Is tackling neglect no longer the job of social workers?

Neglect is a perennial issue for social workers, but the recent serious case review of Abigail, a three year old girl with severe developmental delay, has reinforced  just how difficult it is for social workers to deal with.

Abigail was never put onto a child protection plan. She was admitted to hospital in November 2012 with malnutrition, anaemia and weak bones, as well as severe nappy rash and head lice. At nearly three years old she was unable to walk. Both her parents were convicted of criminal neglect earlier this year.

Gary Walker, a solicitor specialising in child abuse claims points out Abigail’s case was characterised by an incident-led approach. Because each incident alone wasn’t severe enough to reach child protection thresholds, this  created “systemic paralysis, not allowing social workers to go any further in seeking help from other professionals.”

A child protection plan would have enabled a wider ranging investigation.

This incident-led approach is problematic but it’s nothing new, according to Anne Hollows, a social work professor at Sheffield Hallam University

“Because individual situations don’t reach the threshold, people don’t communicate about it with the level of concern they would if there was a physical injury or maltreatment,” she says.

This approach leads to professionals in all agencies failing to put all the pieces together and see the bigger picture, which might be one of severe neglect.

Neglected children may not be subjected to intentional physical harm, but they have some of the worst outcomes, with 19 out of 20 neglected children having special educational needs. By the age of three they have poorer speech and language. By the time they get into school they’re already destined for poor performance. They are more vulnerable to sexual exploitation, poor mental health, turning to youth offending and suicide. They have poorer outcomes as children, but they also have poorer outcomes as adults.

But while we know more than ever about the long term impact of neglect on a child, cases like Abigail (and even Daniel Pelka before her) are still slipping through the cracks.

Nushra Mansuri, professional officer with the  British Association of Social Workers’, says the problem cannot be separated from a lack of resources, which distorts social workers’ ability to make correct judgements.  The enormous pressure on services forces social workers to wait for a trigger event such as a physical injury to happen, prioritising cases which have already come to a crisis.

“I don’t believe thresholds are at the right level and that is a great concern,” Mansuri says.

In many cases, she says, social workers will raise the alarm to managers, only to be told by their legal department  there is not enough evidence to escalate the case. The incident can only be stored away as a piece of future evidence for when some crisis does trigger greater social services involvement.

By the time a case even gets on the radar of social services, the neglect  has often become entrenched and the case extreme.

Deanna Neilson, head of safeguarding for Action for Children says this means that for many families, social workers are no longer the people best placed to help them.

“They’re always dealing with the much higher end, the crisis cases and they struggle to do some of that early intervention.

“Social workers are not the only people in communities who can help families- it has to come from schools and education and welfare officers.”

Children’s teams are now having to rely on agencies like schools, which have contact with the child no matter what, to hold the ring on neglect. Hollows describes schools up and down the country where teaching assistants are bringing in toothpaste and flannels to keep in their desk for children who regularly come in late, unwashed and unfed.

“Teaching assistants are just doing this and getting on with it, but it needs to be shared and recorded.”

Hollows says a clear and agreed communication strategy between all agencies would help, but the reality is the responsibility for recognising signs of neglect cannot fall to social workers alone.

“If we’re going to rely on all the early intervention work being done by other professionals, then we’ve got to be a lot more rigorous in what we get those other professionals to do and how we help them.”