14.40 – 15.10 Dr Aideen Naughton

Q: How can you use this knowledge about the impact of Neglect on the development of children and young people (like Aaron, Janet, Shelley and Jack) to inform they key components of interventions at each three stages? To prevent Neglect before it has started?

Table 1

  • Early identification and intervention – training & education to all service areas who may come into contact with family.
  • Raise with family concerns and help them to identify recognise and accept so that they are receptive of help.
  • Know what to do, when you have a concern and how to make a referral make it early enough.
  • Make sure services put in are meeting the needs of the whole family.
  • Close monitoring by agencies and not to be afraid to seek advice.
  • Open lines of communication to build the bigger picture. Often the use of confidentiality is an excuse.

Table 2

  • Assessment and identification very early on – other children.
  • Information sharing – G.P.
  • Even identifying risk at antenatal stage – what’s mum’s experience? Of being parented (family assessment tool)
  • Other children/attitudes towards pregnancy.
  • Are they attending anti – natal appointments?
  • Parenting courses
  • Sure Start/Social Services Child in Need Referral/Families First.

Table 3

  • Review education system – basic life skills
  • Break the cycle of neglectful parenting – parenting skills
  • Develop emotional intelligence – parents and children.

Table 4

  • Early detection through trigger points
  • Communication – early stages – midwife stage
  • Education (Parents) – obtaining knowledge of parents.
  • Community based projects – education via camm members
  • Flying Start – Area specific issues.
  • Specifically directed at socio-economic classes.

Table 5

  • Early intervention. Talking/sharing information with other agencies.
  • Early recognition (Shelly) Recognising change – stress points.
  • Recognise the support needed before it started.
  • Recognising resilience – long term support system (Brain Development) identify needs. What can be resolved by intervention?
  • Work with families where all four case examples are in the same family!!
  • Pre-birth: Education & Intervention.

Table 6

  • Antenatal education – maintaining aspirations and high expectations after the birth of the child.
  • Questionnaire about their won childhood experiences – pregnant women. To highlight and support parent/s (Early Intervention).
  • Traffic light system to assess need/s of mother/parent.
  • Education children/schools.

Table 7

  • Education – parents work on thresholds and parenting classes antenatal Flying Start – positive role models.
  • Education in schools – embedded in curriculum sexual, self-esteem, DA, substance misuse, mental health, exploitation programme of preventative work.
  • Programme of preventative work.
  • Attachment – education, child development.
  • Training on child development for professionals – all agencies sharing knowledge on Neglect.
  • Education around resilience factors. Develop interventions based on knowledge about resilience factors for families and individuals.

Table 8

  • Education
  • Appropriate relationships
  • Starts before parenthood
  • Breakable before becoming parents
  • Link theory – everyday life.
  • Reinforce – due to previous concerns at birth.
  • Early identification.
  • Break down barriers.

Table 9

  • Counselling and supporting Shelly on the death of her father reference to young carers.
  • Jack – school history and attendance looked at by supporter in supported housing. Housing support to look at reasons for stealing – should have been looked into.
  • Paralleling groups – offered when HV, Child Protection referral for Aaron – DNA +.

Table 10

  • Sharing information/concerns.
  • Training for parents/professionals to increase awareness.
  • All take responsibility for safety of children – increase public awareness and understanding.
  • Be clear what neglect is?
  • Society has to be clear what is ok? And what is not?
  • Understanding the harm to the child including the unborn child.
  • Identify early point and intervene proportionality.
  • Make Flying Start and other initiatives across the board not postcode lottery.
  • Confidence is no challenge – support/supervision/confidence to do so. This should be in all three boxes.

Table 11

  • Pre-birth intervention plans based on previous risk assessment of a particular family.
  • Sharing and digesting of information already held on a family.
  • Identification of changes in relationship dynamics (e.g. domestic violence beginning)
  • Relying on strong referral procedures/support referrals in schools.

Table 12

  • Putting resources into early intervention measures.

Table 13

  • Vigilance
  • Educate all Mum’s and Dad’s – what it is like to have a baby – bring up baby, especially the indicator of psychopath if not reacting when his mother left/returned.
  • Using our understanding Aaron to identify signs.
  • Tier 1 – Health & Education to teach all young people about early child development (more then on PHSE on contraception).

Table 14

  • Promoting parents to produce support with children’s development!
  • Antenatal visits – pre-birth – family history – historical indicators.
  • Social Work & CS should intervene quicker and not allow it to drift.
  • Disguised compliance – too SW, HV, Schools and other agencies to positive about parents progress and engagement!
  • All agencies have a duty to share and have a responsibility to Child Protection.

Table 15

  • Multi-agency services – communication – liaison between Midwives, Health Visitor & Flying Start.
  • Early intervention – pre birth assessment.
  • Wider general knowledge about child development.
  • Work in schools about these issues.
  • Relative rather than pro-active services.
  • TAFF/JAFF
  • Family information service.

Table 16

  • Flying Start – Sure Start (Flying Start as part of generic services?).
  • Monies into Health Visitors (For them to pick all children).
  • Invest monies into what services like Health Visitors (Equality and equity is needed for equal number of visits per family).
  • No register.

Table 17

  • Ensure parents have the skills to become parents (Parenting Classes).
  • Early identification/intervention 0-3 months.
  • Breaking the cycle through Education/Backs to basics.

Table 18

  • Early intervention – Family support.
  • Education – Parenting at schools.
  • Breaking the cycle – Teaching children how to be’good’ parents.
  • More Health Visitors.

Table 19

  • Shared awareness of Neglect across all services and more fluidity of threshold between services i.e. between statutory and preventative.
  • Further debate about those families that need long-term and on going services – why not.

Table 20

  • Raise awareness – to all – Education, Young person, young parents, new parents, pre-natal and PSE Lessons.
  • Education in Schools.
  • Recognising triggers – alcohol and drugs.

Table 21

  • Alcohol Worker – reflects on working with adults about the impact of their behaviour on their children.
  • Educating teenagers and showing them about Neglect/becoming parents early. Why their behaviours are as they are?
  • Training to staff in voluntary sectors about Neglect.
  • Neglect training alongside personal education (Social) and sexual education in schools to young people.
  • More support for parents via the school to train around Neglect. Schools working with children and parents.
  • HV training should be around Neglect to look at how this impacts brain development for example.
  • Nurseries offer early intervention and support where needed. However, it is capacity to take this up.

Table 22

  • Address issues across family.
  • Training/Awareness.
  • More preventative services.
  • Mother & baby work/ Health Visiting.
  • Help parents understand it and its impact.
  • Identify triggers.
  • Need for more therapeutic services.
  • Being consistent and maintain relationships.

14.40 – 15.10 Dr Aideen Naughton

Q:To intervene when problems first arise?

Table 1

Make sure those workers: -

  1. Listen to the child and keep their feelings/views etc at the forefront of everything you do.
  2. Look at what has been done before and consider any differences and will it work this time.
  3. Make sure correct intervention is put in.
  4. Timely and measurable interventions.

Table 2

  • Does the School Health Nurse know about the situation?
  • Find out if there has been previous intervention?
  • Communication – multi-agency approach
  • What support services can be accompanied – dependent on the area?
  • Ask the parents what they think.
  • Ask the child.
  • Setting time limits when plans are in place.
  • Professional engagement at all levels and not withdrawing at later stages when things are perceived to be ok.

Table 3

  • Improve access to support services (CAHMS) – Ed Psyc.
  • Parental support courses.

Table 4

  • Children and young people with learning difficulties are an extremely vulnerable population.
  • Is there any research being conducted in the way this group of children are being assessed and needs are being met.
  • Delay in interviewing – agency sharing of information.
  • Issues of research led.
  • Issues of children perspectives.
  • Issues with regard to gate keeping and intervening. Barriers to consent to refer to family and other Child Protection concerns.
  • Social Services department image with regard to Child Support Services.
  • Good local ex-agency intervention (Outside SSD).

Table 5

  • To intervene early. Recognise the ‘’patterns’’ (Do we work with hindsight).
  • Educate.
  • What are we able to do? Routine. Break the cycle.
  • Law – what do we keep allowing the parents to keep doing?

Table 6

  • Preventative support
  • Use of child Neglect tools.

Table 7

  • Being aware of resources – where to refer effective intervention. Building confidence in professionals being decisive – identifying Neglect early on x taking action.
  • Universal assessment tool that can be used by all agencies.
  • Greater – More fluid information sharing. Live WASPI – working document that everyone signs up to.
  • Positive working relationships.
  • Clear risk assessment and management.

Table 8

  • Antenatal focused on mother not child.
  • Early intervention or pause and look at what is actually happening.
  • Recognise – manage – escalate.
  • Look at the triggers and recognise use of toolkits.

Table 9

  • Training brought to a younger age – raising awareness more true/reality based campaigns from agencies, housing to raise awareness of their laws.
  • Llamau e.g. carry out schemes to help young people. Who intervenes – other agencies are reluctant to challenge.

Table 10

  • Understanding attachment, what Neglect is?
  • Identify and report Neglect at earliest opportunity.
  • Use preventative and universal services.

Table 11

  • Consistent engagement with continuity of practitioners where possible so trust can be built up.
  • Engagement with children to understand what day-to-day life is like.
  • Pro-active intervention to break cycle of Neglect.

Table 12

  • Role of step up and step up services to prevent courses going in and out of services. Child in need. CP.
  • Don’t give in to professional optimism.
  • Being able to tap into resources to prevent escalation.
  • Social Services are reaching other agencies and are likely to pick up early signs.

Table 13

  • Get a more knowledgeable about incidents and know how to raise concerns and be less territorial between services.
  • Clear pathways for support.
  • Data Protection (impact of postal regulations etc.)
  • Get all parties together.
  • The child is a victim not the problem.
  • Schools could disseminate on phone call time so services can contact staff.

Table 14

  • Promote and support as soon as possible, when problems arrive don’t allow blockages or drift! Concerns need to be truthful even when parents are in the room or have a right to the copies of the concerns!

Table 15

  • Assessment leading to services.
  • Co-operation/voluntary working rather than SSD ‘intervention’.
  • Support rather than intervene but using intervention when necessary.

Table 16

  • So are we intervening because we have concerns about: -

- Couples counselling for families to strengthen the relationship on the model of appropriate parenting. In the case of Domestic Violence working with the perpetrator to reduce violence.

Table 17

  • Early intervention when the problem is identifying the issue.
  • Multi-agency meetings prior to the school exclusions.
  • More family support/meetings/home visits (Keep the family involved with the process).
  • Voluntary v Statutory – There is a conflict between the adults needs v the child’s need. The right of the child is paramount.

Table 18

  • Youth Service
  • Early intervention from Social Services.
  • Women’s Aid.
  • Barnardos.
  • Advocacy.
  • Counselling – waiting times.

Table 19

  • Discussion about how to support children – who have experience in Neglect e.g. specialist foster care.
  • Preventative/universal positive relationship building at school.

Table 20

  • Intervene in a structured plan
  • Timed limit – when locking to intervene.
  • Resources.

Table 21

  • From Social Services perspective in-depth assessments/accurate analysis with clear recommendation – can there be a change or will the child suffer further from harm.
  • Better information sharing between agencies – sharing it at the right time. Working together.
  • To accept that there are concerns/issues/substances misuse/abuse of children across all socio-economic backgrounds.
  • Approach needs to be open. Empower service users.
  • Bring people along with change.
  • Role of the medical impacts professionals and service users.
  • Education and working with people is important.

Table 22

  • Educate (Cultural norms and education).
  • Move therapeutic services (change parenting).
  • Identify Neglect symptoms and signs early.
  • Continued support/persistent support, work together not against each other.

14.40 – 15.10 Dr Aideen Naughton

Q: To prevent reoccurrence or persistence in established Neglect?

Table 1

  • Build the reliance of the family – this is making sure the interventions have been put in.
  • Not building professional dependency – judging this might time to withdraw and accept that sometimes.
  • Clear expectations and timescales of intervention and family e.g. PLO.
  • Honesty and use of tools to show progression.
  • Understand the parent history and need of the parents too.

Table 2

  • Difficult when parents don’t engage.
  • Once case is open to Social Services – removal of children should be considered.
  • Multi-agency working with family.
  • Time scheduled plans.
  • Provision / building children’s support networks.

Table 3

  • Break cycle
  • Robust and effective enforceable Child Protection Plan.
  • Fully reviewed CPP.
  • Early parental educational input.
  • Across service recognition of early indicators/signs.
  • Continued support of Social Services after initial ‘’sticking plaster’’.

Table 4

  • Creation around early intervention outside of the agency. So continued services directed at good parenting.
  • Budget and workforce.

Table 5

  • Neglect is the hardest to prove, break the cycle.
  • Relationship with family.
  • Time.
  • Inversions not always dependent on cost intensive resources.
  • Use of buddy/key person in the family/YP to offer support.
  • Useful to have professionals together.

Table 6

-No comments-

Table 7

  • More decisive intervention, effective intervention and earlier intervention to stop propping up Neglect – throwing resources at families without a proper assessment.
  • Change the away we work with families.
  • Child focussed assessment. Hearing the voice of the child.

Table 8

  • Recognise disguised compliance.
  • Sound evidence base.
  • Look at thresholds regarding removal.
  • Look at motivation to change.
  • Process to look at ‘’stuck’’ cases.
  • Peer review.
  • Resilience around staff – large turnover – children missed.

Table 9

  • Don’t remove support too soon/step down support look at patterns in the past of the family issues.
  • Long-term intervention (On a monitoring level).
  • More confidence in liaising with other agencies.
  • Make plans ‘clear’, ‘concise’ and model achievable targets.

Table 10

  • A spectrum of services available from universal to very specialist, clear thresholds, good communication between them.
  • Too many-short term services and these families need long-term, sustained support across the spectrum of their needs.
  • CPN, CAHMS, School counselling.
  • Time limited, clear plans.
  • Clear measures of progress.
  • Good interagency communication if problems emerge again.

Table 11

  • A continued level of engagement even on a reduced scale.
  • Information sharing for schools identifying revision to past behaviours by pupils.

Table 12

  • Long-term solution, depending on type of Neglect.
  • Don’t facilitate dependency from parent.
  • Need to empower parents.

Table 13

  • Reliable/secure long –term key worker
  • Never stop trying to separate the behaviour from the person.
  • Use a change model – and check a) if able b) if motivated.
  • Build ‘’executive function’’.

Table 14

  • Key person in child’s life – too many changes of Social Worker within the teams for families.

Table 15

  • Time limited plans.
  • Not repeated plans.
  • Communication between services about plans and outcomes for individual cases.
  • Educate people to help themselves.
  • Prevent dependency.
  • Working with families to ‘show’ them what to do rather than tick the box to say that they have been told.

Table 16

  • Tracking families
  • Predicting by checking
  • Child Protection cases and continuing – Vs human rights of bring tracked.
  • Offer support of services.

Table 17

- No comment -

Table 18

- No comment -

Table 19

- No comment -

Table 20

  • Understand what the child’s view of this is.

Table 21

  • Responses of professionals are key.
  • Monitoring/support from the beginning.
  • Not to just pull out.
  • Move early intervention/prevention further than just crisis.
  • Sustainability – investing to save.
  • Voluntary sector being used enough.
  • Lack of community resources – support
  • Societful responsibility.

Table 22

  • Working with families (identify siblings and treat each child in a unique way).
  • Staff to have Child Protection training (Good practice in schools is that all staff are trained).
  • Guidance/posters to raise awareness.