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

Neglect and Serious Case Reviews
lack of support for staff
uncertainty in the practitioners. In these circumstances assessments tended to remain
incomplete and cases could be closed without a full assessment. In one case the reason
for a children’s social care core assessment not being completed was said to be the
family’s unwillingness to cooperate. This was in spite of this being a section 47 child
protection enquiry (under the Children Act 1989) and a child protection conference
having been called, cancelled and not re-scheduled. Where families were hostile or
resistant it was not uncommon for services across any sector, especially health, to be
withdrawn in spite of NICE guidelines indicating that missed appointments should
trigger greater vigilance. Withdrawal or a pulling back of services occurred in a number
of these neglect cases where physical abuse had been overlooked or downplayed by
professionals.
A recurring theme in these cases was a lack of skill, confidence and experience in
dealing with the challenges that the case presented. Muddle and confusion permeated
planning and decision making especially when there was a high turnover of staff and
numerous professionals involved in a single case. There was little evidence of adequate
management support and back up for staff to make sense of complex cases and make
sound assessments, decisions and judgments. Management of these cases was not proactive.
development of a sibling or harm to a sibling as a clue to harm in babies
68
Where parents keep babies and young children away from developmental checks
and immunisations, they are potentially lost from view. In these and indeed other
circumstances, concerns about older siblings from nursery or school should trigger
the need to carefully assess other children in the family and especially babies who are
innately the most vulnerable. Staff who see children regularly, for example at school or
in nursery, are well placed to notice problems with their development or changes in their
behaviour. Noticing changes can provide a warning in relation to the individual child at
school, but the changes in an individual child might also provide a sign of a downturn in
overall family functioning which is likely to affect all other siblings. Being able to pick
up on these clues requires school and nursery staff to have, firstly, a good grounding
in child development and secondly, the confidence to discuss these concerns with a
supervisor or child protection designated staff member.
Similarly, recent previous injury to a sibling may indicate physical abuse as a risk for
all children in the family. Previous injuries to siblings in these cases included swelling
to the head (in more than one case) and limb injuries, but in each case the possibility
of physical abuse was discounted and not borne in mind in later planning or decision
making.