Hoarding and Learning from Inquests – Safeguarding to prevent tragic outcomes

Hoarding is a recognised disorder where someone acquires an excessive number of items and stores them in a chaotic manner, usually resulting in unmanageable amounts of clutter. In this article, we consider the importance of the wide scale issue for local authorities, housing providers and health and care providers. We also offer some practical recommendations and approaches from our experiences.

On 3 April 2025 Crispin Oliver, Senior Assistant Coroner for the coroner area of County Durham and Darlington, issued a Prevention of Future Deaths Report  following an inquest touching upon the sad death of Loraine Cheesman. Ms Cheesman died as a consequence of a fire at her property and the Coroner concluded that the Hoarding Disorder from which she suffered contributed to that fire. 

Hoarding

Hoarding is a recognised condition in itself and is often associated with self neglect or mental health problems such as depression or obsessive compulsive disorder.

The NHS considers hoarding a significant problem if: the amount of clutter interferes with everyday living (e.g. the person is unable to use their kitchen or bathroom and cannot access rooms); or the clutter is causing distress or negatively affecting quality of life (for themselves or others, such as odours, vermin, fire hazards). 

Hoarding disorders are challenging to manage or treat because the individual in question often does not see it as a problem, or have little awareness of how it's affecting their life or others. Some people are reluctant to seek help because they feel ashamed, humiliated or guilty. They may also lack the capacity to manage or dispose of items and belongings due to strong emotional attachments. We commonly see disengagement with landlords and health and care professionals.

When considering hoarding and someone’s mental capacity, as with any other capacity decision under the Mental Capacity Act 2005, it is essential to consider the precise decision that needs to be taken and the relevant information to that decision. We provided a previous article which goes into the issue of mental capacity in more detail here. In summary, where someone is assessed as lacking capacity to make decisions about their items and belongings, best interests decisions may need to be taken by family and professionals – possibly with oversight from a judge.

Information that may be considered relevant to making decisions in respect of one’s items and belongings include:

1. Volume of belongings and impact on use of rooms: the degree to which they impair the usual function of rooms in the property for the individual (and other residents) (e.g. whether the bedroom is available for sleeping, the kitchen for the preparation of food etc). 
2. Safe access and use: the extent to which the individual (and other residents in the property) are able or not to safely access and use the living areas.
3. Creation of hazards: the extent to which the accumulated belongings create actual or potential hazards in terms of the health and safety. This would include the impact of the accumulated belongings on the functioning, maintenance and safety of utilities. Direct hazards would include hygiene (toilets, food storage and preparation), vermin infestation and risk of fire.
4. Safety of building: the extent to which accumulated clutter and inaccessibility could compromise the structural integrity and therefore safety of the building.

Safeguarding Interventions 

During the course of the evidence the Coroner heard from social workers and safeguarding professionals. He noted that a decision on whether a professional response is required under existing safeguarding processes “will depend on the adult’s ability to protect themselves by controlling their own behaviour. There may come a point when they are no longer able to do this, without external support.”  However, the Coroner was concerned there was no specific guidance for professionals in assessing when “the point” had been reached.

He felt professionals “are constrained by existing guidance for assessing mental capacity, which does not directly recognise Executive Dysfunction, or for assessing whether the adult’s behaviour constitutes a potentially chargeable criminal or regulatory offence, for example in relation to public nuisance, health hazard, or anti social behaviour, rather than the root cause of the behaviour – a mental disorder or disorders.”

We recognise the challenges voiced by the Coroner and, no doubt, the professionals involved in this inquest. The responses and support available are often framed by subjective analysis of a person’s needs. Where we see the best outcomes for vulnerable individuals with hoarding is normally when there are contributions from multiple stakeholders:  the individual, their friends, families, landlords, health and care professionals. Rather than constraining these stakeholders, the existing frameworks can and should work in harmony to provide safeguarding interventions with someone with hoarding disorder. We explore these below. 

A Tragic Outcome to a Common Issue

Assessing capacity and knowing when to provide external support can be a tricky area for professionals to navigate (see our earlier article here for further guidance). This inquest highlights the importance of professionals being aware of their duties and responsibilities and the support and approaches available to them when coming into contact with vulnerable individuals who have issues with hoarding.

It is not uncommon for landlords to bring cases to court when they have reached breaking point:  a property is in such poor state that professionals aren’t physically able to access areas to carry out routine maintenance. Alternatively, there might be significant concerns about physical and mental health risks to the person in question. Often there is a breakdown in relations and opposing views: tenants unable to understand the impact of their actions and housing providers having responsibilities to the property and neighbouring tenants. 

The most frequent challenge is difficulty in getting people who self neglect or hoard to engage with support and services available to them. Tackling the immediate and significant manifestation of hoarding is only the tip of the iceberg. 

People who have Hoarding Disorder often have underlying or other complicating factors to consider, including mental health, substance misuse, and long history of insecure housing. Multi-factorial challenges almost always need a multi-agency response. There are examples of this approach working really well in practice and professionals being able to work effectively to manage hoarding with the person in question and to address the underlying basis for the hoarding behaviour or self-neglect. It’s normally a longer-term approach that needs sensitivity, trust and relationship building with professionals.

Housing Management

Registered providers of social housing, whether they manage larger or smaller portfolios of housing stock are under statutory, regulatory (and invariably contractual) obligations to carry out regular gas and electrical safety checks, general inspections of the property and to ensure that a particular property has safe exit routes in the case of fire.

When attempting to discharge those obligations, it is inevitable that providers will have to engage individuals with either a formal diagnosis of Hoarding Disorder or an individual who is suspected as likely meeting that diagnosis. When an individual’s clutter has a marked impact on their everyday living, it typically impacts upon the landlord’s ability to discharge their obligations because it can make inspections or utility checks impossible. 

The obvious consequence of a landlord not being able to check a boiler or a tenant’s electric supply does not only place the tenant at an increased risk of harm but also that tenant’s neighbours. The issue is particularly acute for supported housing providers offering accommodation for a large number of vulnerable individuals. 

Tackling the issue of hoarding in the Housing Management context is almost always a complex task and one which requires careful handling. Whilst there is always a theoretical ability for an application to be made for an 

access injunction, with a power of forced entry in serious cases, the potential harm of any such legal proceedings on the individual should be very carefully considered. 

In the vast majority of cases, we work closely with registered providers to adopt a soft approach to these issues by speaking with any number of third party agencies including hoarding prevention charities, adult social care, the relevant fire service and family in an attempt to settle the matter without having to make a formal legal application. 

In rare cases, it becomes necessary to commence proceedings to recover possession of a tenant’s property to avoid a potentially catastrophic incident. We are able to navigate these types of proceedings precisely because of the careful approach adopted to demonstrate that possession is the last realistic course of action available, drawing on our expertise of mental health and mental capacity law. 

Legal Frameworks

• The Care Act 2014 can promote wellbeing, provide assessment, and offer support for certain unmet needs. Alongside the Care and Support Statutory Guidance, it outlines a local authority’s powers, duties and safeguarding framework. This may be relevant where there is self-neglect and unable to safeguard themselves or others living with them
• Section 42 of the Care Act 2014 is an effective and well established framework led by local authorities bringing different agencies together to coordinate a response in order to address safeguarding, care and support needs (including self-neglect). The process enables the local authority and other stakeholders to decide what action should be taken in an adult’s case, such as interim support to an individual, or decant accommodation while a property is cleared.
• The Mental Health Act 1983 and associated Code of Practice is relevant where an individual has hoarding disorder or associated mental health condition, such as depression, obsessive-compulsive disorder or cognitive decline due to Alzheimer’s disease or dementia. They set out rules, guidance and powers of detention and treatment. It offers a route for guardianship which may ensure that a person receives help and guidance on decisions around accommodation and treatment. It offers powers of entry to an individual’s property under certain conditions. 
• The Mental Capacity Act 2005 provides a legal framework where someone lacks, or there is doubt about someone’s capacity to make decisions in respect of their items or belongings, their tenancy, permitting access to a property, their property and financial affairs and other welfare related matters. This jurisdiction also allows appointment of deputies to make relevant decisions for people who lack capacity.
• The Inherent Jurisdiction of the High Court is available in extreme cases of self-neglect where a person with capacity is at risk of serious harm or death and refuses offers of support. Also, where someone is unduly influenced by someone else.
• The Housing Act 1988 allows landlords to seek outright or suspended possession orders against a tenant who is acting in breach of a term of their tenancy where the court is satisfied that such an order is reasonable.
• The Housing Act 2004 is relevant where there are hazards to property that pose risks of harm to health or safety.  It permits risk assessments to identify hazards and, if appropriate, act to remove them or reduce the risk of harm. It sets out powers for improvement and prohibition notices to be issued.
• The Anti-Social Behaviour, Crime and Policing Act 2014 gives some categories of landlords the ability to seek either a mandatory or prohibitive injunction to prevent anti-social behaviour where it is considered just and convenient. Community Protection Notices are also available to the district council and the police to address unreasonable conduct that has, or is likely to have, the potential to be detrimental to the quality of life of a resident or visitor to the area. Exercise of such powers should be used with caution particularly if there are vulnerabilities, which is usually the case if someone has Hoarding Disorder.
• The Public Health Act 1936, 1936 and Public Health (Control of Disease) Act 1984 set out duties and powers to intervene or require actions be taken (e.g. fumigation, cleaning) in situations posing risks to the public, which may be relevant where there are vermin or an unsanitary environment.
• Environmental Protection Act 1990 and other refuse regulations, might be relevant where there is evidence of significant infestation of vermin. The Act provides a power of entry and a notice can also apply to the area outside a property.
• Warrants and powers of entry for the police and other relevant professionals or landlords with the power to gain forced access in some limited circumstances.
• Animal Welfare Act 2006 outlines duties on the owners of animals ensuring appropriate food and shelter.
• The Homelessness Reduction Act 2017 and Housing Act 1996, Part VII set out duties of the local authority to applicants who are homeless or threatened with homelessness.
• Consider the Human Rights Act 1998 where interventions to manage hoarding will interfere with their lives and property: Article 2 (right to life), Article 3 (protection from inhuman and degrading treatment), Article 5 (protection of liberty and personal security) and Article 8 (respect for private and family life). 
• The Equality Act 2010 sets out responsibilities to promote equality and eliminate discrimination, harassment and victimisation, advance equality of opportunity and foster good relations.  This means taking steps to minimise or remove disadvantages associated with someone who may be hoarding who has protected characteristics (including age and disability).

Helpful Resources

• Our free Management Update webinar where we discussed key updates and topic for the Housing Market. 
• Hoarding Disorder: a panel discussion on practical and legal steps, 23/11/2023
• There are a number of multi-agency groups and (free) guidance explaining collaborative ways to support people with Hoarding Disorder.  
• Clutter rating tools can help monitor the extent of hoarding and progression at a point in time and its progression.
• See if specialist hoarding services can help in your area.
• Research and information sharing through the Kings College London. There are opportunities for professionals and individuals to contribute to projects and learning.
• Training on how to work with people who have hoarding disorder.

How we can help

We work with independent and public housing providers, safeguarding teams, local authorities, NHS providers and commissioners to help them navigate this legal and regulatory landscape. Some examples of the practical support and solutions we provide to clients include:

• Exploring your legal options, including when someone lacks capacity, or where capacity is unknown.
• Engaging other stakeholders to develop collaborative working.
• Developing tailored tenancy management plans, working together agreements, multi-agency responses.
• Producing care, treatment and transition plans. (e.g. property entry, monitoring, or maintenance). 
• Involvement of deputies for long term management of personal finance, property and welfare.
• Making emergency injunction applications to Court seeking powers of forced entry, powers to remove individuals and decant (temporarily or permanently), powers to clean and discard items/ material, powers to enter and exit tenancies.
• Making applications to recover possession of properties. 
• Developing operating procedures to ensure staff are working in accordance with expected practice. 
• Providing customised training for professionals in your organisation. 
• Providing representation and advocacy in inquests.