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Developing shared understandings of multi-agency working with adults who self-neglect

Aspinwall-Roberts, E (2020) Developing shared understandings of multi-agency working with adults who self-neglect. Doctoral thesis, Liverpool John Moores University.

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Abstract

The Care Act 2014 imposes a duty on local authorities to make statutory safeguarding enquiries when they suspect that an adult with care and support needs is self-neglecting. The Act also imposes a duty on local authorities and relevant partners, such as health and housing, to work in partnership. However, safeguarding adult reviews and government ombudsman investigations have shown a consistent failure of agencies to work together on cases involving self-neglect. The aim of this research is to develop an understanding of how multi-agency working in self-neglect cases can be improved, whilst respecting the autonomy of service users who self-neglect. This research applies the methodology of professionalising action research in a new setting, that of multi-agency working in the public sector. It is the first study to include the views and input of the full range of agencies who might typically work with people who self-neglect. Following a pilot project, fifteen different professional groups from two local authorities in the North of England were identified, who work with people who are self-neglecting. More than 30 group interviews were carried out with these staff in the problem-sensing phase of the action research, to identify priorities for change. Subsequently, two multi-agency workshops were held in each local authority, involving a total of 120 staff from the various agencies, to identify how change could be implemented. The research provides important insights into how practitioners assess the effectiveness of working together in this complex and demanding area of practice. A key message from the research is the extent of the disarray in multi-agency working, and the research extends the discourse on multi-agency working in four main areas of difficulty; inter-agency conflict, inter-agency communication, professional role understanding, and achieving change in multi-agency working. New findings in the research challenge assumptions about how practitioners from a wide range of agencies operationalise the Mental Capacity Act 2005 in relation to people who self-neglect. Overall, rich insights into working practices emerge, and the author gives recommendations for changing and improving multi-agency working with people who self-neglect. Furthermore, using a professionalising action research approach allowed solutions to be identified by participants, which have begun to be translated into practice.

Item Type: Thesis (Doctoral)
Uncontrolled Keywords: Self-neglect; Multi-agency; Action research
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RT Nursing
Divisions: Nursing & Allied Health
Date Deposited: 07 Apr 2020 08:36
Last Modified: 07 Apr 2020 08:36
DOI or Identification number: 10.24377/LJMU.t.00012670
Supervisors: Fleming, V, Khatri, R and Jones, PA
URI: http://researchonline.ljmu.ac.uk/id/eprint/12670

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