Hoarding and housing: person-centred approaches to a growing problem

Most people have possessions in their homes that they can’t bring themselves to throw out, from clothes and furniture to photographs, books and ornaments. But the growth of clutter around the house can sometimes escalate to become so severe that it causes significant risks to the health and wellbeing of residents and their neighbours.

For housing providers, problematic hoarding has become a serious and costly issue. In 2014, Inside Housing magazine reported an increase in the number of social housing landlords seeking injunctions to inspect homes where they suspected the resident of hoarding. But a housing management solicitor highlighted underlying difficulties with taking legal action against problematic hoarders.

“Even if the housing association wins and costs are awarded against the tenant, the chances of the tenant paying are slim. It’s a problem because it’s a huge expense.’

The nature of hoarding

A 2012 paper from the Chartered Institute of Environmental Health (CIEH) provided an overview of hoarding, and observed:

“As a behaviour, it is quite common and most people who hoard possessions do not suffer from any psychiatric disorder. However, in some cases the problem may progress to become so severe that it causes significant distress and impairment.”

The CIEH paper noted that three components have been identified with problematic hoarding:

  • acquisition of and failure to discard possessions that appear to be of little use or value
  • living spaces sufficiently cluttered so as to preclude activities for which those spaces were designed
  • significant distress or impairment in functioning caused by the hoarding

The problems and risks for housing providers and their tenants

For housing providers, residents and neighbours, hoarding presents particular problems and risks, including:

  • overcrowding issues
  • health and safety hazards, including fire risks and falling /tripping
  • environmental health concerns, including infestation and vermin
  • properties falling into disrepair

Tackling the problem

Under mental health and environmental legislation, local authorities and health agencies can take action where hoarding constitutes a statutory nuisance or health and safety risk. Social landlords may also resort to legal action against tenants. But taking an enforcement-only approach raises tricky ethical questions, especially if a resident is mentally unwell. And, as the Inside Housing article reported, taking tenants to court can be ineffective and expensive. Housing organisations, therefore, are increasingly developing person-centred approaches to help compulsive hoarders understand and change their behaviour.

Orbit Housing: support and advice

For some years, the Orbit housing group has been collaborating with Coventry University and the Knowledge Transfer Partnership to tackle the growing problem of hoarding.

In 2013, Orbit launched a toolkit designed to support practitioners and organisations working with people who compulsively hoard. The toolkit was developed with input from mental health support organisations, environmental health bodies and service users. It addresses environmental and social isolation issues and includes advice on the assessment process, intervention tools, improvement measures, relapse prevention, and sign-posting.

In 2015, Orbit obtained funding for two specialist case workers, enabling the launch of a new hoarding support and advice service. In addition, Orbit has also developed a hoarding policy setting out the aims, principles and values to be adopted in the housing group’s approach to individuals with hoarding tendencies.

Derbyshire:  Vulnerable Adult at Risk Management

Because problematic hoarding can require responses from different agencies, including social housing providers, environmental health and fire and rescue services, a multi-agency approach is helpful in tackling the issue.

In Derbyshire, this kind of multi-agency policy has been established to develop a risk management plan for people who would not necessarily fall into the responsibility of adult social care direct service provision.

Vulnerable Adult at Risk Management (VARM) is managed by Derbyshire County Council and Derby City Council, with support from the Fire and Rescue Service, police, social housing providers, environmental health and others. The policy aims to support vulnerable adults who are at risk of serious harm through self-neglect and risk-taking behaviour, and it has already been applied in cases of hoarding.

Last year, the Chief Fire Officers’ Association highlighted a case where the VARM policy helped a Derbyshire social housing provider to support an elderly man who was putting himself at risk due to hoarding behaviour.

“His care package was adjusted, to include assistance with household chores; he was visited and helped by health practitioners; his home was cleared allowing his central heating to be repaired. Fire risks were mitigated down to an acceptable level without the need to revisit and upset him.”

Similar approaches have been developed by Circle Housing Association in the London borough of Merton, and by Knightstone Housing in the West of England.

Positive outcomes

Hoarding is one of many resource-intensive problems facing social housing landlords. But, as these examples demonstrate, a collaborative, sensitive and supportive approach to problematic hoarding can achieve positive outcomes for housing organisations and their tenants.


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