Verbal report and presentation.
Minutes:
The Group Manager Prevention, Kirsty McCreesh, informed Members that hoarding was defined as where a person acquired an excessive number of items and stored them in a chaotic manner, usually resulting in unmanageable amounts of clutter. The items could be of little or no monetary value. It was estimated that 1 person in every 100 had a problem with hoarding which seriously affected their life. An accurate number to give a scale of the problem could be difficult to provide as a person who hoarded might be embarrassed and so would avoid inviting people into their property. That could be where the Service was made aware of the problem, although it would tend to be at the ‘incident’ stage and barriers might be encountered when trying to access the property for a HFSC.
Hoarding was considered a significant problem if:
- The amount of clutter interfered with everyday living – for example, if the person was unable to use their kitchen or bathroom and could not access rooms; or
- The clutter was causing significant distress or negatively affecting the quality of life of the person or their family – for example, they became upset if someone tried to clear the clutter and their relationship suffered.
Hoarding Disorder had been recognised as a distinct mental health problem which might present in isolation or as part of another mental health problem such as;
· Physical illness
· Dementia
· Depression
· Alcohol and drug misuse
· Schizophrenia and other psychotic disorders
· Learning disability
· Autism and related disorders
· Obsessive Compulsive Disorder
Hoarding was a very complex issue and more than providing a means of disposing of items. It was important not to assume why people were hoarding or make judgements as there were many reasons, causes and medical conditions that could lead to hoarding. Hoarding Disorder could be diagnosed when there was no other illness to account for the problem. It was noted that those with a hoarding disorder strongly believed that their hoarded items were valuable.
Hoarding was a concern for LFRS as clutter and hoarding increased the risk of a fire occurring and made it more difficult for people living in the property to evacuate safely. Fire could also spread to neighboring properties and any fire could also be more difficult to tackle posing a greater risk to firefighters. In addition, the occupier was likely to have little or no engagement with other services and a higher risk of social isolation.
To support individuals who were hoarding, LFRS could:
- Conduct a Person-Centered Home Fire Safety Visit;
- Ensure smoke alarms were fitted and they were aligned to risk and where the householder spent their time;
- Create Escape Plans and stress the importance of clear exits;
- Use the clutter image rating scale for additional information and guidance on how to support the person; and
- Record risk where appropriate to provide notification to fire crews attending an incident.
The clutter rating scale had been adopted by LFRS and guidance had been produced to support staff when working with hoarding. Training was also provided to all personnel who conducted HFSCs on hoarding and how to approach dealing with the issue. The scale was recognised nationwide and most importantly, by the Service and other agencies including Social Care in Lancashire. Staff were advised to refer to the scale and guidance whenever working with hoarding and record the level relating to the scale on all paperwork following a visit/incident.
Hoarding was complex and multifaceted, therefore, an integrated approach between multiple agencies was often required. LFRS worked with many agencies which included Safeguarding teams, Integrated teams in different area, Local Authority Environmental Health, and Housing and Health and Social Care partners. A key partner was Lancashire Safeguarding Adults Board who had a Multi-Agency Self-Neglect Framework. The framework was intended to be used when:
- There were significant concerns by agencies about an individual’s safety or wellbeing as a result of self-neglect, and/or significant concerns about the safety or wellbeing of others (risk of serious harm, injury or death);
- Existing agency involvement and appropriate multi-agency working had been tried and was unable to resolve the issues; and
- Where the adult appeared to have the capacity to make decisions regarding their environment and lifestyle choices pertaining to issues of self-neglect.
All partner agencies must take all reasonable steps to work with the individual and address the concerns when made aware of them. If that approach was unsuccessful, the Lancashire Safeguarding Adults Board partners should follow the framework.
Members were presented with a Case Study of an over 65, single occupier. The property had 3 attempted visits from MASH (Multi-Agency Safeguarding Hub), the local mental health team and the police but no contact with the occupier was made. The occupier was a known hoarder who lived alone and had a long-term Community Risk against their property. There were numerous ongoing concerns for the occupant’s safety including hoarding, self-neglect, a recent hospital admission and diabetes. Adult Social Services and an LFRS Community Safety Advisor completed a joint visit to the property and were able to gain entry in addition to reviewing the known Community Risk (RADAR). Additional fire safety concerns were poor mobility, no care provision in place, numerous trailing wires and the occupant slept downstairs. Following the Home Fire Safety Visit, 3 smoke alarms were fitted (including one in the living room where the occupier slept), the occupier was undergoing a Mental Health Capacity Assessment, and care support was put in place through Social Services. There had been no significant reduction in hoarding due to the occupier’s reluctance, however, all access and egress routes were kept clear and trip hazards moved. The occupier continued to engage with local services and remained under the supervision of the local Multi Agency Team which included LFRS. A regular review of the Community Risk would be completed by Community Safety staff.
It was noted that communities could help by being respectful to the occupier, encouraging them to seek help from their GP (Icebreaker form could be used), signposting them to local support groups and national organisations, checking they had safety equipment in place (smoke detectors carbon monoxide detectors etc.), encouraging them to obtain a Home Fire Safety Check visit from the Fire Service, and considering referrals to other agencies.
The Chair thanked Group Manager Prevention for a very interesting presentation.
County Councillor Jennifer Mein commented that she had a constituent with severe mental health issues that was at risk of being evicted due to problems with hoarding. The social landlord brought in the Fire Service to conduct a HFSC. The Fire Service was able to connect with the constituent who then worked with partners and her tenancy was saved.
The Assistant Chief Fire Officer stated that the extent of hoarding could far exceed the images shown on the presentation and asked for Members help to raise awareness to constituents in relation to identifying vulnerable neighbours who could be potential hoarders. Often those people would not want to engage and remain under the radar. If the Service could get access to the property at an early stage, the potential to help the person was greatly increased.
Members requested links and information to share on social media, as appropriate, to raise awareness of the various topics.
RESOLVED:- That the Committee noted the ‘Risks to the Community from Hoarding’ presentation.