Aged in his 80s, vulnerable William had been ‘getting by’ until Covid restrictions were brought in... then severe self-neglect led to his death
REPORT SAYS HEALTH PROFESSIONALS DID NOT WORK CLOSE ENOUGH TOGETHER
MISSED opportunities to provide wider support or intervention led to an elderly Derbyshire man dying due to “severe self-neglect”.
The Derbyshire Safeguarding Adults Board has reported on the case of a man referred to as William, aged in his 80s, who had depression, schizophrenia and extensive mobility issues and was visually impaired.
A safeguarding adults review carried out into William’s death showed the wide range of health professionals who were consistently in touch with him did not work close enough together or in a joined-up manner with one agency taking the lead.
It found “at no time, did all agencies involved meet to assess risks, plan responses, appoint a lead and agree contingency planning and review”.
The criteria for a vulnerable adult risk assessment (VARM) was met on eight occasions but “no agency took forward ownership to initiate the VARM process until William’s final admission to hospital which sadly, was the day he died”, the review reports.
Five referrals for safeguarding adult enquiries were made but these were never progressed.
A review report on William’s case says: “William’s lack of care for himself resulted in loss of weight, pressure sores, lack of personal hygiene and continence care and unkempt clothing. He was a keen smoker and often had burns to his face from lighting cigarettes from an open gas flame.
“The conditions of his environment were described as uninhabitable due to lack of heating, minimal lighting, levels of clutter, unhygienic conditions including slippery floors due to lack of continence. This placed him at risk of hypothermia, increasing falls and fire risk.”
The report says William had been active before the pandemic, regularly visiting a local cafe, but this ended when restrictions were brought in and his reduced mobility during this time ended up leaving him housebound.
He was well supported by his neighbours and had some phone contact with his sister and a friend but he often spoke of “loneliness and isolation” in the three years after, up until his death. The report continues: “William had a high level of involvement from health agencies, adult social care and fire and rescue services. William was well engaged with health services and could be amenable to receiving help for his physical and mental health needs, at times, being proactive in requesting help.
“However, he could struggle to take medications consistently and declined some aspects of care such as aids/adaptations and some hospital admissions.
“William minimised the concerns. He repeatedly declined care and support, either because he did not want to pay and/or did not feel he needed it.
“On occasions when he had agreed to accept some support, this consent was soon retracted. William was resolute that he wished to remain in his property despite its condition.”
The review found that while many professionals were involved in William’s care, they were rarely the same people, leading to issues gaining his trust and ability to comprehensively understand his situation in full.
There was a “lack of consistent health and care practitioners” and a “lack of adequate multi-agency responses”, it says.
The review said: “Overall, there was an episodic and fragmented response to the concerns raised regarding William. Practitioners did not all recognise the recurring nature of the concerns, William’s disguised engagement and the escalating risks.
“This led to repeated cycles of arranging care plans that had already proved to be unsuccessful.”
Overall, there was an episodic and fragmented response to the concerns raised regarding William. Review