Neglect Strategy – information for practitioners working with children & young people

Neglect can result when adults fail to meet the basic physical and /or emotional needs of the children they are responsible for.

All children and young people need food, clothing, warmth, love and attention, in order to grow and develop properly.

Neglect is when a parent or carer fails to provide adequate food, clothing, shelter (including exclusion from home or abandonment), medical care, or protection from physical and emotional harm or danger.

It also includes failure to ensure access to education or to look after a child because the carer is under the influence of alcohol or drugs.

In pregnancy neglect may occur as a result of misusing alcohol or drugs.

Common examples of neglect are a failure to:

Indicators of Neglect

As practitioners, common indicators of neglect can include:

  • frequent A& E attendances (e.g for injuries); these are often associated with accidents through lack of supervision;
  • poor uptake of immunisations;
  • untreated medical conditions or not giving essential treatment regularly or consistently for serious illness and/or minor health problems;
  • poor dental hygiene and care;
  • inadequate or poor nutrition;
  • physical care and presentation of the child outside acceptable norms for the population (e.g inappropriate clothing for the winter);
  • child’s attendance at school is poor or the child is consistently late; parent takes no interest in child’s school-work;
  • parent carer does not have the ability or motivation to recognise and ensure the needs of the child are met;
  • house is in a dirty, unkempt state with poor safety provision;children’s bedrooms may be worse than the communal areas;
  • parental behaviour is overtly risky and of concern i.e substance misuse, domestic abuse, denial of access to child, frequent home moves, homelessness etc.

Neglect can often become an issue when parents are dealing with complex problems, sometimes including domestic abuse, substance misuse, mental health issues, social-economic issues or they may have been poorly looked after themselves. These problems can have a direct impact on parents’ ability to meet their child’s needs. Even when parents are struggling with other personal issues they have a responsibility to care for their child or seek help if they are unable to parent adequately.

Effects of neglect

Apart from being potentially fatal, neglect causes great distress to children and leads to poor outcomes in the short and long-term. Possible consequences include an array of health and mental health problems, difficulties in forming attachment and relationships, lower educational achievements, an increased risk of substance misuse, higher risk of experiencing abuse as well as difficulties in assuming parenting responsibilities later on in life.

Neglect could result in a child who:

  • is frequently absent from school;
  • begs or steals money or food;
  • doesn’t get the medical or dental care, immunisations or glasses they need;
  • lacks appropriate clothing, e.g. for weather conditions, shoes are too small, ill-fitted clothes;
  • wears clothes that are consistently dirty or ‘smelly’;
  • has teeth that are dirty, hair quality that is poor and contains infestations;
  • has hands that are cold, red and swollen;
  • looses weight or is constantly underweight;
  • has suffered physical harm or danger because their parent or adult caregiver has failed to protect them.

The above may play a cumulative part in isolating the child in society, e.g. at school because of body odour or head lice, or because of violent behaviour. The damaging effects of severe neglect can lead to accidental injuries, poor health, disability, poor emotional and physical development, lack of self-esteem, mental health problems and even suicide.

The degree to which children are affected during their childhood and later in adulthood depends on the type, severity and frequency of the maltreatment and on what support mechanisms and coping strategies were available to the child.

Our Neglect Improvement Journey

Neglect is a strategic priority for the Manchester Safeguarding Children Board and the new multi-agency Negelct Strategy is driving development and improvement.

It was important to refresh and re-energise activity around neglect – there had been a Neglect Strategy in place in the past but it was insufficient and too focussed on defining neglect and the impact of it, rather than offering an analysis of the Manchester context, the impact of Neglect on children in Manchester, and what the partnership were going to do to strategically improve practice and services to children and families. This resulted in limited focus and impact.

At the time of drafting the current Strategy, there were 840 children on a Child Protection Plan (71.6 per 10,000 child population).  By comparison the rate for our statistical neighbours was 62.9 per 10,000 child population.  Of the children in Manchester on Child Protection Plans, 57% were on the plan for a primary reason of neglect.

Actions and service development – What have we done?

  • MSCB have agreed a multi-agency Neglect Strategy 2016/19 that was signed off by the board in June 2017.
  • The MSCB Neglect Strategy (issued June 2017) is being formally launched at a series of large monthly events starting in September 2017.
  • Graded Care Profile 2 has been selected as our agreed Neglect Assessment tool and we are working closely with the NSPCC to develop and implement this.

Implementation Plans are in place and the first phase of multi-agency Train the Trainer sessions will take place in October 2017. The two year Implementation plan will span all levels of need, Early Help to Statutory Services.

We cannot yet demonstrate direct impact for children but we will measure the success and effectiveness of this Strategy by the impact on outcomes for children and young people.

A multi-agency data set will be developed that enables us to measure impact.

Future planning – what do we still need to do?
Neglect Implementation Plans are in place. We will review and monitor the activities detailed under the strategic objectives on an ongoing basis and report on them on an annual basis.

Guidance for professionals – MSCB Neglect Strategy

The MSCB Neglect Strategy (issued June 2017) should be read alongside the relevant sections of the GMSP procedures.

Guidance for professionals – Graded Care Profile 2

Graded Care Profile 2 has been selected as our agreed Neglect Assessment tool and we are working closely with NSPCC to develop and implement this.

Implementation Plans are in place and the first phase of multi-agency ‘Train the Trainer’ sessions will take place in October 2017.

The two year Implementation plan will span all levels of need, Early Help to Statutory Services.

Find our more on the NSPCC website www.nspcc.org.uk/graded-care-profile/

Further Resources

A topic paper on Neglect is included in the Children and Young People’s JSNA, this is updated as new data and guidance becomes available so please refer to this via the link below for a more detailed narrative: www.manchester.gov.uk/children_and_young_peoples_jsna

The NSPCC has lots of information about neglect on its website www.nspcc.org.uk/neglect/signs-symptoms-effects-neglect/

The NSPCC has published a report giving an overview of research on child neglect, evaluations of assessment tools and services, and evidence on how we can work together to prevent child neglect  Spotlight on preventing child neglect: an overview of learning from NSPCC services and research

Action for Children ‘Action on neglect’ provide resources for professionals on their website www.actionforchildren.org.uk/  including the ‘Action on Neglect Resource pack’.

Ofsted’s report ‘In the child’s time: professional responses to neglect’ can be found on the website webarchive.nationalarchives.gov.uk/

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