Neglect and serious case reviews (PDF, 735KB) - nspcc

learning:
themeS aNd learNiNg poiNtS
Not taking account of a history of violence
hostility to professionals
3. A thematic analysis of neglect
This case highlights the problems of gaining a full understanding of a case
when the family moves around regularly and their history is unknown, or
only partially known. However it also shows that when new information
becomes available professionals are reluctant to reappraise the case and
change their view. It shows how powerful the label of ‘low level neglect’
can be and the way that it can downgrade thinking and activity. The
combination of a mindset about low level neglect and parental hostility
kept professionals at bay.
In a number of these cases the past history represented very serious risks of harm to the
child but was not present in the minds of the professionals. This history was sometimes
not taken seriously because professionals had decided that the key risk of harm to the
child was neglect or emotional maltreatment and so the risk of violence was effectively
discounted. Evidence of serious past physical abuse from a parent included: putting a
pillow over a child’s face, previous unexplained child death, a history of a previous child
being adopted because of a prosecution for assault by a parent, and very serious offences
of parental violence, including offences against children.
These cases of combined physical abuse and neglect often included parental violence
and hostility towards professionals as well as extreme distrust of workers. In most instances
the hostility and violence was perpetrated by the father or male figure, but in
other cases, as in the case vignette, it was the mother who posed the greater risk of
violence to the baby or child and was the most hostile part of the couple. Sometimes
both parents were hostile but in most of these cases there was one especially controlling
partner who tended to dictate the terms of the relationship with professionals. Any
services were usually only accepted on the controlling parent’s terms, with considerable
reluctance and following much negotiation. In some cases parents insisted on following
their own idiosyncratic beliefs about how to meet children’s health and dietary needs as
well as refusing immunisations and medical treatments. Professional concern about the
family tended to dissipate however if the less hostile parent appeared to cooperate, even
if there was no cooperation from the more hostile parent.
Our first two biennial reviews noted that the level of cooperation or hostility between
families and agencies had an impact on the way that practitioners understood the families
and the risks of harm to the child (Brandon et al 2008, 2009). In the cases here there
was a reluctance to challenge hostile parents who appeared to induce fear, paralysis and
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