Time to introduce definite limits

The cupboards are bare and takeaway boxes litter the filthy kitchen worktop. In the lounge plastic, garden chairs sit where you would expect a sofa to be and a television blares on the floor in the corner. The door, sticky from years of children's fingerprints, opens and a toddler in a soiled nappy makes his way across the matted carpet, falls and starts to cry. Mum or dad does not come. Thousands of children live in similar situations across England and the numbers are increasing. Almost half of the 34,100 children on child protection plans – formal plans of support for children at continuing risk of significant harm – are there because of neglect, more than for both physical and sexual abuse, and the numbers have been steadily rising over the past five years. But at what point do parents go from being capable, given the right support, of being a beneficial influence on their children, to inflicting serious emotional harm on them? Earlier this year the NSPCC said social workers and other professionals were failing to intervene early enough in cases of neglect. And while some social workers still dispute the allegation, others agree that there is a problem. The NSPCC said such cases tended to drift because many professionals do not have the skills to deal with early signs of neglect. But some social workers argue that family courts' reluctance to remove children due to neglect, a lack of resources to work with such families, and the difficulty of getting agreement between professionals are the real reasons. "It's much easier for neglect cases to drift," says Joanna Nicolas, a child protection consultant, trainer and independent social worker. "If a child is being physically abused, you get to a point where all the agencies say this child is not safe enough. Emotional abuse is hard to quantify. It's the same problems going on and on. Where do you draw the line and say this isn't good enough parenting?" she asks. Nicolas says that, while a lack of skills among professionals is an issue, many social work managers would be unwilling to add such children to their ballooning caseloads, even if these skills were improved. The situation is made worse, she says, by many family court magistrates and judges not understanding the damaging effects of neglect and their reluctance to remove children on such grounds. "A social worker can put support in and see no evidence of improvement, yet it wouldn't meet the threshold in court – and that's when social workers get criticised," she says. Sarah (not her real name), a children and families social worker in the north of England, has experienced similar situations. "I have worked on cases where the family has been on different social workers' caseloads for years and the damage to the children is awful. The health visitor, teacher and social worker can all have different opinions on when the child is being significantly emotionally harmed and this can make it very difficult. These are the hardest cases to get into court – and even then you need judges and magistrates who understand. The system is geared toward giving parents yet another go." Deep-rooted problems The NSPCC agrees that courts' attitudes and the child protection framework itself play a part. Ruth Gardner is the charity's lead on neglect and a senior research fellow at the University of East Anglia's Centre for Research on the Child and Family. She says the experience of practitioners is that courts often look at the most recent incident rather than taking past patterns of neglect into account. "The tendency is to start again when it comes to families. That's fine as long as the past history of neglect is kept in mind, but in many cases this is put aside and then it all happens again," she says. Neglect can influence every aspect of children's lives, affecting their ability to form relationships and causing them to be withdrawn. The NSPCC wants quicker intervention. It has called for government guidance on the need for each case to have a definite timeframe, within which the parents must improve or stand to lose custody of their child. "We have to be focused on early assessment of the child's needs, the parent's capacity, and how best to respond to neglect. If a child has to wait months – or for a court case – for that to be done, the mental and physical deterioration caused by waiting can be as bad as the original damage," says Gardner. Home truths Home-based family support is known to work with families displaying signs of neglect. In these services, workers engage in household tasks alongside parents and help to set up routines, such as getting children up for school. Helen Dent is chief executive of Family Action, a charity for families that provides this type of support. "The worker actually gets into the shoes of these parents and sees the world from where they sit," she explains. Many cases of neglect involve parents with mental health problems and learning disabilities and the charity carries out a lot of targeted work with these groups. Dent says such parents, alongside others who are hard to reach, have been missed by the government's Sure Start scheme as they lack the confidence to attend communal services. She feels investment in the programme has been at the expense of home-based family support in some areas and, as a result, access to such services varies. For Dent the signs of neglect in many child death cases are evidence enough that things need to change. "We don't treat neglect as seriously as we should. We need a public debate," she says. Keeping it together: Family Action's Building Bridges Kate Bright, 37, lives in a council house in Islington, north London with her son, 13, her partner and her partner's father. She has been working with Family Action's Building Bridges service, which provides support to parents with mental health problems, for the past year, and her son has been supported by its young carers project for the same period. Bright (not her real name) has had mental health problems since she was eight and describes herself as having been "in a really bad way" a year ago. She explains how bailiffs were at her door, she was having seizures and her home was severely damp, having been flooded by a neighbouring property. Bright says her family support worker from Family Action helps her to take control of her life. "She arranges my hospital appointments and makes sure that I attend them and take my medication." Her support worker also works with Bright to improve her family's living conditions, organising visits from surveyors and speaking to the council. Bright is certain that without the service her family would have been split up."Family Action keeps my head together and that keeps my family together. Without them my son would have gone into care, I would have been sectioned and my partner would have lost everything," she says. Web links Child protection plan figures: tinyurl.com/ygoavmg