Neglect

Children

The persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the impairment of the child’s health or development. Neglect may occur during pregnancy as a result of maternal substance abuse.”

Neglect erodes the child’s resilience. It makes a child or young person lack worth.

Are you worried that a Child’s Basic Needs are not being met?

Are they attending school on a regular basis?
Are they attending health appointments?
Do they appear to be hungry?
Are they dressed appropriately for the weather?
Are they protected from harm by their parent or carer?
Is the child scapegoated / ignored / dismissed?
Is the child deprived of food as a punishment?
Are they exposed to domestic violence?
Are they exposed to alcohol or drugs?
Does parent/carer have mental health issues?
These are just a few examples of issues and behaviours that may lead to a child becoming neglected.

Graded Care Profile 2

The Graded Care Profile 2 is an evidence based assessment tool for evaluating levels of parental care. It measures the quality of care delivered to an individual child over a short window of time and uses a graded scale to capture levels of physical and emotional care. The tool identifies strengths as well as areas of care that need to be improved and it targets aspects of neglectful care. The impact on the child can be measured effectively using this tool and it provides evidence that can inform care and intervention plans.

To be given access to the the Graded Care Profile 2, you need to first of all complete the Graded Care Profile 2 training, as you have to be licenced to use the Tool.

Responding to Neglect

In supporting a family in which neglect is an issue, the greatest of 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. It is important to explore why the child is being neglected and what the barriers are to improving that child’s life.

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. To explore concerns of neglect a Team around the family (TAF) meeting could also take place, which should include all professionals that are currently working with the family and a collaborative approach must be applied throughout. This includes capturing the voice of the child and those with parental responsibility. The completion of an Early Help Assessment, serves as a conversation tool that will help identify the right support at the right time. Placing the child at the heart of the assessment it will highlight individual need and enable the family and professionals to identify the best interventions at the earliest opportunity. The Team around the family will work together with external partners and children services to ensure the health and wellbeing of the child is paramount in all decision-making processes, with aims to prevent incidences of neglect, harm, and abuse.

Where there are concerns about standards of a child’s care it is important to regularly assess and plan with intervention and review. In this process consider an objective measure of the care of the child across all areas of need Assessment Triangle (PDF, 74KB) , 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 themselves to understand why such behaviours are harmful.

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 in line with the Referrals Procedure should be considered with a chronology.

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 and interventions are often beneficial but their impact on meeting the child’s needs must be kept under review. The carers ability to recognise their childs vulnerabilities and needs is more crucial than the professionals offer of a practical ‘quick fix’ such as supporting the carer to tidy the house.
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 relationship 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;
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. Create SMART actions and allow the carer and child to express what they think needs to happen and what that help and action looks like.

Adults

Neglect is the failure of any person who has responsibility for the charge, care or custody of an adult to provide the amount and type of care that a reasonable person would be expected to provide.

Behaviour that can lead to neglect includes including ignoring medical or physical needs, failing to allow access to appropriate health, social care and educational services, and withholding the necessities of life such as medication, adequate nutrition, hydration or heating.

Neglect can be intentional or unintentional. Intentional neglect such as withholding meals may constitute ‘wilful neglect’ and is a criminal act punishable under law (Mental Capacity Act 2005 Section 44).

Neglect includes ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating. Such acts of neglect can result in serious physical or emotional harm to adults – such as pressure sores, starvation, dehydration and serious illness or death.

Failure to provide or allow access to food, shelter, clothing, heating, stimulation and activity, personal or medical care
Providing care in a way that the person dislikes
Failure to administer medication as prescribed
Refusal of access to visitors
Not taking account of individuals’ cultural, religious or ethnic needs
Not taking account of educational, social and recreational needs
Ignoring or isolating the person
Preventing the person from making their own decisions
Preventing access to glasses, hearing aids, dentures, etc.
Failure to ensure privacy and dignity

What does Neglect look like?

Symptoms and signs can be, but are not limited to:

Poor environment – dirty or unhygienic
Poor physical condition and/or personal hygiene
Pressure sores or ulcers
Malnutrition or unexplained weight loss
Untreated injuries and medical problems
Inconsistent or reluctant contact with medical and social care organisations
Accumulation of untaken medication
Uncharacteristic failure to engage in social interaction
Inappropriate or inadequate clothing

Reporting a concern about a child

If you have concerns about a child please report your worries to the NELC Children’s Integrated Front Door using the online form , by calling 01472 326292 Option 2 or contacting the NSPCC helpline 0808 800 5000.

Reporting abuse on adults

Anyone that suspects another professional or adult of abuse or neglect has a duty to refer it to the relevant employer or safeguarding agency to be investigated.

If you need to raise a Safeguarding Adults concern, please call 01472 256 256. This number is available 24 hours a day, 365 days a year.

Related agencies

Families First Information Service or Family Hubs – 01472 326293

Health Visiting and school Nursing Service – 01472 323660

NSPCC Grimsby Service Centre – 01472 803500