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Developing capacity

Opening the "Too Difficult Box": Strengthening Adult Safeguarding Responses to Homelessness and Self-neglect


This study explores how self-neglect is experienced by people who are homeless, and how this can be addressed through strengthening local adult safeguarding responses. Little is known about what constitutes ‘positive practice’ and the services and support that are needed to address this problem, particularly where they intersect with substance misuse and other extreme forms of deep social exclusion such as ‘rough sleeping’. Concerns have been raised by government about the adequacy of safeguarding, why there have been so few Safeguarding Adults Reviews into the deaths of people who are homeless, and whether learning from these Reviews is being implemented.


2019 – 2022

Research team

Michelle Cornes, Jess Harris, Jill Manthorpe, Stephen Martineau (HSCWRU); Michela Tinelli, LSE; James Fuller, PPIE/Peer Researcher; Bruno Ornelas, Brighter Futures/Voices of Stoke


NIHR School for Social Care Research


This study will employ participatory and action orientated methods to work collaboratively with Safeguarding Adults Boards across three English local authority areas to identify positive practices and areas for improvement. Communities of Practice (CoPs) will be tested in each site as a theoretically informed approach for facilitating reflective practices and embedding a culture of learning and improvement. Finally, so that the learning from the research can be shared widely, we will develop (national) practice guidance on self-neglect and homelessness and, if the findings support this, a ‘tool kit’ for using CoPs in adult safeguarding more generally.


The project began October 2019 and both qualitative and quantitative findings will be reported throughout as well as at the project’s end.

Outputs & Impact

This project will provide Safeguarding Adults Boards and their constituent partners with practice guidance on self-neglect and homelessness and will work collaboratively with them to implement this. By strengthening adult social care responses to self-neglect and homelessness this research will improve outcomes for this marginalised group.

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