Neglect
Neglect Strategy Campaign Toolkit 2024-26
Child neglect – recognising the signs | Haringey Council
The HSCP Neglect Strategy 2023-25
The documents below have been approved for circulation by the Haringey SCP as part of the shared approach to tackling neglect In Haringey.
Please use them to help direct your work and when considering a referral to other services.
If you are working with, or providing services to children, you should have access to these tools and the strategy so that you understand the approach to neglect that has been agreed in Haringey. These documents should be discussed at team meetings and in supervision to ensure there is confidence in understanding when and how to use them.
The Haringey Safeguarding Children Partnership Neglect Strategy
A strategic approach to neglect is critical to all professionals and agencies with responsibility for safeguarding. We know from national research, as well as local experience, that when children are neglected not only does this impact on their development through childhood, but that it will also have an enduring effect on achieving a safe, happy, secure, and successful adult life.
The objective of this strategy, therefore, is to strengthen the partnership approach to the challenge of responding to the neglect of children in Haringey.
This strategy seeks to promote a shared understanding of neglect, how it impacts upon children and how multi agency partners’ work with families to identify, intervene and support children and families that is consistent across Haringey. The strategy will inform how practitioner skills and systemic processes will be developed to recognise neglect at the earliest opportunity and provide the most appropriate, timely and joined up response to support early intervention and long-lasting change.
The successful implementation of this strategy will organise practitioners from across Haringey to work to protect children who are currently at risk of neglect whilst also anticipating and avoiding a wide range of health and social impacts for future generations of adults and their children.
The Impact of Neglect
The impact of neglect during the first two years of a child's life can have profound and lasting effects on the development of the brain, leading to later problems with self-esteem, emotional regulation, and relationships. Neglect during the first five years of a child's life is likely to damage all aspects of the child's development. A neglected child may have difficulties with:
- Basic trust
- Self-esteem
- Ability to control their behaviour
- Social interaction
- Educational attainment
Neglect in childhood can also lead to problems during adulthood, including:
- Compromised ability to independent living in the community.
- Reductions in the prospects of developing the skills and resilience to transition into adulthood and avoid the factors leading to vulnerability to exploitation.
- Normalisations to the increased vulnerability of abusive relationships (including the risk of sexual & criminal exploitation and being trafficked);
- Decreased chances and opportunities to access employment and education.
- Prospects to parent effectively - children who experience neglect may lack a role model for good enough parenting.
- Healthy Self-care habits and routines - diet, physiological and psychological/mental health care.
A particularly damaging combination for children is growing up in an environment of low warmth and high criticism attributable to parental responses. Neglect can affect children of all ages, including adolescents and older children, and so it must not be assumed that older children will be resilient to neglect, and professionals and parents should be supported to understand affluent neglect.
Where parents/carers have specific beliefs, which may influence their views on how the child receives health care and treatment or general nutrition, the outcome can be that the child's health and well-being can be seriously compromised.
It is important to remember that neglect can be fatal to a child.
Most neglect related deaths of very young children involve accidental deaths and sudden unexpected deaths in infancy where there are pre-existing concerns about poor quality parenting and poor supervision and dangerous, sometimes unsanitary, living circumstances which compromise the children's safety. These issues include the risks of accidents such as fires and the dangers of co-sleeping with a baby where parents have substance and/or alcohol misuse problems.
Indicators of Neglect
Neglect differs from other forms of abuse in that there is rarely a single incident or crisis that draws attention to the family. Rather, it is repeated, persistent neglectful behaviour that causes incremental damage over a period of time.
It is important to emphasis the need to avoid the ‘start again' syndrome. Neglect should not only be measured by the most recent set of events but should be assessed by the cumulative impact on the child of any previous incidents.
There is no rigid set pattern of signs that indicate neglect other than that the child's basic needs are not adequately met. In this context:
The child's basic needs are: food, shelter, clothing, warmth, safety, stimulation, protection, nurture, medical care, education, identity, and play.
- Adequately means sufficient to avoid harm or the likelihood of significant harm.
- Failure to meet the child's needs does not necessarily mean that the parents/carers are intentionally neglectful, but it points to the need for intervention.
- It is essential to monitor the outcome of any intervention - are the child's needs being adequately met after the intervention and is there a sustainable improvement?
The essential baseline indicators in recognising that a child is being neglected:
The child is suffering, or is likely to suffer, significant harm.
- The harm, or risk of harm, arises because of the failure of parents or carers to meet the child's needs.
- Over time, the harm or risk of harm has become worse, or has not improved to the point at which the child is consistently receiving a "good enough" standard of care.
- Persistent, severe neglect indicates a breakdown or a failure in the relationship between parent and child.
- Non-attendance at or repeated cancellations of appointments and lack of access to the child on visits are indicators that should increase concern about the child's welfare.
Where there are concerns about standards of care the HSCP Neglect Guidance, Toolkit and Checklist provides a tool for assessment, planning, intervention and review. This gives an objective measure of the care of the child across all areas of need, showing both strengths and weaknesses. Improvement and/or deterioration can be tracked across the period of intervention. It allows professionals to target work as it highlights areas in which the child's needs are, and are not, being met. It may also help parents/carers who may have experienced neglect to understand why such behaviours are harmful.
Protection and action to be taken
In supporting a family in which neglect is an issue, the greatest care must be taken to resist the pressure to focus on the needs of the parents/carers: intervention should concentrate on ensuring that the child's needs are being met. This may require action to ensure that the parents/carers have access to specialist (and if necessary independent) advice and assistance, including assistance in communicating with professionals.
Neglect may arise from lack of knowledge, competing priorities, stress, or deprivation. It may also be linked to parents/carers who retain cultural behaviours which are inappropriate in the context in which the family is living.
When a child's needs are unmet because the parents/carers lack knowledge or skill the first choice for intervention should generally be the provision of Early Help services such as information, training, and support services. If there is no progress and the assessment by professionals is that progress is unlikely without more proactive intervention a referral to Children's Services should be considered. childrensportalehm.haringey.gov.uk
Neglect often occurs in a context in which parents/carers are dealing with a range of other problems such as substance misuse, mental ill-health, learning disability, domestic violence, and lack of suitable accommodation.
On many occasions the birth of an additional child may add to the pressure on the family. The parents/carers may provide an acceptable standard of care until a new pressure, or an unexpected crisis arises then they lose sight of their child's needs. In this situation the first choice for intervention should be the provision of support in dealing with the competing pressures. This may require referral to appropriate adult services or family support services.
Messages for Good Practice
- Practical resources are often beneficial but their impact on meeting the child's needs must be kept under review.
- Relieving financial poverty does not necessarily relieve emotional poverty.
- Neglectful families are more likely to be isolated and to have weak informal networks. Providing volunteer support and facilitating better relationships with family and in the community, can be effective in raising standards of care.
- Dealing with neglect can be overwhelming for professionals: support and regular supervision are crucial.
- Accurate, detailed and contemporaneous recording by all professionals, and sharing of this information, are crucial to the protection of the child.
- Records should include a detailed Chronology of what has been tried, and to what effect.
- It is important to carry out regular reviews of the rate at which the required change is being achieved in terms of the child's improved health and development.
Issues
Neglect is characterised by a cumulative pattern rather than discrete incidents or crises, and so drift is always a potential problem. Drift may result in a loss of focus on the needs of the child, and a change in professional expectations of what an acceptable level of care might be. Styles of appropriate care vary widely, influenced by gender, class, culture, religion, age etc. The common factor in all styles of appropriate care is that they address the needs of the child.
If the child appears resilient, professionals should not accept this at face value, but should check for evidence of unmet needs and impaired health and development. When reviewing progress in cases of neglect it is important to look for evidence of sustained improvement in the child's health and development. Where there is a pattern of short-lived improvements, the overall situation remains unsatisfactory - if adequate standards of care cannot be sustained, the child remains at risk of significant harm.
Professionals must resist the temptation to "start again" at key points such as the birth of a new child or a change of worker. It is important to see current events in the light of the full history of safeguarding and child protection issues, including previous responses to support. The families’ histories are often complex and confusing, and professionals may be tempted to set them aside and concentrate on the present. This can result in an over-optimistic approach to a family with deeply entrenched problems.
As noted above, neglectful adults are often enmeshed in a complex network of problems. The clamour of the parents'/carers' needs tends to draw professional attention away from the unmet needs of the children. When addressing the needs of neglectful parents/carers, it is necessary to ask repeatedly:
- They understand what action is needed and within what timescales?
- Are they able and willing to meet the child's needs?
- Are they able to access appropriate support services?
- Is anything changing for the child? Is the change enough to bring the standard of care up to an acceptable level?
If adult services are supporting the parents/carers, it is important to stress the need for them to notify children's practitioners if the parents/carers fail to engage with the services offered.
If there is a vulnerable adult living in the same household as a child whose needs are neglected, then their needs may also be neglected or unmet. Practitioners should report any concerns about the welfare of vulnerable adults to adult social care.
Intentional Neglect
Where there is strong evidence that the parents/carers know and understand the likely effect of their actions or inaction on the child but intend to cause harm or are reckless as to whether harm is caused to the child, this should be regarded as serious physical and/or emotional abuse. In these cases, support is unlikely to reduce the risk to the child. Unintentional neglect should not be confused with deliberate or malicious failure to meet the child's needs in the full knowledge of the potential effects on the child.
One Child Singled Out
Historic Serious Case Reviews and recent Safeguarding Practice Reviews have demonstrated that in some instances a child in a family may be singled out and cared for in a manner which amounts to serious neglect. Where an agency raises concerns about the child, and the parent's response, the first assessments of the family may mask the particular treatment in the home of that child, particularly if the siblings appear well and cared for. Assessments where there are concerns of neglect should always include speaking to the child on their own.
Neglect by Secondary Carers
Neglectful care may also be found in secondary carers such as childminders, foster carers, day care or residential settings. In this situation concerns should be reported to:
- The child's primary carers, so that they can take appropriate action to protect their child;
- The designated officers in the local authority / LADO; and
- The registration authority for the secondary carer (for example Ofsted), who can consider the possible implications for other children;
- In the case of emergencies see childrensportalehm.haringey.gov.uk or dial 999