Agencies missing neglect in older children
Joint inspection urges greater focus on neglect in older children
Published on 7th July 2018
Neglect of older children often goes unseen, a joint inspection has revealed.
The signs of neglect of older children may be more difficult to identify than signs of neglect in younger children, and older children may present with different risks, the inspection by Ofsted, the Care Quality Commission, and Her Majesty’s Inspectorates of Probation and Constabulary, Fire and Rescue Services explains.
“When older children who have experienced neglect come to the attention of agencies, the most obvious risks of, for example, exploitation or offending behaviour may elicit an appropriate response from professionals initially. But, without understanding and addressing the underlying impact of neglect, the effectiveness of any work to support these children will be limited,” said the third joint targeted area inspection.
The Children Act 1989 defines neglect that has been expanded on in government safeguarding guidelines as ‘The persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development’. Neglect may occur during pregnancy as a result of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to provide adequate food, clothing and shelter, failing to protect a child from physical and emotional harm or danger, failing to ensure adequate supervision or ensuring access to appropriate medical care or treatment. It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.
The report considers the most significant learning from six inspections of local authority areas with a focus on the neglect of older children. The report recognises that much has been done by agencies to address neglect of younger children but it calls for a greater awareness of the neglect of older children and a focus on trauma-based approaches to tackling it. It also calls for a greater awareness among professionals in adult services of the risks of neglect of older children who are living with parents with complex needs.
It highlights that:
1. Neglect of older children sometimes goes unseen.
2. Work with parents to address the neglect of older children does not always happen.
3. Adult services in most areas are not effective in identifying potential neglect of older children.
4. The behaviour of older children must be understood in the context of trauma.
5. Tackling neglect of older children requires a coordinated strategic approach across all agencies.
The report found that professionals and parents can sometimes view the presenting issues older children face as the problem: this was often an unconscious assumption. When a child’s presenting issues become the sole problem, professionals do not always consider their behaviour in the context of the impact of neglect on the child and they can fail to take action with parents regarding any ongoing neglect.
In some areas and agencies, effective processes at the front door, such as use of chronologies, were making a significant difference as to whether professionals were supported to identify neglect.
“Children are not the problem,” said the report. “Older children still need parental care and support. Professionals are not always doing the work to tackle neglectful parenting.”
The report highlights that as children get older, we expect them to take more responsibility for their actions which is an important part of a child’s development from childhood to adulthood. However, older children still need a great deal of parental care, support and guidance. Parenting older children requires different skills, as does working with older children. Inspectors highlighted that they saw evidence of professionals across agencies who lacked the skills and training to work with older children as effectively as they could.
While inspectors saw some good examples of skilled work with older children and work that did address all of the risks to those children, including the neglect at home, in some cases, agencies did not always recognise the fact that work was needed with parents, too. If children of any age are suffering neglect, professionals must address this with their parents, the report stressed.
The investigation revealed that adult services in most areas, including adult mental health and substance misuse services, the National Probation Service and Community Rehabilitation Companies are not effective in identifying older children at risk of neglect. For services to be effective in identifying the neglect of older children, there needs to be a whole-system approach, the report said. This includes adult services that work with parents where professionals are well placed to identify risks parents may pose to children because of adult mental ill-health, substance misuse or offending behaviour.
CRCs had very high caseloads which was severely limiting the ability of these agencies to gather information about children, including any risk of neglect of older children. However, inspectors praised practice in one of the adult substance misuse services seen as particularly strong. The service effectively assessed the impact of adult behaviour on children and how these behaviours contributed to neglect. The service then supported adults and children to reduce the risk, demonstrating that the way in which adult services respond to risk can make a real difference to children.
The report highlights that professionals need to understand children’s behaviour in the context of trauma. Many of the children the inspectors saw had experienced multiple forms of abuse including domestic abuse, parental substance misuse, sexual abuse, physical abuse, sexual and criminal exploitation and serious youth violence.
“Early childhood or chronic trauma will most likely affect a child’s mental and emotional well-being and behaviour into adolescence and beyond,” the report warned.
In some areas, social workers and Youth Offending Teams had received training on the impact of trauma on children and its relationship to neglect and the impact of this training was clear to see in the work with older children, because their need for therapeutic support to address the impact of neglect including trauma was prioritised.
“Where there is a coordinated strategic approach across agencies to support a shared understanding of the needs of neglected older children, we observed a significant difference to the quality of practice and experiences of older children suffering neglect,” said inspectors.
However, leaders and managers across children’s social care, youth offending services, health services and the police cannot assume that staff have the necessary skills and knowledge to identify and tackle the neglect of older children.
Some areas took a strategic multi-agency approach, which ensured that staff across agencies had the support, training and tools they needed to tackle neglect of older children. These areas had a more consistent and considered way of working that was having a positive impact on many children, said the report.
To increase practitioner confidence and impact, there needs to be investment in specialist training for professionals for working with older children which should include a clear understanding of child development during adolescence and trauma-based approaches to neglect as well as access to evidence-based approaches to inform interventions. Practitioners need to be caring, curious, capable, and confident in their practice.
To achieve this, all professionals need to understand how neglect within the home may have an impact on a child’s behaviour and emotional well-being and how this may increase their vulnerability to risks outside of the home.
“We are becoming increasingly aware of risks of exploitation, including the risk of county lines and this very vulnerable group of older children are at particular risk of being exploited,” the report warned. “Understanding the relationship between neglect in the home and abuse and exploitation outside of the home is crucial if older children are to be more consistently and effectively helped.”
“In summary, this is a complex area and one in which many individual agencies and partnerships can play a significant role in identifying and supporting older neglected children. Partnerships are at different stages in developing good and best practice to address the range of risks that older children face and are developing approaches and an evidence base about what works,” said the report.
“We would encourage local safeguarding partners to ensure sustained mutual challenge to: secure the very best local practice; develop responses informed by what older children tell you about what works; and adopt a continuous learning and improvement culture in local responses to this challenging area of multi-agency practice,” the report concluded.
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