Project aim

The study aims to influence Safeguarding Adults Boards (SABs), Local Authorities (LAs), and other stakeholder organisations to develop and/or commission improved training offers for professionals working with cases of hoarding behaviours, subsequently improving practice, which should also better address the needs of people who hoard. The project seeks to add to findings from two previous projects caried out in the NIHR Health and Social care Workforce Policy Research unit.

Analysis by the Local Government Association (2020:17) of Safeguarding Adults Reviews (SARs) identified that self-neglect, which includes hoarding behaviours, was a feature in 104 of 213 cases and was the highest category.

At its worst the lives of people with hoarding behaviours, and those living in the same property, are severely compromised by the volume of possessions hampering basic life functions (Frost & Steketee, 2011), leading to possible falls, isolation, pests, eviction, fire, and death. Mental health problems including depression and anxiety, together with relationship difficulties and isolation, are pervasive for those with hoarding behaviours (Stumpf et al., 2018). People who hoard often come to the attention of adult services at ‘crisis point’ (Owen et al., 2022) and are said to be challenging cases requiring substantial resources and well-organised inter-agency working (Orr et al., 2017).

Why this research is needed

Findings from two previous studies undertaken by the NIHR Health and Social care Workforce Policy Research unit have found that supporting someone with hoarding behaviours requires a good knowledge about the potential causes, the ways hoarding behaviours can present, best practice ways of assessing an individual and working with people who hoard, legal implications, and local resources or service provision by specialist agencies. 

This knowledge is often gained by frontline professionals in local authorities and other statutory agencies as well as external service providers, such as professional declutterers, by attending training. This training is supplied by a range of providers including: hoarding behaviours charities, professional training agencies, and specialist hoarding professionals who also engage in decluttering work.

However, researchers have found that the quality and quantity of training differs, with its main focus on causes and consequences, but less so on overcoming challenges of working in situations of hoarding behaviours, such as resistance by individuals, conflicts in families, or how to balance the need for rapid response to prevent harm but not wanting to cause additional trauma. Practitioners in the previous studies have also asked for more external supervision/opportunities to reflect on cases with ‘experts’ in the field. But there seem to be no national standards or requirements that would regulate training providers, so it is necessary to understand the qualifications and experiences that good providers bring to their practice.

How the project will be carried out

The study will use a multi-methods approach, including interviews, literature review and document analysis. This will be followed by a synthesis of findings from the previous studies and this project.  

How the public are involved in the project

The researchers will be supported by a diverse group of people with lived experiences of hoarding behaviours who have been involved in previous studies on hoarding behaviours.  

Understanding and improving training offers for professionals working with individuals at risk of harm is crucial to ensure that they have the latest knowledge and skills, to effectively identify and respond to potential risks in an appropriate and timely manner.

Nicole Steils

Dr Nicole Steils, research fellow, King's College London

Potential benefits of the project

The James Lind Alliance Priority Setting Partnership on Adult Social Work (2018) identified that finding the most effective ways of working with people who self-neglect – and therefore also those who hoard – is a priority topic for service users, carers, and practitioners. 

This project is funded by the NIHR School for Social Care Research. It was adopted by the ARC South London Executive in October 2023.