Navigating the multi-dimensional landscape of self-neglect practice:An ethnographic study exploring social workers’ experiences.

This thesis presents an ethnographic study of local authority social workers’ experiences of working with people who self-neglect. Self-neglect has been brought into focus in England with the implementation of the Care Act 2014 and its Statutory Guidance, which identifies selfneglect as a category of abuse and neglect within safeguarding adult procedures. This change requires local authorities to assess whether self-neglect concerns meet the safeguarding
criteria under s.42 of the Care Act, with social workers often taking the primary role in this process. However, few studies explore how social workers experience this work. This empirical study contributes to remedying this knowledge gap by being alongside social workers undertaking home visits and asking them how they experience working with self-neglect in the following contexts: the law and policy framework that informs self-neglect work, organisational responses, multi/interagency working, and the impact of self-neglect work on the social workers themselves. A thematic analysis of the findings identified that social workers’ experiences of self-neglect work are multi-faceted. Their work is located within a practice framework that requires them to navigate a multi-dimensional landscape of law and policy, organisational and multi/inter-agency expectations, professional values, and personal relationships. This often contradictory interface can result in ethical challenges for social workers who struggle to meet managerial demands in what they describe as a ‘case management’ model that can deny them time to build the critical relationships needed in self-neglect work. The findings identified that social workers could be adversely affected by the sensory and emotional impact of self-neglect work,
but they struggled to recognise or articulate this in professional supervision. The evidence from this study suggests that social workers need a safe space to explore the sensory, emotional and ethical impact of self-neglect work, and these impacts need to be understood by managers, partner agencies and more broadly within organisational and community settings to ensure social workers gain the appropriate support in this growing area of practice