A number of recommendations have been made after the man – who has been given the pseudonym Mr Hunter – died in hospital following his decision not to undergo surgery which could have saved his life.
Jersey Safeguarding Adults Partnership Board arranges serious case reviews when an adult with care and support needs dies from, or has experienced, serious abuse or neglect.
Although the report, which was published yesterday, said that there was evidence of good practice from agencies which worked with Mr Hunter, it repeated recommendations made in earlier serious case reviews. These include a need for:
*The States to better support the Safeguarding Partnership Board to train agencies about self-neglect.
*The allocation of resources to manage self-neglect cases.
*Improving the understanding and response of parish officials to self-neglect cases.
Mr Hunter was described as a cultured and well-educated man who had studied electrical engineering at university but had spent 40 years living ‘off grid’ in a caravan in a farmer’s field.
Last winter, paramedics attended Mr Hunter’s home after he had contacted his cousin to say he was in pain. They noted he was living in poor conditions.
The crew submitted a safeguarding adult self-neglect referral to Adult Social Care which resulted in Environmental Health and the Fire and Rescue Service carrying out a public safety interest assessment on Mr Hunter’s property.
The assessment found there was no electricity, toilet, running water or cooking facilities, that Mr Hunter was using a bucket for a toilet, and that he was feeding rats, which he saw as pets.
An abatement notice was issued requiring the site to be cleared.
The report says: ‘Mr Hunter’s living conditions were described by some agencies as “squalid”. They were concerned he was putting his own health and safety, and the health and safety of others, at risk.
‘Mr Hunter disputed this and was very happy with his lifestyle – neither he nor his next of kin accepted that he was neglecting himself.’
It was also noted that there was no evidence that Mr Hunter, who had received support from the parish over the years, had any mental impairment which affected his decision-making ability.
When Mr Hunter was discharged from hospital he was taken to a residential care facility for two weeks. This was funded by social care. He then went into a hotel.
The report found that the agencies worked to try to find Mr Hunter alternative accommodation but he told them he did not want to live with others or in a urban setting, nor did he wish to fund either private accommodation or residential care.
In spring last year, with no alternative options, the parish sourced a Portakabin so Mr Hunter could return to the parish, although concerns were expressed by some agencies about the lack of basic facilities for him and the issue of building control regulations.
Mr Hunter moved into the Portakabin before it was completed despite it not having heating, lighting or refrigeration.
However, when his health deteriorated further he was readmitted to hospital and advised that due to the poor condition of his leg and foot, amputation was the only option. Mr Hunter declined the surgery and died a few days later.
Glenys Johnston, chairwoman of the Safeguarding Partnership Board, said: ‘The Safeguarding Partnership Board has already taken positive steps to address self-neglect in Jersey. The review has identified areas that may further strengthen multi-agency work in responding to self-neglect.
‘The review also highlighted areas that will strengthen multi-agency work in responding to self-neglect and the valuable contribution that parishes can play in safeguarding.’
