What are the challenges for public services in tackling neglect?
Alice Haynes, senior policy and research analyst, NSPCC: “Neglect is one of the most pressing challenges facing practitioners, policymakers and families. We know that the child protection system is under a great deal of pressure at the moment, in the face of a combination of reduced funding and increased demand for services. This means that children and families are slipping through the net and the majority of child neglect is happening in the community and outside the reach of children’s social care. We urgently need to find additional ways to get help to children as early and efficiently as possible, and for me, that means a whole system approach for preventing and intervening early is needed. We need to call on everyone – from communities, to universal services, to children’s social care, to local government – to work together.”
Marion Russell, principal child and family social worker, Cornwall council: “In a time of dwindling resources we need to make sure the resources we do have are the best, and used to best effect. There is something about having difficult conversations, but also something about being clear with families about what is reasonable to expect. Small changes with big impact, that are achievable, that give children and families some control, that make enough of a difference, that reduce the shame and guilt, and improve the child’s lived experience, rather than grandiose, unrealistic expectations.”
Fiona Smith, professional lead for children and young people’s nursing, Royal College of Nursing: “Often health practitioners may recognise early signs of the need for support and early help but don’t know where to access [this], particularly where services have been cut as a result of public service cuts. Research also highlights that some practitioners do not have the skills to have difficult conversations or to initiate some early interventions themselves. If greater attention was made to upskilling frontline universal practitioners there might be fewer children ending up requiring child protection plans.”
Should one service be responsible for responding to neglect?
Haynes: “I think we are being challenged to consider how and where safeguarding risk is held. Currently, risk is held mainly by local authority children’s services; if there is any doubt whatsoever about the safety of a child, the expectation is that the concern is immediately escalated to local authority children’s social care. But could risk be held more elsewhere, for example with universal services? How can this be achieved in a safe way?”
Russell: “Often when social care is involved, the actual work with the family doesn’t change. It’s the same services, but social care has managed the anxiety of other agencies. It is very difficult to get people to be comfortable with risk in the wider ‘blame culture’, although individual organisations and leaders within them can do something. And this is another role for the Local Safeguarding Children Board.”
Diane Hampshire, recently retired director of nursing, Leeds clinical commissioning group: “Risk has to be held more by universal services but I think we have to define where those services sit. Risk sitting with a GP who has eight minutes from start to finish of a consultation would worry me a great deal. But risk can and does in some areas sit with health visitors and school nurses. The safe way to achieve this is through professional support and discussion. All professionals need to feel safe in the decisions they make.”
How can services and professionals work together to help neglected children?
Susannah Bowyer, research and development manager, Research in Practice: “Staff across all services need support to build knowledge and skills in key areas – such as recognition of neglect and assessing parents’ capacity to change. There are some strong resources and approaches that can be used, not just by social workers, but by family support, youth workers and so on. Goal Attainment Scaling, for instance, is an approach to setting meaningful, measurable goals for change with parents. Used well, this can help professionals to make timely decisions for individual children.
Russell: “We also have to consider the role of adult services – the offer being made to parents who have significant problems that can impact on their parenting such as mental health issues, addiction issues. It may be that if the services being offered are the right ones, and effective, then the risk of them impacting on parenting in a neglectful way is reduced.”
Simon Westwood, Local Safeguarding Children Board chair: “Professionals working in universal services have a responsibility to identify the symptoms and triggers of abuse and neglect, to share that information. We all need to be more ‘professionally curious’ if we have an uneasy feeling about something. The real challenge is to have local systems and mechanisms for assessing a range of intelligence about concerns for a child that leads to better informed decision about when, how and who should intervene. Many multi-agency safeguarding hubs that have developed could provide this. Providing an advice line for professionals is a key part of that.”
Alison O’Sullivan, president, Association of Directors of Children’s Services: “The role of the community in helping professionals in the sector to recognise signs of neglect is crucial. A neighbour can play a vital role in identifying parents/carers who may be struggling to appropriately care for their children; who with some support could go on to adequately support and care for their child themselves and be able to lead happy and successful lives. And let’s not forget that it was the taxi driver who intervened and insisted on taking Victoria Climbie to hospital. We need to find the right way of supporting and enabling communities to play their part.”
How can we move forwards?
O’Sullivan: “Neglect is a safeguarding issue and is everyone’s responsibility; every agency has a role to play. Effective early help relies on the efforts of all local agencies working together to identify children and families who would benefit. It is important to recognise the power of a multi-agency approach. Tackling neglect, and all other forms of abuse, requires the commitment and effort of each safeguarding partner including local authorities, schools, health services and police.”
Yvalia Febrer, social work academic and consultant: “Neglect is still significantly underestimated in terms of the damage it does. It suffers as a result of our ‘incident-led’ culture in statutory services, there is not enough joint working across agencies, and teenagers suffering neglect get ignored. There are clearly pockets of excellent practice – what we should be doing is implementing these more broadly. We should also be raising awareness nationally via television campaigns and leafleting so that the message is out there about the damage caused by neglect.”
Russell: “I think we need to work towards a shared understanding of neglect, and the impact it has on children. All agencies, including those who work with adults, need to be thinking of prevention, and when there are problems, identify early. There needs to be a clear understanding that each have a role, and we need to provide the knowledge and skills of that role. Intervention should be proportionate and effective – transparent, understood and reasonable – to give it the best chance of working. Most of all, we need to understand that relationships are what works.”