Laura Dover
Everyone’s Children Project Development Worker

A summary of the key points from the Child Protection Committee’s Neglect Summit on 6th March.

The Child Protection Committee’s recent Neglect Summit encouraged practitioners to take a more holistic view of child protection issues, considering not only parenting and family relationships but the whole circumstances of a family and how agencies can work more effectively together to support them. The event included discussion of the ‘Child B’ Significant Case Review, a case involving neglect which received extensive media coverage, and the lessons that can be taken from it. Challenging questions around the relationship between child poverty and neglect were considered, as was the impact of adverse childhood experiences on personality development and coping skills. Examples of how the third sector and Education can identify and prevent neglect were also highlighted.

Marc Kozlowski, a forensic psychologist at Edinburgh Napier University who has extensive experience of working in prisons and the criminal justice system, spoke about the relationship between adverse childhood experiences, trauma, personality disorders and offending. Children who have been neglected are more likely to struggle when interacting with others. They may develop coping mechanisms which can be healthy as children but will become maladaptive if they are retained into adulthood, and can manifest as diagnosable personality disorders. However, Marc cautioned that practitioners should not lose sight of the ‘whole person’ when their client has a personality disorder and remember that the disorder will manifest differently from person to person. Instead, a professional’s task is to consider how their symptoms are problematic for the client or those around them, and how their challenging traits can be managed or alleviated. It’s also important to bear in mind that a diagnosis of a personality disorder is not a risk factor for violence in itself, and that practitioners’ personal dislike of a client should not be a factor in their risk assessment. Marc advised that it’s particularly important to maintain professional boundaries with such clients and ensure that all agencies are transparent and united in their message to them, as this will help to build trust. When a practitioner has an emotional response to a client, Marc suggests being honest about it and seeking support from a supervisor who can provide a balanced perspective.

Staff from Action for Children and Stepping Stones for Families highlighted examples of how their organisations had tackled child neglect and prevented child protection registrations through their family support models. Karen McFadzean, manager of the Action for Children North Glasgow Family Support Centre, spoke about a case study where “Child R”, who was in primary 3, had poor school attendance and presented as being insecure and tearful. His mother had severe mental health difficulties and a history of substance abuse. The family home was in poor condition and the family was considered by Social Work to be on the edge of a child protection registration. They were referred to Action for Children for family support, who completed the Child Protection Committee’s ‘Neglect Toolkit’ with the family which was to be reviewed again in three months. Action for Children then worked closely with the family, offering the mother 2 weekly appointments to focus on routines and supporting Child R within his school. The family support worker obtained a referral for the Mother to the Community Mental Health Team and Lifelink for counselling. The worker also liaised with Housing Services to get household repairs done and their living room redecorated. A grant was obtained from the Care Foundation to buy new household goods including new bedding for Child R. After three months, the Neglect Toolkit was reviewed and Social Work decided that a child protection registration was not necessary: the mother’s mental health had improved through counselling, R’s attendance at school had improved and he appeared more confident and able to share his anxieties. The family continued to work with Social Work but on a voluntary basis. The Neglect Toolkit was viewed positively in this case as the worker was transparent with the family: they used the toolkit with them openly rather than covertly, and it captured their strengths as a family as well as the challenges they face.

Isobel Lawson, CEO of Stepping Stones for Families, presented a draft evaluation of their Family Wellbeing Service, which has operated from 2014 and involved placing Family Wellbeing officers in 8 nurseries across Glasgow. The model sounds simple: workers are to “go and do what works to help parents in their lives”, but it is delivered by highly skilled staff making nuanced and difficult decisions about how best to support people in complex circumstances. During the evaluation, 30 parents were interviewed along with 19 nursery staff members and 9 ‘Stepping Stones’ staff members. The nursery staff and Family Wellbeing workers said that the initiative has resolved some child protection issues and prevented others from worsening. Children whose parents were supported appeared calmer and better behaved, and in some cases, cleaner and better dressed with better attendance and engagement at nursery. Isobel also pointed to significant savings given the cost of providing intensive family support compared to the much higher cost involved with ‘worst case scenario’ Social Work interventions. These practice examples from third sector organisations demonstrate how a holistic family support model, which looks at the totality of a family’s circumstances and resolves issues that were leading to a crisis, can avert a child protection intervention and create sustainable change for the family.

Attendees at the summit had the opportunity to discuss the ‘Child B’ Significant Case Review, which involved a young child who died as a result of long-term neglect by her parents. Cathy Coll, a senior social worker, described some of the changes that had been implemented as a result of the review, which brought up the issue of thresholds for child protection registration. This is still under debate as it involves asking difficult and complex questions about what is ‘good enough’ parenting, what neglect looks like and how to include the child’s perspective when assessing a case of potential neglect. Cathy said that a holistic assessment of the whole family is needed and emphasised the importance of using chronologies to recognise non-engagement. Child Protection Committee training has been refreshed and the duty social work system has been reviewed. There were also implications for Health Visiting and Education, with a review of the current health plan status for children aged 20 -22 months and the introduction of a ‘Vulnerable Pupil’ case file to improve recording and monitoring of the most at-risk children. The review highlighted communication issues between agencies, such as over-reliance on telephone calls rather than face-to-face conversations, and lack of clarity about who is responsible for follow-up actions. Cathy also said that professionals need to be prepared to challenge parents if their child’s needs are not being met.

Kate Morris, a professor of social work at Sheffield University, examined the relationship between child poverty and child abuse and neglect. She acknowledged that this can be a difficult topic due to concerns about stigmatising families in poverty and that while poverty is neither a necessary or sufficient cause for neglect, it can be a contributory factor. According to a study of child welfare inequalities across Scotland, England, Wales and Northern Ireland, the relationship between neglect and poverty is a gradient, with a child’s chances of an intervention increasing with poverty levels. The direct effect of poverty is that families experience material hardship and cannot afford to pay for support; the indirect effect is that it increases parental stress and worsens neighbourhood conditions. The study also found that, while social workers understand the impact of poverty, this is rarely reflected in practice as income maximisation is not seen as their core business due to already high workloads. Kate referred to a further study which discusses the ‘dance of responsibility’: the constant transfer of families between different services due to thresholds and eligibility criteria, which they find demeaning, demoralising and costly. Long waiting times can allow family situations to worsen while they are waiting to access support, and when an intervention ends families can be left feeling abandoned if they have not been empowered to sustain changes and cope without support. Kate said that, while austerity and diminishing resources make tackling poverty incredibly difficult, professionals can support families by considering whether they are being humane in their interactions with clients and by poverty-proofing their practice, such as by providing travel expenses for meetings held outwith the family home. She also suggested that families should be involved in the commissioning and design of services. Ultimately, Kate maintained that child poverty is a child protection issue and raising family incomes will reduce instances of abuse and neglect, so anti-poverty work must be part of our approach to tackling neglect.

Mike Burns, Head of Children’s Services, closed the event by saying that neglect is everyone’s responsibility. Rather than transferring pressures away from Social Work and onto other agencies, we need to work together more effectively. He acknowledged that inter-agency working brings challenges and that statutory sector staff will become comfortable working with some third sector providers but not aware of the full range of services available locally, and these links need to be improved. Mike went on to discuss the need for transformational change and a shift away from spending on expensive residential placements to prioritising prevention of neglect and family support. The ‘Glasgow Together’ consortium in the north east locality involves a partnership between Social Work and third sector organisations, and families who are struggling but not yet at the threshold for a child protection registration can be referred to an appropriate organisation for family support to prevent their circumstances from worsening and avoid the need for Social Work to intervene. GCHSCP are currently developing a citywide family support strategy with the aim of early intervention for families in need of support.

Below are some further resources on child protection and neglect, including research discussed at the summit: