Neglect 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 or development.
Neglect may occur during pregnancy as a result of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to:
- Provide adequate food, clothing and shelter (including exclusion from home or abandonment)
- Protect a child from physical and emotional harm or danger
- Ensure adequate supervision (including the use of inadequate care givers)
- Ensure access to appropriate medical care or treatment
It may also include neglect of, or unresponsiveness to, a child's basic emotional needs.
However, specific needs which are often considered under the banner of failing to meet 'basic needs' include:
- Medical neglect
- Nutritional neglect
- Emotional neglect
- Educational neglect
- Physical neglect
- Lack of supervision and guidance
As a coordinated multi-agency response to address neglect, the SSCP has developed the Salford Neglect Strategy for children, young people and families which has been developed in conjunction with the Salford Early Help Strategy. A key component of the strategy is the use of the Graded Care Profile.
Graded Care Profile - a tool for assessing neglect
The Graded Care Profile (GCP) was originally developed as a practical tool to give an objective measure of the care of children across all areas of need by Drs. Polnay and Srivastava. The profile was developed to provide an indication of care on a graded scale. It is important from the point of view of objectivity because the ill effect of bad care in one area may be offset by good care in another area. This has recently been redeveloped by Dr Bruce Thornton to meet Greater Manchester requirements within a range of tools as part of the Multi-Agency Risk Assessment Model.
It is a descriptive scale. The grades indicate quality of care and are recorded using the same 1 to 5 scale in all areas. Instead of giving a diagnosis of neglect it defines the care showing both strengths and weaknesses as the case may be. It provides a unique reference point. Changes after intervention can demonstrably be monitored in both positive and negative directions.
It can be used to improve understanding about the level of concern and to target areas of work as it highlights areas of greater risk or poorer outcomes. It should be used in all cases as soon as there are concerns of neglect. The Profile can be used with the family by individual workers, or groups of workers to inform assessments and reviews across the thresholds of need. Where factors associated with neglect are identified, the GCP should be used at the earliest opportunity in partnership with families and actions identified incorporated into any corresponding plans.
Finally it should be remembered that it provides a measure of care as it is actually delivered irrespective of other interacting factors. In some situations where conduct and personality of one of the parents is of grave concern, a good care profile on its own should not be used to dismiss that fact. At present it brings the issue of care to the fore for consideration in the context of overall assessment.
Multi-Agency Risk Assessment Model Tools
'The Multi Agency Risk Assessment Model (MARAM) is a framework for screening and assessing risk in services for children and families. It assists agencies to accurately identify levels of need in working with families.
The Multi Agency Risk Assessment Model includes two key components.
- Risk Screening followed by the Risk Assessment are tools that check cases for indication of concerns about significant harm in relation to children. These will be implemented in different ways by different agencies. It should however, include:
- Asking the critical question, 'do you have any concerns about significant harm?'
- Recording your decision
- Acting on the decision
- Screening routinely and regularly
Risk Assessment is a detailed framework for undertaking an assessment of the risk of significant harm. It explores components including the capacity of parents, the child's needs, level of harm, prediction for the future and what may make harm, significant. Assessing the threshold of significant harm guidance is also available to accompany the Risk Assessment form.
The MARAM framework is also supported by
- Two Assessment Tools for Understanding Neglect
- Three Assessment Tools for understanding Capacity to Change
- 7 Steps of Contemplation
- Continuum of Motivation
- Change Checklist
Further information on the MARAM tools, guidance and leaflets are available on the secure upload page. All completed tools can be submitted via secure upload to be attached to the individual child's file. Seminars on the Graded Care Profile are available to support managers and practitioners.
Worried about a Child
All enquiries concerning the welfare or safety of a child must go through the Bridge Partnership on the online referral form.
If you have any safeguarding queries, please call The Bridge Partnership on 0161 603 4500 (Monday to Friday from 8.30am to 4.30pm). If you need to speak to somebody outside these hours, please call the Emergency Duty Team on 0161 794 8888.
If you have any queries around early intervention and prevention services or submitting the MARAM tools via secure upload, please call 0161 603 4239.
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