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ALL WALES PRACTICE GUIDE

Safeguarding children from neglect

To be used in conjunction with the Wales Safeguarding Procedures

Who is this practice guide for?

This guide is primarily for practitioners working with children (up to the age of 18).

This includes those working in early years, social care, education, health, the police, youth offending and youth, community and family support services (including the third sector) and foster care and residential care.

What is this guide for?

Safeguarding children is a responsibility shared by everyone in contact with children.

The Wales Safeguarding Procedures support individuals and agencies across Wales to understand their roles and responsibilities in keeping children and adults safe. They support a consistent approach to safeguarding practice and procedures.

This practice guide provides additional information about safeguarding responses where a child is affected by child neglect. It should be used in conjunction with the Wales Safeguarding Procedures.

Effective safeguarding arrangements in every local authority area should be underpinned by two key principles:

There are some issues which are common across safeguarding practice guides and some which are specific to the safeguarding issue being considered:

What do we mean by Neglect?

The Social Services and Well-being (Wales) Act 2014 includes the following definition: _“neglect” (“esgeulustod”) means a failure to meet a person’s basic physical, emotional, social or psychological needs, which is likely to result in an impairment of the person’s well-being (for example, an impairment of the person’s health or, in the case of a child, an impairment of the child’s development).3

Neglect is the failure to meet a child’s basic and essential needs including physical, emotional and medical needs. It can include a failure to provide adequate food, clothing and shelter, failure to protect a child from physical and emotional harm and failure to provide adequate medical care or treatment. It can occur during pregnancy as a result of maternal substance abuse. It can also occur before a child is born where a parent fails to prepare appropriately for the child’s birth, fail to seek ante-natal care, and/or engage in behaviours that place the baby at risk. Neglect can take different forms, ranging from obvious physical signs such as being inadequately clothed to young children being left alone in their home or on the streets for long periods of time. Children may lack parental support to go to school, miss health appointments, and be ignored when distressed.

Physical neglect: A parent or carer has a duty to take care of a child’s basic needs which includes providing food, shelter and clothes, and keeping the child clean and hygienic. A failure to meet these basic needs is physical neglect.

Supervisory neglect: Where a parent/carer fails to provide an adequate level of supervision and guidance to ensure a child’s safety and protection from harm. For example, a child may be left alone or with inappropriate carers, or appropriate boundaries about behaviours (for example, under-age sex or alcohol use) may not be applied.

Nutritional neglect: Where a child does not receive/is not provided with adequate calories or nutritional intake for normal growth (also sometimes called ‘failure to thrive’). At its most extreme, nutritional neglect can take the form of malnutrition.

Emotional neglect: A child has emotional needs as well as physical and educational, and if parents and carers don’t meet these requirements, it’s known as emotional neglect. Emotional neglect could mean that a child isn’t getting the amount of attention, stimulation or affection that they need from a parent or carer, but it can also be more deliberate than that. Emotional neglect can result in long-lasting mental health problems and can lead to issues maintaining healthy relationships with partners, friends or even their children when they reach adulthood. Research has indicated that the emotional unavailability and unresponsiveness of the parent can be particularly damaging to the child. It can occur if the parent has mental health difficulties, substance or alcohol misuse or is persistently preoccupied with other difficulties such as domestic violence. Parents may be less likely to complain about their child in these situations and observations of interactions are particularly important. This is not to suggest that all parents who e.g. have mental health difficulties are emotionally unavailable to their children.4 Emotional neglect is a particularly hidden form of maltreatment5 and resources are available from the NSPCC which consider emotional neglect at different points in the child’s development.6

Medical neglect: This involves a parent or carer minimising or ignoring children’s illness or health (including oral health) needs, and failing to seek medical attention or administrating medication and treatments. This is equally relevant to expectant mothers who fail to prepare appropriately for the child’s birth, fail to seek ante-natal care, and/or engage in behaviours that place the baby at risk through, for example, substance misuse. Public Heath Wales has issued Primary Care Guidance: ‘Children and young people who are not brought to healthcare appointments’. The guidance sets out that missing appointments for some children may be an indicator that they are at an increased risk of abuse or neglect. Oral health: As part of the Healthy Child Wales programme Health Visitors are delivering the Lift the Lip initiative which is an integral part of the Welsh Government Designed to Smile Programme to improve the oral health of children in Wales. Public Health Wales has published safeguarding Guidance for dental teams in Wales. Dental disease and neglect including a failure to keep dental appointments when the parent / carer knows the child is in pain, or failing to seek dental care when a child is in pain.

Educational neglect: This involves parents or carers failing to ensure a child receives a suitable education.7 Parents may choose to provide their child with a suitable education by sending them to school or through home education. Some parents and their children may need support to enable engagement in education and where parents make reasonable efforts to engage with this support a common sense approach should be taken in reaching a decision about whether there is educational neglect. Arrangements for responding to children of statutory school age who are missing education are set out in the Welsh Government statutory guidance this guidance should be followed in the first instance. Each local authority and school has a responsibility to attempt to trace all children who cease to attend education. This is vital as there is always a possibility that the child or young person may be missing because they are at risk of significant harm. An All Wales Practice Guide on Safeguarding home educated children is also available and updated Statutory Guidance on Elective Home Education including safeguarding information is to be issued.

The following characteristics of neglect may make it harder for practitioners to recognise that a threshold for statutory intervention has been reached8:

Evidence base

A proportionate response

When a child has been reported under section 130, the local authority must consider whether there are grounds for carrying out an investigation under section 47 of the Children Act 1989.

Appendices

These organisations are there for all children and young people in Wales. Practitioners should let children know about these organisations and how to contact them.

Meic is the helpline service for children and young people up to the age of 25 in Wales. From finding out what’s going on in your local area to help dealing with a tricky situation, Meic will listen even when no-one else will. They won’t judge you and will help by giving you information, useful advice and the support you need to make a change. You can:

You can contact the Children's Commissioner for Wales Investigation and Advice service which is free and confidential. It’s there as a source of help and support if children and young people or those who care for them feel that a child’s been treated unfairly. You or you parent/carer can:

Childline is a free, private and confidential service where anyone under 19 can access support and advice. The Childline website www.childline.org.uk has information and advice pages as well as tools to help you work through problems yourself. If you want to talk or chat to Childline you can:

If you want to talk to Childline in Welsh see www.childline.org.uk/get-support/

Serious Crime Act 2015: Part 5 Protection of children: Child cruelty offence (Section 66)

Section 1 of the Children and Young Persons Act 1933 (“the 1933 Act”) provides for an offence of child cruelty. This offence is committed where a person aged 16 or over, who has responsibility for a child under that age, wilfully (i.e. intentionally or recklessly) assaults, ill-treats, neglects, abandons, or exposes that child in a manner likely to cause “unnecessary suffering or injury to health”; or causes or procures someone else to treat a child in that manner. The maximum penalty for the offence is ten years’ imprisonment or a fine or both.

The 2015 Act amends section 1 of the 1933 Act to make it explicit that the offence covers conduct which is likely to cause psychological suffering or injury as well as physical harm; and that ill-treatment could either be physical or non-physical. In terms of non-physical behaviour the Government has given (outside the Act) the examples of isolation, humiliation or bullying, if it is likely to cause unnecessary suffering or injury to health.

It also extends the 1933 Act provisions that deem the suffocation of a child under three years when in bed with a drunken person to constitute child neglect to:


1 https://learning.nspcc.org.uk/media/1067/how-safe-are-our-children-2018.pdf

2 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/175391/Munro-Review.pdf

3 Social Services and Well-being Act (Wales) 2014 http://www.legislation.gov.uk/anaw/2014/4/pdfs/anaw_20140004_en.pdf

4 https://www.nscb.org.uk/sites/default/files/Emotional%20Abuse%20Practice%20Guidance.pdf

5 Hanson, E. (2016) The relationship between neglect and child sexual exploitation: an evidence scope. Totnes: Research in Practice.

6 Emotional neglect and emotional abuse in pre-school children: Core info leaflet which can be downloaded from: https://learning.nspcc.org.uk/research-resources/pre-2013/emotional-neglect-abuse-pre-school-children-core-info-leaflet/

Neglect or emotional abuse in children aged 5-14: Core info leaflet which can be downloaded from: https://learning.nspcc.org.uk/research-resources/2014/neglect-emotional-abuse-children-aged-5-14-core-info-leaflet/

Neglect or emotional abuse in teenagers: Core info leaflet which can be downloaded from: learning.nspcc.org.uk

7 Parents have a duty to ensure that their children receive an efficient full-time education suitable to their child either by regular attendance at school or otherwise (under section 7 of the Education Act 1996) and they may choose to arrange this education themselves outside the state or independent school system.

8 http://www.cwrc.ac.uk/documents/RR404_-_Indicators_of_neglect_missed_opportunities.pdf

9 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachmentdata/file/379747/RR404-_Indicators_of_neglect_missed_opportunities.pdf

10 Brandon M, Bailey S, Belderson P, Warren C, Gardener R. and Dodsworth J. (2009). Understanding Serious Case Reviews and their impact. London: Department for Children, Schools and Families.

11 https://learning.nspcc.org.uk/media/1145/child-neglect-an-evidence-scope-executive-summary.pdf

12 Pithouse, A. and Crowley, A (2016) ‘Tackling child neglect: key developments in WalesResearch, Policy and Planning (2016) 32(1), 25-37

13 See 6 above.

14 Farmer E. and Lutman E. (2014). Working effectively with neglected children and their families – what needs to change? Child Abuse Review, 23, pp 262-273.

15 https://learning.nspcc.org.uk/media/1334/learning-from-case-reviews_disguised-compliance.pdf

16 NSPCC (2018) How Safe are our children? https://learning.nspcc.org.uk/research-resources/how-safe-are-our-children/

17 Brandon, M., Sidebotham, P. Bailey, S., Belderson, P. Hawley, C., Ellis, C and Megson M (2012) New learning from serious case reviews, Department for Education. Research Report DFE-RR226

18 Brandon M, Bailey S, Belderson P. and Larsson B. (2013). Neglect and Serious Case Reviews. University of East Anglia/NSPCC