Working with children experiencing neglect: challenges and solutions

Neglect is the most common reason for a child to be on a child protection plan or register in the UK, accounting for half such cases in 2020 (NSPCC, 2021).

It was also found to be present in three-quarters of concerning the death or serious harm of children in England from 2017-19).

But despite its continued prevalence, responding to neglect in a timely way that provides children with the support they need remains a complex and challenging task for practitioners (Child Safeguarding Practice Review Panel, 2021).

Neglect remains challenging to identify and conceptualise. Whilst in its broadest sense, it can be understood as a child’s needs not being sufficiently met, there are narrower definitions in legal, policy and organisational contexts.

Neglect also varies across time, space and cultural contexts, making it more challenging to classify compared to other types of maltreatment, such as physical or sexual abuse.

In addition, it is much more challenging to evidence the absence or omission of something in a child’s care, rather than identifying an act of commission, such as physical chastisement.

Understanding neglect

Our understanding of neglect is also often rooted in our individual experiences and perceptions, such as our:

• experiences of being parented;
• experiences of being a parent;
• professional training;
• personal and professional experiences;
• awareness and recognition of inequalities and poverty; and
• cultural biases.

These points are critical for unlocking access to sparse resources, in that our understanding underpins our ability to articulate concerns effectively and clearly evidence levels of harm (or risk of harm) in line with local authority thresholds for intervention.

Our perceptions of neglect can make it difficult to classify concerns, and often create obstacles for practitioners identifying neglect at the earliest point possible.

This means it is more difficult to get the right support to families and address issues before they escalate and become critical, as emphasised in the final report of the Independent Review of Children’s Social Care. (MacAlister, 2022).

Whilst it can be beneficial – and perhaps reassuring – to be guided by specific assessment tools, the use of scales and tools for assessing neglect has its limitations, as these are often based upon the practitioner’s own beliefs, biases and judgments.

The value of reflective discussion

There are, however, some approaches that can help us examine and unpick our understandings of child neglect, such as reflective discussion. Engaging in reflection is central to achieving shared conceptions, and can be applied within peer, team or organisational supervision.

These spaces and places can assist professionals to articulate and evidence their thoughts, observations or intuitions, and reveal the potential for personal biases and experiences to occur.

These spaces provide opportunities for individuals to challenge themselves by asking: ‘Where does my knowledge come from? What prejudices may I hold? What do I know about individuals with this particular cultural background? What personal or organisational norms do I take with me?’

Inter-professional practice has long been acknowledged as a sizable and persistent challenge across all social work settings.

Agencies’ roles, funding streams, language and understandings of what collaborative working entails unite to create a perfect environment for misunderstandings and miscommunications to arise.

When we are required to work together across organisational boundaries, processing concerns or worries about children who are being neglected in a clear and systematic way is crucial.

Good recording practice

Keeping clear and accurate multi-agency chronologies is one simple, yet effective, way for practitioners to compile an overview of a child’s circumstances and experiences over an extended period of time.

They can be used as a tool to record events and concerns and build a bigger picture to monitor or identify patterns in a child’s care or lack of care. Key points for good recording practice include:

• the child’s voice;
• telephone and face to face contacts;
• observations;
• parental attitudes;
• failures of parents to take the child to appointments;
• evidence of non-compliance and/or resistance to intervention;
• being concise and factual.

However, the challenges of responding to child neglect within a multi-agency context are likely to be accentuated by the proposed revisions to the Working Together to Safeguard Children guidance.

Concerns over lead practitioner role

The 2023 Department for Education (DfE) consultation proposes that the ‘lead practitioner’ with responsibility for management of child in need (section 17) cases may be drawn from a wide range of professional backgrounds, such as family support workers, drug and alcohol practitioners, domestic abuse workers and youth workers.

This is a significant shift from existing practice where designated social workers manage section 17 interventions under the Children Act 1989.

This raises concerns about the quality of assessments for children living with neglect. It would mean non-social work qualified workers holding the responsibility for effective identification and conceptualisation of neglect at the earliest point possible. They would also be doing so with the added challenge of working and communicating across differing professional understandings and backgrounds.

There would be further challenges if lead practitioners were based outside the local authority.

Whilst the consultation specifies that a social work qualified practice supervisor or manager must have oversight of key decisions made, it is not clear whether or not lead practitioners’ will be employed by the local authority.

The proposed change to Working Together is part of the DfE’s ambition to create family help services – merging current targeted early help and child in need provision – to improve the quality and timeliness of family support.

As set out in the DfE’s draft strategy on reforming children’s social care, Stable Homes Built on Love, published earlier this year, family help teams, though led by councils, would “incorporate support from universal, community and specialist services”.

Risks of moving case responsibility outside of councils

If lead practitioners were based in such services within the community, this would introduce a supplementary interface between the practitioner’s and children’s social care.

Our understandings of neglect are often connected to our disciplinary training and personal experiences. Having lead practitioners outside of children’s social care manage section 17 cases – where the sharing of information is limited to parameters of consent – serves only to increase the opportunity for misconceptions to occur across different fields of responsibility and organisational boundaries.

Social workers have access to the wider contextual knowledge held by children’s social care in relation to any previous statutory support families have received or historic or current concerns shared through multi-agency safeguarding hubs (MASH). They are also conversant with the application of their agency’s statutory thresholds for intervention in neglect.

It is not clear how social work managers would provide supervision for support, approval of assessments and any review of section 17 cases managed by lead practitioners outside of the local authority.

Guidance on neglect

Whatever the outcomes of the consultations on Working Together and Stable Homes, Built on Love, practitioners will continue to face significant challenges in relation to neglect.

To help, we have written Working with children who have experienced neglect, a new good practice guide, published by CoramBAAF.

The book provides detailed guidance and helpful strategies on identifying and responding to neglect in a range of relevant practice contexts, and gives particular focus to working effectively with other agencies.

It draws upon empirical research conducted by Sharley (2020) to set out a range of strategies to promote critical thinking and improve inter-professional communication, and thereby enhance relationships between practitioners and across services when working with neglect.

Victoria Sharley is senior lecturer in social work with children and families at the University of Bristol, and Alyson Rees is professor of social work at Cardiff University