Lancashire Multi-Agency Neglect Strategy 2022–2024

Foreword

Phillippa Williamson
Leader of Lancashire County Council

I am pleased to present the Lancashire Neglect Strategy 2022-2024.

The aim of this strategy is to provide an overarching view of the response to neglect in Lancashire.

This strategy encapsulates the approach we are taking to neglect in the Lancashire County Council area and is the foundation to other policies and approaches aimed at addressing neglect and improving outcomes for children and families. It is a key part of our vision to make Lancashire the best place to live, work, visit and prosper and to ensure that our children are safe, healthy and achieve their full potential.

Since the previous strategy was implemented our pan Lancashire Children’s Safeguarding Assurance Partnership (CSAP) has identified neglect as a priority area and as a partnership, we are working to address neglect in Lancashire.

We recognise the importance of supporting children and families early and have invested significantly in our Children and Family Wellbeing service which provides early help to families. We have implemented the Family Safeguarding Model which has already shown the benefits in supporting children and families in a strength-based way. We have invested in the implementation and roll out of the NSPCC Graded Care Profile - a further tool that will help in both identifying and improving outcomes for children experiencing neglect.

This is a partnership strategy as our aim in Lancashire is to have developed a truly multi agency response to families. That is why partners have played a key role in its development. By working together, we will see improvements in the health of our children and families, improvements in their educational achievement and reductions in the numbers of children having to be cared for outside of their families.

This neglect strategy has been developed by listening to the children and the families that we serve. Our best measure of success will be hearing them tell us that we have improved their lives.

Overarching principles

What we have achieved so far:

This is our third neglect strategy in Lancashire. This version builds upon the foundations laid by the previous strategies.

What that strategy helped us achieve as a partnership included:

• Multi-agency operational group established and driving the neglect agenda across the Lancashire County Council footprint
• Improved partnership working across the Lancashire County Council footprint
• Improved working relationships across the pan-Lancashire footprint
• Raising awareness and understanding of neglect during the pandemic
• Implementing Family Safeguarding and an approach to working with families that builds upon their strengths and supporting parents with some of the key factors found in neglect - specifically substance misuse and mental health problems
• Working with partners internally and externally such as the DWP to encourage the take up of 2-year Early Years Education funded placements
• Undertaking multi agency audits to develop practice
• Agreed to adopt the use of the NSPCC Graded Care Profile 2
• Spending time listening to children and hearing and understanding their lived experience

What our new strategy will do

• Listen to the voice of the child and their lived experiences and reflect that in our work with children and families.
• Elevate child and adolescent neglect to the highest level of awareness and priority that this single most prevalent form of child abuse merits.
• Build upon the foundations of multi-agency strategic buy in to address neglect, with multiagency governance and operational approach.
• Deliver a well-trained multi-agency workforce confident in tackling neglect and a public that recognises and reports neglect.
• Ensure that we have approaches and polices in place to address the different elements of neglect.
• More effectively mitigate the impact this form of child abuse has on children and young people.
• Reduce the number of children that suffer neglect and reduce the impact and time they suffer.

Pan-Lancashire principles in respect of neglect

This Lancashire Neglect Strategy is guided by the below overarching Pan-Lancashire principles in respect of neglect.

• We have the safety and wellbeing of the child at the heart of everything we do, and we are aspirational that every child should achieve their full potential.
• We will work in a trauma informed way, seeking to understand the lived experience and behaviours of the child and their family.
• We recognise that neglect is multi-dimensional and that children may have their medical, nutritional, emotional, educational, physical or supervisory needs neglected. These forms of neglect can have different impacts at different stages of a child’s life, from pre-birth through to adolescence and can have an enduring impact for the rest of their life.
• Each organisation, whether working with children or adults, will have a different role but all have a responsibility to work collaboratively to bring their unique perspective to the partnership assessment and response.
• We will adopt an evidence-based approach, appropriate to the family’s unique circumstances. We will upskill our workforce and communities to prevent, identify and provide the right support in the right place at the right time.
• We will have shared evidence-based tools to assess neglect and inform our partnership offer of support.
• We will seek to work with families, positively to build on their strengths and collaborate to help them to find their own solutions.
• We will seek to develop a positive culture and use language that explores and explains the impact of neglect so that families feel respectfully challenged and are supported to understand the concerns. For example, talking about ‘was not brought’ instead of ‘did not attend’.
• Children can experience neglect in all socio-economic groups, but where they and their families are living in poverty it can be challenging to differentiate between their unmet needs and neglect. We will ensure that we support our workforce to differentiate between unmet needs and those children who are experiencing or at risk of significant harm.
• We will understand the prevalence of neglect in our area and evaluate the impact of the support that we provide to families.

The views of others in Lancashire

Children in Lancashire’s views of neglect

Our strategy will only work if we make a difference to children and families in Lancashire. To help guide and formulate this strategy, we worked with children and young people to hear their views.

We have gathered some of the experiences and thoughts of those children and young people who have experienced neglect. Through our safeguarding surveys, they have told us that they do not understand the term ‘neglect’ and would not know how to spot the signs or how to support a friend who was experiencing neglect.

What young people have said neglect is and what it feels like:

• "Feeling alone"
• "It means overlooking or ignoring someone’s needs or wants. Pretending or being forgotten by someone. Not taking care of things."
• "Not taking responsibility"
• "Not being there emotionally"
• "Ghost"
• "When no one bothers about you"

Professionals in Lancashire’s views of neglect

As well as children and young people, this strategy must involve the professionals who are support them. That’s why we undertook a survey of professionals’ views of neglect and what our approach to neglect should be within Lancashire. Some of the feedback from professionals is set out below:

• "Use plain, clear language"
• "Better understanding of outcomes"
• "Early identification of neglect is vital"
• "Voice of the child"
• "Underpinned with quality multi-agency training"
• "Measurable action plans"
• "Long term neglect requires long term solutions"
• "Definition of neglect needs to be clear and consistent across partner agencies"
• "Shared understanding of neglect across all partners"
• "Prevention and early intervention is paramount"
• "Support and focus on root causes - poverty, mental health, substance misuse, domestic abuse"

The current picture of neglect

Neglect the Lancashire context

Neglect continues to be an area of priority and focus in Lancashire. Alongside domestic abuse, neglect is one of the main reasons that Lancashire County Council and its partners support families at an Early Help level. As a result, it is a key reason that ‘Requests for Support’ are made to Children’s Services and that support is provided either by the Children and Families Wellbeing Service or Children’s Social Care.

Children who are experiencing neglect:

• make up over 40% of all children supported by Children and Family Wellbeing
• are 40% of the reasons children require the support of a Child in Need plan

In terms of neglect, over 30% of all the children looked after by Lancashire County Council experienced significant neglect prior to becoming looked after. 30% of children who are on a Child Protection plan in Lancashire are on the plan due to neglect.

Neglect impacts upon our communities our children and their families. Whilst poverty should never be equated with neglect, poverty can impact upon resilience and lead to neglect occurring. Within Lancashire, Burnley and Hyndburn are home to two areas in the 10% most deprived parts of the country. Lancaster, Wyre, Pendle and Preston are in the 20% most deprived areas. You can read more about the relationship between poverty and child abuse and neglect on the Joseph Rowntree Foundation website.

Neglect can be viewed narrowly, such as imagining a child living in poor home conditions and lacking material comforts, such as clean clothing clean bedding and toys. Whilst this sadly isn’t uncommon, there are many and various forms of neglect. However, neglect isn’t about just the physical environment a child experiences. A child who is not being supported by their parents or carer to receive education or a child with health conditions who is not being supported to receive the medical support they require could both be described as experiencing neglect.

The impact of the pandemic on children and families in our county should not be underestimated. Lancashire experienced very high rates of Covid-19 infections within our communities. School readiness of our youngest children has been disrupted and the impact upon the emotional and mental health of students has been significant. For those children who are experiencing neglect, these impacts are far greater.

What is neglect?

The definition of neglect from statutory guidance ‘Working Together to Safeguard Children’ (HM Government, 2018) is:

‘The persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health and development. Neglect may occur during pregnancy as a result of maternal substance misuse. Once a child is born neglect may involve a parent or carer failing to:

a) Provide adequate food, clothing and shelter (including exclusion from home or abandonment)
b) Protect a child from physical and emotional harm or danger
c) Ensure adequate supervision (including the use of inadequate care givers)
d) Ensure access to appropriate medical care or treatment

It may also include neglect of, or unresponsiveness to a child’s basic emotional needs.

As well as the statutory definition, it is necessary to recognise the specific needs of children and in turn understand ‘failure to meet basic needs’. Neglect is defined as “the ongoing failure to meet a child’s basic physical and psychological needs” (Department for Education, 2018; Department of Health, 2017; Scottish Government, 2014; All Wales, Child Protection Review Group, 2008). It is a form of child abuse that can have serious and long-lasting impact on a child’s life - it can cause serious harm and ‘The persistent failure to meet a child’s basic physical and/or psychological needs, even death.

The main types of neglect are:

Physical neglect - not meeting a child’s basic needs, such as food, clothing or shelter; not supervising a child adequately or providing for their safety.

Educational neglect - failure to ensure a child receives an education.

Emotional neglect - failing to meet a child’s needs for nurture and stimulation, for example by ignoring, humiliating, intimidating or isolating them, witnessing the harm of another.

Medical neglect - not providing appropriate health care (including dental care), refusing care or ignoring medical recommendations. Minimising, denying, exaggerating and/ or inducing a child’s health needs.

Nutritional neglect for example, obesity and failure to thrive and lack of supervision and guidance, for
example, monitoring on-line activity or whereabouts when out alone when out alone

The impact of neglect

Pre-birth a child can experience neglect at any age. The impact of neglect can start before birth – a mother may neglect her own (and therefore unborn babies) health during pregnancy which would affect the development in the womb. Once a baby is born, physical and emotional neglect during the early years of life can also have a profound impact on the development of the brain and the body. Infancy (birth to two years) babies’ growth and development is linked to their interaction with the world and their caregivers. Emotional and cognitive development, for example games like ‘peek-a-boo’ where actions are repeated for social and emotional reinforcement from the reactions of caregivers, and neural connections are ‘fixed’ through stimulation.

Disinterest or indifference to such actions and/ or failing to offer stimulation will limit the child’s development and growth. A secure attachment to a primary caregiver is the foundation that allows children to learn to trust others and explore the world around them. Studies have shown that children with disrupted attachment who have experienced neglect have problems coping and managing emotions, are more hopeless, and have a poor self-concept. The ongoing nature of chronic neglect significantly impacts the brain in infancy and early childhood.

Pre-school (two to four years)

Most children of this age are mobile and curious, but lack understanding of danger; they need close supervision for their physical protection, which neglected children may not experience. Children may not be appropriately toilet trained if they are in neglectful families, as this process requires patient and persistent interaction and encouragement. Children’s language development may be delayed if their caregivers are not interacting with them sufficiently, and physical care may be inadequate, for example dental decay.

Primary age (five to eleven)

For some neglected children, school can be a place of sanctuary. However, if their cognitive development has been delayed and they are behind their peers at school, it can also be a source of frustration and distress. Signs of neglect, for example dirty or ill-fitting clothing, will be apparent to peers, teachers and to the children themselves, and may cause embarrassment and difficulties in their social interactions. Children without clear and consistent boundaries at home can struggle to follow school rules.

Adolescence (twelve to eighteen)

Neglect is characterised by the absence of a relationship of care between the parent/carer and the child and the failure of the parent/carer to prioritise the needs of their child. It can occur at any stage of childhood, including the teenage years. Adolescents are often viewed as being more resilient than younger children but, as referenced by the Children Society report ‘Understanding Adolescent Neglect – Troubled Teens’, they still need dedicated care to meet their physical and emotional needs and to support their education and to keep them safe. A lack of attention to any, or all, types of care can be neglectful to adolescents and create a catalyst for poor well-being and risky behaviour that can jeopardise a young person’s health and future prospects.

Children and Young People with disabilities

Children and young people with disabilities are one of the most vulnerable groups in terms of safeguarding their wellbeing because they trust and rely on their caregivers to be sensitive to their personal care needs, their health, their emotional well-being and their safety. Disabled children may be especially vulnerable due to a number of reasons; for example, they may:

• have fewer outside contacts than other children do.
• receive intimate care, possibly from a number of carers, which may both increase the risk of abusive behaviour and make it more difficult to set and maintain physical boundaries.
• have an impaired capacity to resist or avoid abuse.
• have communication difficulties which may make it difficult to tell others what is happening.
• be inhibited about complaining through fear of losing services.
• be especially vulnerable to bullying and intimidation.
• be more vulnerable to abuse by peers.

Priorities and action plan for 2022-2024

Our priorities

Priority 1

Children, including unborn, young people and families being at the heart of everything we do.

Priority 2

Continued strategic commitment across partner agencies.

Priority 3

Intervene and support at the earliest point possible.

Priority 4

Improve awareness, understanding and recognition of neglect in all its forms.

Priority 5

Evidencing the impact of outcomes of what we have achieved both for individual children and more broadly on the Neglect agenda.

Making our priorities happen

Action plan

The action plan associated with this Neglect Strategy sets out the key actions we think we need to do to achieve our priorities. This will be reviewed and updated quarterly to ensure delivery of this strategy.

Governance

The governance of this Neglect Strategy will sit with Lancashire’s Keeping Children Safe Board. We will also report into Children’s Safeguarding Assurance Partnership (CSAP). An agreed data set will be shared including the roll out of the Graded Care Profile Training will be shared at each board. In addition, every quarter, a report will be provided updating the Keeping Children Safe board as to the work being undertaken and the impact of that work.

Operationally, the plan will be driven via Lancashire’s Neglect Operational Group. This group is a multi-agency
group that includes all key partners. 

This operational group will drive the action plan and the implementation of the Graded Care Profile. It will coordinate scrutiny of the impact of this strategy through activity including audit.

Measuring success

The success of the strategy will be measured based on a range of quantitative and qualitative measures set out in this strategy. Several measures will be monitored and reported through the governance arrangements. These include:

• Multi-agency audits of children known to plans show good impact of the plan and use of the Graded Care Profile (GCP).
• The independent review of children in need plans for neglect shows effective planning and impact and good use of tools.
• Feedback from parents collected at Early Help Child in Need, initial child protection case conference, child protection case review meetings and at case closure.
• Young people’s views of neglect through participation forum’s/surveys/feedback following the completion of Early Help intervention and at Children in Need, initial child protection case conference, child protection case.
• Feedback from frontline staff through frontline visits/surveys.