

iHasco will be offering discounts on their Sexual Harrassment courses during Sexual Abuse and Sexual Violence Awareness Week. Click here to see more.

On Monday 5th February there will be a Light Up The Night event held in Market Harborough and London (as well as various other locations across the UK) to help raise awareness of sexual abuse and sexual violence. Click here to see the event poster for Market Harborough and here for London, and here to find other events being held across the country.

 

Sexual Abuse and Sexual Violence in the News

Coventry man accused of kidnap and rape in Rugby to stand trial
Rape survivor sees attacker brought to justice thanks to charity's support
Bedworth man charged with rape and making threats to kill
Time's Up: Hollywood women launch campaign to fight sexual harassment
Rose McGowan's memoir Brave details alleged rape by Harvey Weinstein
Women's March: What's changes one year on?
Revenge Porn: What to do if you're a victim
Sexual abuse of disabled adults revealed
Kevin Spacey sexual harassment scandal costs Netflix $39m
Vicious rumours, sexist comments and harassment: life as a female councillor in the UK
'I have experienced such behaviours in local government' - Weinstein allegations prompt top council boss to speak out against sexual harassment
Tories and Labour hit by fresh complaints about behaviour of MPs

 

Informative Videos, Posters & Leaflets

Fashion models expose sexual harassment - Victoria Derbyshire programme

Sexual Abuse & Sexual Violence Awareness Week logo

Stop Rape Now campaign - CNOSENT (Don't Mix It Up)

The Survivors Trust information leaflet

Revenge Porn A4 poster

Behind Closed Doors - Preventing sexual abuse against adults with a learning disability

 

Useful and Important websites

Mencap - Relationships and sex FAQs
Revenge Porn - GOV.UK
Report Rape and/or Sexual Assault - GOV.UK 
Coventry Rape and Sexual Abuse Centre (CRASAC)
Survivors UK - male rape and sexual abuse
World Health Organisation (WHO) - Sexual Violence Prevention report 
Safeline Warwickshire
RoSA Warwickshire
Refuge Warwickshire
Action on Elder Abuse - Sexual Abuse
Conservatives Code of Conduct
Blue Sky Centre Warwickshire

The Warwickshire Safeguarding Adults Board would like to put a spotlight on our priority of Making Safeguarding Personal (MSP), as well as the process of Safeguarding Adult Reviews (SARs). We have put together some information, and news articles in relation to the topic, to help expand understanding and awareness.

What is meant by ‘Making Safeguarding Personal’?
Making Safeguarding Personal (MSP) is about having conversations with people about how we might respond in safeguarding situations in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety. It is about seeing people as experts in their own lives and working alongside them. It is a shift in culture and practice in response to what we know makes safeguarding more or less effective from the perspective of the person being safeguarded. In other words, it is a shift from a process supported by conversations to a series of conversations supported by a process.

What are Safeguarding Adult Reviews?

Safeguarding Adults Reviews (SARs) provide a way for all partner agencies to identify lessons that can be learned from particularly complex or serious safeguarding adults cases, where an adult with care and support needs has died or been seriously injured, and abuse or neglect is suspected.
SARs provide an opportunity for partner agencies and their staff to learn and make improvements including in policy, practice and procedures, where necessary. SARs are not about attributing blame, but are about learning to prevent similar circumstances in the future. Several cases in Warwickshire have been considered for a SAR. Partner agencies should consider if the most serious cases meet our SAR criteria to help partners identify and apply learning from them.

Case Studies, Posters and Promotional Materials

Resources to support Making Safeguarding Personal
Case Studies on Making Safeguarding Personal

MSP and SARs in the News

‘Hidden’ mum found weak and emaciated in her own home in Milton Keynes

Safeguarding adults who have mental capacity: key principles

Community approach to social work delivers more personalised care

Poor multi-agency working a factor in case where self-neglecting woman died

Assaults between care home residents reported daily

Safeguarding Adults Annual Report Now Published

Useful websites for further information on MSP and SARs

Local Government Association - Making Safeguarding Personal
Safeguarding Warwickshire - Making Safeguarding Personal
Hampshire Safeguarding Adults Board - Learning from experience database
Safeguarding Warwickshire - Safeguarding Adult Reviews

Saturday 2nd December 2017 is the International Day for the Abolition of Slavery. The Warwickshire Safeguarding Adults Board would like to take this opportunity to put a spotlight on the issue of Modern Slavery and Human Trafficking. We have put together some information, news articles and a list of upcoming events in relation to the topic, to help expand understanding and awareness.

Spotting the Signs of Modern Slavery

The Gangmasters and Labour Abuse Authority are a Non Departmental Public Body (NDPB) governed by an independent Board, who works in partnership to protect vulnerable and exploited workers in the UK.

On their website they have ‘Spot the Signs’ to recognise someone who may be a subject to Modern Slavery. In short the signs to look out for are:

  • Restricted Freedom  
  • Behaviour shows fear and anxiety   
  • Live in poor or substandard accommodation   
  • A lack of belongings    
  • Have no access to their earnings   

For a further detailed list please look at this PDF leaflet from the The Gangmasters and Labour Abuse Authority.

 

Videos and Written Case Studies

The following videos and case studies will help you understand the different forms of modern slavery and how they translate in day to day life with some typical examples of the environments in which this is most prevalent.

VIDEO 1 - Examples on how to act when spotting the signs of Modern Slavery:


CASE STUDY 1 - BEN's STORY: "A British man called Ben, who was unemployed and living on the streets of a major UK city, was approached at a soup kitchen and offered work and accommodation by a couple who ran a block paving business. Ben was socially isolated, having broken up with his girlfriend and lost his job in a short space of time: he lacked any form of support network. Seeing no other option, he agreed to go. He was taken to a site many miles away where, upon arrival, he was subjected to intimidation and violence. He was forced to work paving driveways, and was paid little or often nothing for his labour. He was terrified of the consequences of trying to leave, so submitted to this abuse for a long time." - 
Cheshire Police


VIDEO 2 - Tackling Modern Slavery in the Construction Sector - a victim's story:


CASE STUDY 2 - JONAS'S STORY: “They were taking nearly everything I earned. I lived in fear.” - 
50 for Freedom


VIDEO 3 - Modern Slavery Guidance for NHS Staff:


VIDEO 4 - Modern Slavery Guidance for Local Government:


VIDEO 5 - Modern Slavery Guidance for Emergency Services:


CASE STUDY 3 - MELODY'S STORY: "While grieving for her mother who had just died, Melody was tricked into coming to England from Nigeria to search for her grandmother. On arrival, she was met by a man who took her to a brothel and told her she would work there until she repaid her flight ticket. Every protest from Melody increased the debt she owed.Having suffered horrifically, after four years Melody was finally rescued when the police raided the brothel, and she was brought to Unseen. At our safe-house, Melody has made steady progress and received specialist help for her healthcare needs, anxiety and flashbacks. She enrolled on in-house education and external training courses in the community. However, when she came to move on from the safe-house, she needed ongoing support to secure housing, financial support and employment." - Unseen UK


VIDEO 6 - A video from the Trafficker’s perspective:


Posters and Promotional materials

The following posters and leaflets are available for you to share within your organisation and/or community, to spread awareness and understanding how to spot the signs of modern slavery in your local area.

Modern Slavery Awareness & Victim Identification Guidance.
Help for Adult Victims of Modern Slavery
Modern Slavery is closer than you think

The Anti-Slavery Commissioner has a whole webpage dedicated to resources on Modern Slavery and Human Trafficking. Click here to find out more.

 

Training and E-learning available

The Local Government Authority (LGA) are conducting Modern Slavery Workshops at various locations across the UK in 2018. Who should attend? Elected members and officers with responsibility for: Community safety; Safeguarding vulnerable individuals; Safeguarding children; Police and crime commissioners and their officers. To find out more go to their website by clicking here.

Warwickshire County Council also provide an e-learning module via their Warwickshire Interactive Learning Management (WILMa). If you have access to WILMa, just search for ‘slavery’ and you will find a choice of two e-learning courses on Modern Slavery.

 

Modern Slavery in the news

The following articles illustrate that modern slavery remains a problem worldwide and show the work being done to support and bring about justice for the victims of this crime.

Why celebrities are sharing posts about ‘slave auctions’ - Newsbeat, BBC

If only Slavery really had been abolished - The Guardian

Nine Polish nationals appear in court charged with modern slavery offences - Birmingham Mail

Modern Slavery: An everyday crime - The Telegraph

 

Useful websites for further information on Modern Slavery

West Midlands Anti-Slavery Network

Independent Anti-Slavery Commissioner

Multi-Agency Anti-Slavery Partnerships

Modern Slavery GOV.UK

Gangmasters and Labour Abuse Authority

Modern Slavery and Human Trafficking - Safeguarding Warwickshire

During October we will be focusing on Mental Health, due to it being World Mental Health Day on 10th October. This day is recognised by the World Health Organisation (WHO), as well as the variety of Mental Health charities across the UK and internationally. The theme for World Mental Health Day in 2017 is "mental health in the workplace". WHO have said the following;
"During our adult lives, a large proportion of our time is spent at work. Our experience in the workplace is one of the factors determining our overall well-being. Employers and managers who put in place workplace initiatives to promote mental health and to support employees who have mental disorders see gains not only in the health of their employees but also in their productivity at work. A negative working environment, on the other hand, may lead to physical and mental health problems, harmful use of substances or alcohol, absenteeism and lost productivity."

The Mental Health Foundation have resources on managing your mental health in the workplace, as well as a variety of different publications to help maintain your well-being. They will also be running their famous Tea & Talk event across the country, click here for more information on the event.

Coventry and Warwickshire Mind have several events occurring during the week of 9th-15th October to help raise awareness of Mental Health issues, and encourage the public to get support. Click here to see more about their events, and here for the support they can offer to you if you are struggling.

Please click here for the list of Wellbeing Hubs and Mental Health Support Centres within Warwickshire.

For further reading on Mental Health in the news then click the below articles:

 

 

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