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Child neglect

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Introduction

Neglect is the most common form of child abuse in the UK today. Up to one in 10 children across the UK suffers from neglect, it is the most frequent reason for a child protection referral and it features in 55% of serious case reviews into the death or serious injury of a child1.

Working Together to Safeguard Children defines neglect as……

the persistent failure to meet a child's basic physical and/or psychological needs, likely to result in the serious impairment of the child's health or development. Neglect may occur during pregnancy as a result of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to:

        • provide adequate food, clothing and shelter (including exclusion from home or abandonment)
        • protect a child from physical and emotional harm or danger
        • ensure adequate supervision (including the use of inadequate care-givers)
        • ensure access to appropriate medical care or treatment

It may also include neglect of, or unresponsiveness to, a child's basic emotional needs.

The absence of comprehensive data about children's unmet needs means that it could be difficult to gauge the extent to which resulting services really are sufficient. This is a serious problem and progress towards consistent, specific data collection has to be made if we are truly to know how many children are experiencing neglect.

Neglect has been an ongoing concern of Blackpool Safeguarding Children Board (BSCB) and has been chosen as one of 5 priority areas during the course of its 2017-19 business plan5.The actions taken as part of Priority 4-Addressing specific risk factors, aim to enable an effective multi-agency responseto identify and address to neglect.

Facts and figures

Blackpool has significantly higher numbers of Children in Need and Looked After Children than national and regional averages.

    • The number of Children in Need in Blackpool increased from 1,706 in 2014/15 to 1,897 in 2015/16, an increase of 11%.
    • Almost 60% are primarily referred for abuse or neglect, significantly higher than the national average, figure 1.
    • 18% of Child Protection Plans are related to neglect.

Figure 1: Primary reason for Children in Need referral, Blackpool and England, 2015/16

Source: DfE, Characteristics of children in need: 2015 to 2016 (SFR 52/2016), Table B3

While neglect is cited as the initial category of abuse in 18% of Child Protection cases, in Blackpool the highest proportion of children (48%) are recorded in the 'Multiple' categorywhere more than one category of abuse is relevant to the child's current protection plan.

Reasons for children becoming looked after

When a child starts to be looked after by the local authority their primary need is collected; the proportions of childrenin each primary need group each year have remained fairly stable.

    • The proportion of children looked after due to abuse or neglect in Blackpool has increased slightly from 71% in 2015 to 74% in 2016.
    • This was an increase from 135 to 170 children.
    • By comparison, England's rates fell slightly from 56% to 54%.
    • Blackpool's rate of children suffering abuse or neglect is significantly higher than the national average, figure 2.

Figure 2: Primary reason for children becoming Looked After, Blackpool and England, 2015/16

Source: DfE, Children looked after in England including adoption: 2015 to 2016, Table LAC4

Estimate of child neglect in Blackpool

As previously stated, it is not possible to determine the exact prevalence of child neglect, therefore the level of need in the population is estimated from national research6. These figures should be interpreted with caution as they may under or overestimate the prevalence in Blackpool due to the makeup of the local population, as well as other factors such as social deprivation and lifestyle factors. Given the level of deprivation in the borough together with higher rates of substance and alcohol misuse, domestic abuse and mental health problems, it is likely estimates based on national research will underestimate levels locally. Nevertheless it gives a useful indication of total population prevalence.

It is estimated that almost 2,500 young people in Blackpool experience neglect. This equates to 1 in 14 children under the age of 18, with cases of neglect and severe neglect more common in older age groups, figure 3.

Figure 3: Estimated number of children suffering from neglect in Blackpool
  Age under 11 years   Age 11-17 years   
  Male  Female Total  Male Female Total 
 Rates of neglect by parent or guardian6 4.9% 5.2% 5.0%  14.8% 11.8% 13.3%
 Rates of severe neglect by parent or guardian6  3.3% 4.2%  3.7%  9.9%  9.8%  9.8% 
Blackpool estimated number      
Number of children neglected by parent or guardian  448 460  900  800  624  1,422 
 Number of children severely neglected by parent or guardian  302 372  666  535  518  1,048 
Source: NSPCC, Child abuse and neglect in the UK today, 2011. Blackpool figures calculated from national estimates

Indirect estimation of child neglect in Blackpool

The NSPCC's Graded Care Profile v2 (GCP2) gives an indication of the quality of overall care for a child on a graded descriptive scale and is an objective measure of the care of children across all areas of need where there are concerns about neglect. It provides professionals with five grades which are based on three different factors: the level of care, commitment to care and the quality of care. The grades for assessing child neglect are grouped into areas of physical care, safety, emotional care and developmental care.

Information relating to these areas of care can be an approximate guide to the level of need within Blackpool.

Physical care

Nutrition

Housing

Health

Safety

Safety in the parent's presence

Safety when parent is absent

Emotional care

Developmental care

      • Children achieving a good level of development at the end of reception
      • School Readiness: all children achieving a good level of development at the end of reception as a percentage of all eligiblechildren by free school meal status
      • Average difficulties score for all looked after children aged 5-16 who have been in care for at least 12 months
      • GCSE achievement 5A*-C including English and Maths
      • Primary school pupils who have received a fixed period exclusion
      • Secondary school pupils who have received a fixed period exclusion
      • Pupil absence - % of half days missed by pupils due to overall absence
      • % of people using outdoor space for exercise/health reasons

 

Risk factors

There's still a lot unknown about why abuse happens, but research has highlighted some similarities among children who have been abused or neglected. These similarities, or risk factors, help to identify children who may be at increased risk of abuse and neglect. Some risk factors are common across all types of abuse and neglect but they don't mean that abuse will definitely happen. A child who doesn't have any of these risk factors could be abused and a child with multiple risk factors may never experience abuse or neglect7.

Any child can suffer neglect, but some are more at risk such as children who:

    • are in care
    • are seeking asylum
    • live with a parent who:
          • has a problem with drugs or alcohol,
          • suffers from mental health problems,
          • is in a domestically abusive relationship

Other things that may make neglect more likely include:

    • living in poverty, unsuitable housing or a deprived area
    • having parents who were abused or neglected themselves

 

National and local strategies

HM Govt's Working Together to Safeguard Children (March 2015) provides statutory guidance on inter-agency working to safeguard and promote the welfare of children.

The Ofsted survey report, 'Professional responses to neglect: in the child's time' (March 2014) evaluated the effectiveness of arrangements to safeguard children who experience neglect. With particular focus on children aged 10 years and under, it draws on evidence from 124 cases and the views of parents, carers and professionals from the local authority and partner agencies.

Ofsted's Joint Targeted Area Inspection (JTAI) is an evaluation of the multi-agency 'front door' for child protection, when children at risk of harm first become known to local services. Joint inspections of the response to children experiencing neglect: May to December 2017 will focus on children of all ages who are being or have been neglected.

Neglect is one of 5 priority areas in the Blackpool Safeguarding Children Board Business Plan 2017-19

The serious case review (SCR) into the death of a 3-month old child in Blackpool, published in February 2017, presents the findings and recommendations following the death due to concerns of neglect.

NICE guideline [NG76] Child abuse and neglect (October 2017) covers recognising and responding to abuse and neglect in children and young people aged under 18. It covers physical, sexual and emotional abuse, and neglect.

 

Recommendations

Following the SCR into the death due to concerns of neglect, the review identified the following actions for BSCB and its member agencies:

    • Consider wider promotion and clarification for staff of the Graded Care Profile 2, and any other agreed neglect assessment tool for the multi- agency partnership, to ensure all staff are aware of its implementation and how to use it effectively.
    • Lead an evaluation of the Hidden Harm-Toxic Trio training.
    • Consider an audit focussed simply on how expected outcomes are recorded on Children's Services' documentation particularly Child Protection Plans, to ensure detail is specific to an individual child and/or family's circumstances and clearly highlights what difference is expected to be made, and the consequences should positive change not occur.
    • Audit pre-birth child protection processes, including the effectiveness of assessments completed, to ensure that when siblings are on a child protection plan the needs of an unborn baby in the family are considered separately, and the impact of a new baby on the mother's/care giver's ability to meet the needs of the other children is understood.
    • The Multi-Agency Pre-birth Protocol in the Pan Lancashire Safeguarding Children Procedures should be reviewed by the relevant sub-group with oversight of the Pan Lancashire Procedures.
    • Request the current position of progress of the recommendation regarding safe sleep assessment from the serious case review BV.
    • Explore the development of training focussed on the issue of non- engagement and disguised compliance, and the impac ton children, particularly in cases of chronic neglect, to better equip professionals to respond to such behaviour and the associated risks.

 


[1] Sidebotham et al (2016), Pathways to harm, pathways to protection: a triennial analysis of serious case reviews 2011 to 2014 Final report, DfE, May 2016

[2] Gardner, R. (2008)Developing an effective response to neglect and emotional harm to children (PDF). London: University of East Angliaand NSPCC.

[3] The state of child neglect in the UK, Action for Children and University of Stirling, 2013 https://www.actionforchildren.org.uk/media/3270/2013_neglect_fullreport_v12.pdf

[4] In the child's time: professional responses to neglect March 2014, No. 140059 https://www.gov.uk/government/publications/professional-responses-to-neglect-in-the-childs-time

[5]Blackpool Safeguarding Children Board Business Plan 2017-19

[6] NSPCC, Child abuse and neglect in the UK today, 2011

[7] NSPCC, https://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/neglect/who-is-affected-by-neglect/