Lack of common thresholds allowed neglected child to lose part of his sight

A lack of a common threshold for assessments meant social workers failed to act early to protect a boy whose neglect later caused him to lose sight in one eye.

The serious case review into Stockton-on-Tees Council’s handling of the case also criticised poor multi-agency working, the time taken to complete an initial assessment and social workers’ failure to inspect the child’s bedroom during home visits.

The case concerned child H, who was 12 at the time, and had been diagnosed with juvenile idiopathic arthritis, a condition that can damage vision and other parts of the body if not managed properly.

‘Faeces smeared’

The serious case review found H was living in “extremely poor home conditions characterised by rotting food, lack of bedding, broken toys, unhygienic sanitary provision and faeces smeared to the wall of Child H’s bedroom”. However, H and his sibling were only taken into care after three referrals and two initial assessments. By the time the boy entered in care in 2013, his left eye had developed a cataract that caused temporary blindness and he was in need of urgent medical treatment.

The review found that a lack of a shared common threshold led to no action being taken on the first of the three referrals made about the boy to children’s social care. “So with the same information, the first contact team manager considered the referral should result in an initial assessment but the [referral and assessment team] manager did not agree with this assessment and did not allocate,” the review said.

During the review process Stockton’s children’s social care department said that the referral should have resulted in an initial assessment and that not doing so was an error of judgement on the part of the referral and assessment team manager. The manager was removed from his post prior to the serious case review being carried out.

The council told the review that it now intends to relaunch its early help strategy to help develop “a common understanding and application of threshold for intervention at each stage of the pathway”.

‘Blatant disregard’

The review also criticised the eight months it took for social workers to complete child H’s first initial assessment, which took place after the second referral. This delay, it said, enabled child H’s mother to neglect the boy’s medical needs by missing medical appointments. “During the extended period of the initial assessment therefore, [the mother] showed a blatant disregard for child H’s medical needs,” the review stated. “In these circumstances, the closure of the initial assessment, albeit unintentionally, created the circumstances within which [the mother] could continue to neglect the needs of child H.”

The quality of child H’s assessments also came under fire after social workers failed to contact the consultant rheumatologist who made the referrals or visit the boy’s bedroom during home visits.

The review said that children with medical needs that require specialist inputs need to have a nominated lead professional to coordinate services and oversee outcomes. It also said that any home conditions that could have a negative impact on a child’s welfare should be viewed and acted upon at the earliest possible stage. Social workers should also always consult directly with the referrer when no further action is determined, it added, which did not happen in child H’s case.

‘Doing well’

Colin Morris, the independent chair of Stockton-on-Tees Local Safeguarding Children Board, said child H was no longer in care, his health has improved and was doing well. The boy’s vision is also expected to improve although it is thought that his sight will never recover fully.

“A range of agencies had been involved with child H and during the course of this serious case review, the Stockton-on-Tees Local Safeguarding Children Board has identified a number of failings, most notably that they failed to communicate well or work together effectively,” said Morris. “Had they done so, the outcomes would certainly have been far more positive and this has been acknowledged by the key agencies involved.”

The mother and her partner were jailed for two-and-a-half years and two years and two months respectively after they pleaded guilty to two charges of child neglect.