What is Hoarding Disorder?Definition: When a person is unable to use the rooms in their home for theirintended purpose.

History of HoardingAnimal Instincts

• Squirrels

Winter Reserves•Famine•Wartime babies

Collyer Brothers and Edward Trebus

Andy Warhol

TV Programmes•Richard Wallace•Coronation Street

The Impact of Hoarding

Families suffer when their basic needsare not addressed through loss offunctionality within the home andfamilies are prevented from carryingout activities caused by hoarding, suchas:-

•Use of bathroom included toilet, sinkand bath/shower

•Use of kitchen, such as limited kitchensurface, oven, refrigerator and table

•Restricted living space to sleep, eatand relax impacts greatly on family life

•Nowhere to wash clothing,bedding and towels

•Living conditions – loss of heating, structural damage, loss of water

•Hygiene suffers which has knock on effects with children at school and bullying as well as self esteem issues

•Structural damage, blocked exits, fire hazards, damp, mildew and mould

•Impact on health –dust and damp contribute greatly to respiratory conditions

•Fire safety needsare not being met

•Repairs in thehouse are not ableto be carried out

The Visual Problem

These are Clutter Image Ratings thathave been done from a previous studywhich are widely used across the world.

This shows the severity of the problemin many homes across the UK. 2-5 % ofthe UK are affected by hoarding whichrepresents potentially 1.2 millionpeople.

Hoarding Disorder is a mental healthconcern that manifests itself physicallyand impacts on not only other familymembers, children and pets but alsohas social, health and safetyimplications for neighbours and thewider local community.

The Care Act, 2014 builds on recent reviews and reforms, replacing numerous previous laws, to provide a coherent approach to adult social care in England.

Local authorities (and their partners in health, housing, welfare and employment services) must now take steps to prevent, reduce or delay the need for care and support for all local people. The Care Act introduced three new indicators of abuse and neglect to Adult Safeguarding. The most relevant to Hoarding Disorder is self-neglect.

The guidance states; this covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. In practise, this means that when an adult at risk has care and support needs because of a physical or mental impairment or illness, their case may require a safeguarding enquiry.

The Care Act 2014

The response

It is recognised that hoarding is a complex condition and that a variety of agencies will come into contact with the same person. It is also recognised that not all the individuals that hoard will receive support from statutory services such as Mental Health.

The initial intervention from Adult Social Care might be to offer an individual an assessment of their care and support needs. It is recognised that not all individuals that hoard will have care and support needs and an assessment may result in a more appropriate pathway being followed to support the adult, instead of the safeguarding process.

- Creates a safer and healthier environment for the individual and others affected by the hoarding behaviour, e.g. family, neighbours.

- Develops a multi-agency pathway which will maximise the use of existing service’s and resources and which may reduce the need for compulsory solutions.

- Ensures that when solutions are required, there is a process for planning solutions tailored to meet the needs of the individual and utilising a person centred approach. Possible solutions should include professional support and monitoring, property repairs and permanent or temporary re-housing.

- Develops creative ways of engaging individuals in the process.

- To establish best practice and improve knowledge of legislation that relates to hoarding behaviour through the Hoarding Liaison Group.

Multi Agency Working

UPSTAIRS LANDING TOWARDS STUDY - BEFORE

AFTER

UPSTAIRS STUDY - AFTER

SPARE ROOM - BEFORE

AFTER

MAIN BEDROOM BEFORE

AFTER

BATHROOM BEFORE

AFTER

The Mental Capacity Act (MCA) 2005 provides a statutory framework for people who lack the capacity to make decisions by themselves.

Does the person lack the mental capacity in respect of the issues/risks in relation to:-

- Property- Health & Safety- Household functions- Impact on others- Impact on self

Mental Capacity Act

Do’s and Don’t’s