View Working Together View Working Together

5.28 Neglect Strategy: Getting It Right First Time – Keeping It Going

SCOPE OF THIS CHAPTER

This strategy document for Lincolnshire on Neglect, details the considerable extent to which ‘neglect’ features as part of, or only category of concern for children. The chapter seeks to identify / define what neglect is, the serious impact it can have upon children and, whilst recognising the difficulties in identifying it, supports an Early Help approach to families. Each family should have a ‘Keep it Going’ Plan, designed to maintain standards of care, and each agency should audit their work in this area of family concern.

This chapter was added to the manual in September 2015.


Contents

  1. Purpose
  2. Vision
  3. What is Neglect?
  4. The Role of Early Help in Addressing Neglect
  5. Impact of Neglect on Children
  6. Extent of Neglect in Lincolnshire
  7. Strategic Objectives


1. Purpose

The purpose of this document is to set out the strategic objectives and targets of Lincolnshire's approach to tackling Neglect. This strategy also identifies key risk factors and vulnerabilities of adults with parental responsibilities and children that can have an impact on neglect. It in addition identifies key priority areas of work in order to improve Lincolnshire's response to Neglect. Key to the strategy is the importance of identifying Neglect and supporting children and families through Early Help Arrangements.

This strategy has been developed in conjunction with Lincolnshire Safeguarding Children's Board LSCB partners. Due to the nature of Neglect, and the possibility that parents or carers may not wish to work with various agencies, staff should be particularly aware of the escalation policy within their own agency and this strategy should therefore be considered alongside individual agency and related LSCB strategies, policies and procedures.


2. Vision

LSCB's vision is to reduce the incidence of Neglect of children in the County and further to reduce repeat incidents of Neglect for individual children. We want to get it 'right first time' and then help families to keep the improvements going.

The way forward is that everyone has an agreed understanding of what Neglect is, how it affects the development of children and young people and that together we establish an agreed and effective approach to reducing levels of Neglect in childhood.

Within universal services all agencies work with families to improve and maintain standards of care. Where staff are concerned with a lack of progress or engagement at the universal level, such concerns should be discussed within their own agency and consideration given to initiating a Team Around the Child (TAC) (Team Around the Child Supporting Documentation). Consultation with an Early Help Advisor is available via the Children’s Services Customer Services Centre, (Tel: 01522 782111).

Where early identification of difficulties arises, and supporting the family through sustainable improvements in the care of children through Early Help arrangements is indicated, the development of a TAC is needed. There is a need to promote a culture amongst all agencies of robust planning to promote sustainable improved life chances for children. To deal effectively with identified Neglect of children, the work with the family must clearly set out what needs to happen, by when, and who is responsible for specific parts of the plan. Plans should set out clearly what will happen if improvements do not happen and/or are not maintained.  

In all our work with children, we want to reduce the number of assessments experienced by children and their families and so work with the family has to involve listening to the child and, whenever possible, making sure the child's wishes are followed within the plan. We want to provide parents with the tools and techniques which help them to make changes for the better, and to maintain the improvements. Key to the vision is the importance of encouraging and supporting positive parenting and enabling those caring for children to make sufficient and sustainable changes.

"Some kids don’t realise they are neglected until they get to primary school - because it has just been their life, so teachers need to ask.’   (Neglect Matters – Sophie, young person)


3. What is Neglect?

Neglect is the most common reason for a child to be the subject of a Child Protection Plan in the UK. It happens when parents or carers can’t or won’t meet a child’s needs. Sometimes this is because they don’t have the skills or support needed, and sometimes it’s due to other problems such as mental health issues, drug and alcohol problems or poverty. It may involve a child who is not being protected from sexual harm, Child Sexual Exploitation or the impact of Domestic Violence and Abuse.

Official definitions of neglect

Neglect may occur during pregnancy as a result, for example, of maternal substance abuse. In Lincolnshire there is a Pre-Birth protocol which must be followed. This is one approach which aims to improve pre natal care to help with early identification of potential neglect and to help families understand the importance of preparing healthily and carefully for the new baby.

Once a child is born, Neglect through childhood may involve;

  • A parent or carer failing to provide adequate food;
  • Failing to provide clothing and shelter (including exclusion from home or abandonment);
  • Failing to protect a child from physical and emotional harm or danger;
  • Failing to ensure adequate supervision (including the use of inadequate care-givers);
  • Failing to ensure access to appropriate medical care or treatment;
  • Neglect of, or unresponsiveness to, a child’s basic emotional needs;
  • Failing to ensure a child receives an education.

"Neglect is the most cited reason for children to be referred to Children's Social Care and for becoming Looked After, as reported to central government. Other categories of concern may be masked by the use of the code denoting multiple reasons, which might include Neglect, Physical, Sexual or Emotional Abuse and "Neglect remains the largest category or reason for referral and entering care". (October 2014 the Association of Directors of Children's Services LTD (ADCS). The ADCS report  also noted that 35% of authorities believe that early intervention has started to affect safeguarding activity…There was an overwhelming view that early intervention does play a crucial part in affecting safeguarding activity.

"I think that parents do not always have help, and could have had a difficult time themselves" (Neglect Matters quote from young person).

For the purposes of this strategy, Neglect is considered where it is the primary focus of concern.  It is acknowledged that the concept of Neglect is known to be an element of other areas of abuse.

However the effectiveness of adults' caring responsibilities can be adversely affected by lots of pressures such as:

  • Mental health issues and/ or learning disabilities;
  • Physical illness or disability;
  • Learning difficulties;
  • Domestic abuse;
  • Use of drugs and/or excessive alcohol use;
  • Homelessness;
  • Bereavement;
  • Financial pressures;
  • Family breakdown/dysfunction.

The position of the whole family needs to be considered and understood as the welfare of children is best served through supporting those looking after them, but the focus must always be on improving the outcome for the child.  It also has to be established if the neglect of the child is a transient episode or is entrenched behaviour by the adults.

In some families the approach taken by carers is one of "high criticism/low warmth" and whilst this is neglectful of children's emotional needs, it is an aspect which can be amended through work with families at as early a stage as possible. With Early Help arrangements, describing this aspect can lead to early and sustainable approaches to parenting, and converting this to positive parenting.

A child's needs also change over time, and every child is different. Each child will have different responses and personal resilience to their situation based upon the child's age, ability, disability, behavioural difficulties, experience, understanding, mental health and additional support.  Staff working with families should also be conscious of the need to recognise that children's growth and development can differ significantly and care should be taken to ensure a clear understanding of when developmental traits are outside the expected levels for children generally and are potentially more attributable to Neglect.


4. The Role of Early Help in Addressing Neglect

The impact of Neglect on children is often accumulative, advancing gradually and imperceptibly and therefore there is a risk that agencies do not intervene early enough to prevent harm. It is important that all agencies identify emerging problems and potential unmet needs seek to address them as early as possible. It is equally important that practitioners are alert to the danger of drift and 'start again' syndrome.

In order to address Neglect in Lincolnshire it is important that agencies effectively use the Early Help framework to assess and plan services for children and families. Likewise it is important that any intervention with families is co-ordinated appropriately to enable parents to sustain the changes in care given to children.


5. Impact of Neglect on Children

Neglect is dangerous and can cause serious, long-term damage - even death: Davis and Ward (2012) found that the risk of fatalities from neglect may be as high as that from physical abuse and the risks of further abuse are higher with neglect than other types of abuse.

Neglectful parenting is most damaging in both the early stages of life and in the teenage years.  A longitudinal study commissioned by the NSPCC found a strong correlation between the neglect and maltreatment of adolescents and poorer emotional wellbeing, including self harm and suicidal thoughts (NSPCC 2012). Children who receive care which is unpredictable, rejecting or insensitive are more likely to develop attachments which are less secure.

Children who have experienced neglectful parenting may have:

  • Poorer emotional knowledge and be less able to discriminate between different kinds of emotions;
  • Lower self-esteem and higher levels of emotional problems;
  • More aggressive than children who are not neglected; and
  • More uncooperative and noncompliant;
  •  There is also a related impact on children’s social development: the evidence suggests that neglected children are more withdrawn and socially isolated and less socially competent than their peers.

(Safeguarding Children across Services (2012) Carolyn Davies and Harriet Ward)

Neglect can be far-reaching in its consequences for a child. Not only will the experience of it make a child’s life miserable but it can affect all aspects of their development. It is also likely to influence the relationships they make with others in both early and later life and have an impact on how they parent their own children. (Howarth, 2007).


6. Extent of Neglect in Lincolnshire

1 in 10 children in the UK have experienced neglect (Branson et al, 2012). In Lincolnshire neglect is the primary reason for concern in 41.6% of cases (compared to 42.2% nationally) where children were subject to plans at initial child protection conferences.

cpp


Over 21,300 children in the UK were identified as needing protection from neglect last year.

Nationally neglect is a factor in 60% of serious case reviews.

In Lincolnshire in the year 2013/14 there were 5162 referrals to children's services which cited neglect as a factor, and 959 re-referrals cited neglect as a factor.

275 children becoming subject of an Initial Child Protection Conference had Neglect cited as a plan category reason during 2013/14, whilst for 40 children subject to a second or subsequent Child Protection Plan, Neglect was cited as a plan category reason.


7. Strategic Objectives

  1. Promote a common awareness and understanding of what neglect means in Lincolnshire and the effects upon children.
    • A common understanding of Neglect between and within agencies is crucial to allow effective identification and a common language;
    • This will be achieved by ensuring that the strategy is agreed by LSCB and LSAB by improving and establishing a strong professional base for identifying, understanding and managing situations of neglect with clear and agreed multi agency approaches;
    • Ensure a whole family approach is embedded within all multi-agency assessment cultures;
    • Ensure continued multi-agency training in early identification and help for families.
  2. Minimise the incidences of neglect for children and the repeat incidences of neglect for children.
    • Ensure consistent use of Pre-Birth Protocol (see Pre-Birth Protocol);
    • Ensure after any multi agency plan that the family has an agreed "keeping it going" plan (aimed to keep standards of care raised and when to ask for help). This plan should become known as the "Keeping it Going Plan" (similar to the "Exit Plan" which is in common with practice within Families Working Together);
    • Improve the recognition and assessment of children living in neglectful at an early stage and increase early help provision through Team Around the Child (TAC) arrangement (see Team Around the Child Supporting Documentation);
    • Clear and robust thresholds as identified within “Meeting the Needs of Children Procedure' should be utilised;
    • Increase ongoing support through consistent 'step down' to TAC after Child in Need or Child Protection Plan end.
  3. Ensure the effectiveness of service provision
    • We will continue to use the Signs of Safety approach which helps adults and children and workers to understand what needs to change and what needs to be done, by whom and by when;
    • A multi - agency audit, which includes families and children, must be developed to quality assure processes are being followed, starting with quality auditing of TAC;
    • Ensure that audits of families' situations focus on sustained improvement;
    • To provide practitioners with effective skills and tools to work with families experiencing Neglect;
    • To support practitioners to resolve common problems when working with families experiencing neglect.
We recognise that agencies also have their own approach to working out if children are being Neglected.  For example, we note the use of the Graded Care Profile by Lincolnshire Community Health Services, and we encourage all agencies to use their own resources to both recognise and tackle Neglect at universal, targeted and specialist levels. For example, Lincolnshire Fire and Rescue service have a method of looking at the safety of homes by judging the amount of clutter/hoarding which is seen in homes;  the service understand the connection between this and a neglectful approach to the care of children. See Fire and Rescue Resource.

Click here to view Plan (Neglect Strategy) table.

End