Managing Self-Neglect and Risk in Acquired Brain Injury Services
Share
Self-neglect is one of the most complex safeguarding issues in acquired brain injury services. Cognitive impairment, reduced insight and executive dysfunction can lead to behaviours that place individuals at serious risk while still expressing a desire for autonomy. Commissioners and inspectors expect providers to demonstrate how self-neglect is identified and managed lawfully.
This article explores how ABI services can respond to self-neglect. It should be read alongside Safeguarding, Capacity, Risk & Vulnerability and Positive Risk-Taking & Risk Enablement.
Understanding self-neglect in ABI
Self-neglect may include poor nutrition, unsafe environments or refusal of support.
Commissioner and inspector expectations
Expectation 1: Clear assessment. CQC expects providers to evidence how self-neglect has been assessed.
Expectation 2: Proportionate intervention. Commissioners expect responses to balance safety and rights.
Operational example 1: Environmental neglect
A service identified risks linked to unsafe living conditions and implemented gradual support.
Capacity and self-neglect
Capacity assessments must relate to specific decisions linked to self-neglect.
Operational example 2: Refusal of personal care
Staff assessed capacity and explored less restrictive alternatives.
When safeguarding escalation is required
Persistent or escalating harm may require formal safeguarding action.
Operational example 3: Multi-agency safeguarding response
A provider escalated concerns to safeguarding following repeated incidents.
Evidencing lawful responses to self-neglect
Providers should evidence:
- Decision-specific capacity assessments
- Risk management plans
- Multi-agency engagement records
Why this matters
Effective responses protect individuals while upholding legal rights.
💼 Rapid Support Products (fast turnaround options)
- ⚡ 48-Hour Tender Triage
- 🆘 Bid Rescue Session – 60 minutes
- ✍️ Score Booster – Tender Answer Rewrite (500–2000 words)
- 🧩 Tender Answer Blueprint
- 📝 Tender Proofreading & Light Editing
- 🔍 Pre-Tender Readiness Audit
- 📁 Tender Document Review
🚀 Need a Bid Writing Quote?
If you’re exploring support for an upcoming tender or framework, request a quick, no-obligation quote. I’ll review your documents and respond with:
- A clear scope of work
- Estimated days required
- A fixed fee quote
- Any risks, considerations or quick wins