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

maiNtaiNiNg a healthy, Safe relatioNShip
4. Implications for policy and practice
Crittenden has written extensively about the importance of maintaining a safe, healthy
relationship for a child and ways that parents can be helped to comfort and protect
their children from external danger rather than being a source of that danger themselves
(Crittenden 2008). There were numerous examples in this study where parents were
wittingly and unwittingly a source of danger to their child. We have shown that when
signs of neglect are evident, practitioners can be blinkered to the physical danger that a
parent or carer poses to a child. Similarly we have shown that a child’s life can be at risk
when the relationship between the child and caregiver is so poor that care, nurture and
supervision are almost non-existent.
Situations this severe usually evolve over time but they can also develop rapidly with
the onset of severe parental mental illness or the arrival of a dangerous but unknown
adult in the household, or with an intolerable accumulation of stress. While every effort
should be made to intervene early to prevent a parent–child relationship deteriorating in
this way, once this happens urgent action needs to be taken. Action is stalled when this
danger is hidden, when children and families disappear from view, when appointments
are missed and potentially, when children do not get the ordinary oversight offered by
attendance at school or nursery.
Parent–child relationships are often highly complex and practitioners need to be sensitively
attuned to this relationship, even where parents present as loving but may be
failing to cope, for example with the demands of their child’s complex health needs or
disability. Neglect of medical care can become fatal or cause life-long damage.
Understanding how an adolescent with a history of neglect feels and behaves is also
complex. Older children carry the legacy of their experiences of neglect and rejection
with them and need sensitive practitioners to understand that the impact of their experiences
can be life threatening as a result of their own high-risk behaviour or from
suicide. Like younger children, adolescents need to maintain safe healthy relationships
with their peers and with caring adults.
The Munro Review has reminded us that practitioners need to be supported by a system
that allows them to make good relationships with children and parents and supports
them in managing the risks of harm that stem from maltreatment. This includes the harm
from neglect and the way that neglect can conceal other risks and danger.
messages for decision makers, policy makers, practitioners and managers
• Use routine contact between parents and professionals as an opportunity to promote
sensitive and attuned parenting (Hibbard et al 2012). Where there are early concerns,
targeted help should be offered by services like Children’s Centres or enhanced health
visiting services like Nurse Family Partnerships. Older children should have ready
access to school- or community-based help or services from CAMHS.
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