Child neglect has become a much larger part of child protection work in recent years. It is the failure to meet a child’s basic physical needs for food, shelter, clothing, or medical care, or provide protection from harm or danger, and often includes emotional neglect. However, the findings of the recent Haringey Review of family 'Z', which looked at a case where social work practice fell short in a case of neglect, does nothing to help social workers developing their skills in this area.

This Review pilots the new systems methodology for Serious Case Reviews which is currently being promoted by child protection 'experts'. This offers a non-judgemental approach to the study of the whole system which is thought to be better for allowing errors linked with poor system design to be identified and used as opportunities for constructive learning.

The Review examines the background to events leading up to ten children aged from eight months to sixteen years being taken into care and their mother and partner being sent to prison for child cruelty. It recognises that social workers allowed these children to be exposed to suffering and cruelty for at least five months too long. However, its analysis of the reasons for this is seriously flawed.

The non-judgemental approach of this Review explains why Haringey was so dysfunctional but offers no answers. Haringey was dealing with the aftermath of the tragic deaths of Victoria Climbie and, more recently, baby Peter and there were obviously enormous pressures on staff. However, this Review does not get to grips with fundamental weaknesses in dealing with child neglect and contributes nothing useful to the current debate about the way services are organised for neglected children.

A 'common-sense' approach to this Review would have concluded that there was an authority-wide failure to protect these children; social workers did not take the necessary protective action and allowed the situation to deteriorate until it reached the stage of criminal neglect. This kind of honesty and clarity would have been a useful starting point.

The Review reveals many shortcomings in social work practice but one is so serious that it raises questions about the competence of managers. This is the decision of a Child Protection Conference to remove the children from the Child Protection Register. The Conference had heard that a multi-agency risk assessment had not been carried out, there was a known history of domestic violence, the parents had not co-operated in multi-agency planning meetings and the children were not registered with a GP. The person who chaired the Conference showed very poor professional judgement and there really was no excuse for this mistake. The children should have been kept on the Register and a comprehensive assessment carried out. Once the Chairperson had given away the power that social workers hold it was then very difficult for them to recover from this fateful decision - and their sense of powerlessness had a devastating effect on subsequent work.

Obviously, it is possible that, even if the children had remained on the Register, the standards of care may not have been raised significantly. Extensive 'drift' in neglect cases is not unusual. It often requires considerable commitment and hard work on the part of the social worker to find ways of raising standards to an acceptable level and maintaining them. Nevertheless, post-registration work provides a child protection plan and system of review which leads to more intensive assessment, monitoring and decision-making than that provided by preventative services delivered to voluntary families. In addition, the formal structure provided by registration makes it easier to remove children through Care proceedings if necessary without waiting until there is sufficient evidence for criminal proceedings.

The Review does not explain why this was case was not treated as high priority when the profound vulnerability of these children was never hidden. Cumulative evidence that the children were suffering chronic neglect was on file and one social worker had noted the presentation of the younger children as 'flat' and 'unresponsive' - a classic sign of neglect. The real problem may not have been a lack of understanding of neglect, as the Review suggests, but a belief that there was nothing social workers could do about it.

A major flaw in the Review is the absence of any discussion of the nature of intensive social work with families where a child is on a 'Child Protection Plan' (a term introduced in England to replace the Child Protection Register). It is not clear where responsibility for this type of work is located in the organisation. 'Family support services' and 'Emergency response' are apparently distinct services (though support services for neglect were a myth and child protection teams were struggling to provide an emergency response). However, it is surprising that this Review does not recognise the significance of 'Long term child protection work' - an important relationship-based model of practice which combines support and protection and aims to prevent the need for children to be taken into care. The lack of attention to this area of social work suggests that it is given low priority within the organisation.

It can only be assumed that the Review thought that social workers working preventatively would have the skills to protect children and provide any controls that were deemed necessary. Family support social workers may understand their safeguarding role but their focus on meeting needs makes it difficult for them to think clearly about risks, especially if they do not have good supervision. Many Serious Case Reviews reveal an exaggerated belief in the effectiveness of social work support in transforming seriously dysfunctional families and an inability to recognise clear signs of 'significant harm' to a child.

Many newly qualified social workers have insufficient understanding of the dilemmas involved in combining support and investigation. They leave university without the necessary skills in assessment, without a sound knowledge of normal child development and lacking the confidence to make judgements about risk. Their difficulties are compounded by the widespread uncertainty over the definition of neglect and lack of clarity over thresholds for initiating child protection procedures. There is an urgent need for the profession to clarify roles, develop staff expertise and provide training to improve social work practice so that child protection responsibilities in cases of neglect are better understood.

Some of the problems in dealing with neglect are linked with the Children Act 2004 - which has brought more cases of neglect into the remit of children's services and stretched their resources to breaking point. Neglect is the most common initial category of those made subject to a child protection plan and the total number of children registered has risen by 30% in five years. However, policies to promote the welfare of neglected children are now in conflict with managerial pressures to control workloads - and in the more dysfunctional authorities this means that neglect is given low priority.

Overall, this Review has completely missed the point. It should have concluded:

"Social workers need the skills to separate out less serious cases of neglect from those which need a robust and sustained approach. Managers must recognise that neglect case often need longer term support and children may need to be on the child protection register for years rather than months. Social workers doing this work should focus more clearly on the practical aspects of parenting, such as the physical conditions in the home, safety issues, budgeting, hygiene, food preparation, and also mobilise resources to educate difficult parents in improving the physical and emotional care of their children. Parents should be aware that, if they do not raise their standards of care, they may face care proceedings or even be dealt with through the criminal court."

The time for endless Reviews and platitudes is over; neglected children deserve something better than this. Urgent action is required to ensure that child neglect is recognised as a problem that should be given greater priority. Social workers need appropriate training to give them the skills and confidence to intervene effectively. They also need support from managers to ensure they remain alert to risks and take appropriate protective action.

Hilary Searing

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