SSCB Neglect Risk Assessment Tool

This tool is designed to be completed by practitioners working with families where they suspect neglect may be an issue.

These guidance notes are designed to assist with completing the assessment but are not a substitute for completion of relevant training and ongoing professional development. Remember that seeking advice is crucial when considering safeguarding issues. No policy or procedures can cover every eventuality: if in doubt seek advice from a manager.

Neglect is the failure to meet a child’s basic needs and can happen over a period of time, but can also be a one-off event. Most often it is the cumulative effect that is most impactful. Neglect can have serious and long-lasting effects to all aspects of development and future outcomes and relationships. A child may be left hungry or dirty, without adequate clothing, shelter, supervision, medical or health care. They may be put in danger or not protected from physical or emotional harm and may not get the love, care and attention they need.

As with any assessment tool, there is a need to gather information and then to analyse this in order to make a judgment as to what is happening in a family and the likely outcomes for children. The Safer Surrey questions will help and should be used to help do this

- What are we worried about? (past harm, future behaviour, complicating factors) - What ‘s working well (existing strengths and safety) - What do we need to know (grey areas, unknown information) - What needs to happen (for future safety)

This should lead to a clear conclusion of the level of risk, with reasons given and an indication of what to do next. You should escalate concerns to your manager and/or share information when risk is apparent. The most common theme of serious case reviews following the death of, or serious harm to a child is the failure to share information

Where a child is assessed as being at risk of significant harm or appears to require social work (child in need) service they should be referred to Children’s Services via the MASH. This assessment tool could be used as part of the referral to evidence any concerns and can be sent with the Surrey Multiagency Referral Form (MARF).

Where there are concerns that require an early help response professionals should consider whether needs can be met within their own agency (and universal services or other agencies known to be working with the child) or whether there is a need for further support. In the latter scenario the Early Help Co- ordination Hubs should be contacted to support in accessing further help.

If you suspect anyone is in immediate danger, call the Police on 999. If a child is at risk of significant harm, including from neglect, refer immediately to Surrey Children’s Service Multi Agency Safeguarding Hub (MASH).

Availability: Monday to Friday: 9am - 5pm Phone: 0300 470 9100 Email: [email protected] Out of hours phone: 01483 517898 to speak to the emergency duty team

Page 1 of 6 Neglect Risk Assessment Tool

Name of practitioner: Date: Name of agency: Proposed Review Date:

Child Family Name: First Name: Agency unique child Date of Number: ID: Birth / Age: 1 2 3 4 5

“Neglect is a form of Significant Harm which involves 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); or  Ensure access to appropriate medical care or treatment. It may also include neglect of, or unresponsiveness to, a child's basic emotional needs.”

Some children may be more vulnerable to suffering harm due their:  Age  Health  Disability  Social / Emotional / Cognitive state  Substance use  Access to individuals who can provide support  Previous experiences of abuse / neglect Please see the Surrey Safeguarding Children Board procedures for recognising neglect

Parental Consent: Have you discussed the need to conduct this assessment with the parent(s) and have they agreed to this? Name of parent: ______Signature: ______Name of parent: ______Signature: ______Verbal consent obtained: Yes No

Name of professional who obtained the consent: ______Signature of professional who obtained the consent: ______Date of consent: ______

Part 1: Identification of Risk

Directions: Identify and indicate the presence or absence of risk based on the information that is recorded on files, your direct knowledge / observations and that of other professionals involved with the family. A ‘yes’ indicates that there is a risk present and it can be described and observed, where the information is credible, reasonable and believable. Please identify this with a ‘Y’ for each child identified above. A ‘no’ indicates that there is no risk present or observed or that the information was not deemed to be credible, reasonable or believable to indicate a risk to the child(ren) and or young people.

Child number: Risks Page 2 of 6 (please record with a Y where it applies and an N where it does not): 1 2 3 4 5 Child(ren) and / or young person has a medical condition which is not being treated / monitored by a GP or other medical professional. For instance, it is known that medical appointments have been missed/medication not given to child Child(ren) and / or young person is not growing within expected pattern, with accompanying weight loss. This may also be weight gain. Does the child fit the norm for their age/stage of development Health professionals (GP, Health Visitor, School Nurse, Paediatrician) have previously raised concerns regarding Neglect issues. Is there any evidence documented of referrals or concerns about this child? Child(ren) and / or young person has a need for dental treatment or optical treatment or has not had regular checkups. Child(ren) and / or young person’s immunisations are not up to date, without valid explanation. The red book given at birth to parents is useful to evidence this Child(ren) and / or young person has language and speech delay which is not being appropriately addressed. Is there a delay? If so, have appropriate referrals been made and are appointments attended? Child(ren) and / or young person has sustained a significant injury and medical attention / advice was delayed or not sought. Child(ren) and / or young person appears to be listless, apathetic and unresponsive with no apparent medical cause. There is insufficient food in the house to meet the children and /or young person’s needs for the next 12 hours Insufficient food without credible explanation Babies, toddlers, or children are not given food or drink which is sufficient or appropriate to their age Note – is food in line with their stage of development / weaning There are inadequate facilities / cooking equipment to allow for meals to be prepared (e.g. cooker/stove/fridge/pots/ pans) Are these facilitates in a usable or working condition? Child(ren) and / or young person have no access to vegetables or fruit

Child(ren) and / or young person have been observed to eat either excessively or ravenously or are reported to be extremely hungry Evidence for this might come from schools/nursery/pre school Child(ren) and / or young person appear to be ignored or treated differently from their siblings. There are unrealistic expectations placed on child(ren) and / or young person in comparison to their age. Are the expectations similar for similar age children? Child(ren) and / or young person does not have any knowledge about their ethnicity, culture, religion, and identity. This knowledge would be age appropriate Child(ren) and / or young person does not have boundaries set by care givers / inadequate knowledge of these boundaries. Are the boundaries appropriate for the childs age? Child(ren) and / or young person are indiscriminately affectionate towards strangers. Has this been witnessed? Child(ren) and / or young person have witnessed a member of or someone (of any age) visiting the household being violent or aggressive. This might be evidenced in police reports? Child number: Risks (please record with a Y where it applies and an N where it does not): 1 2 3 4 5 Child(ren) and / or young person have witnessed a member of or someone visiting the household threatening suicide.

Child(ren) and / or young person has been threatened with being put into care if they Page 3 of 6 do not behave. Child(ren) and / or young person presents as frightened or fearful of a member of or someone visiting the household. Child(ren) and / or young person presents as emotionally isolated, sad, feeling little self value or constantly attention seeking. Please indicate which: School may be able to support this evidence? Give consideration to patterns of behaviour which are outside the norm Child(ren) and / or young person’s achievements are not acknowledged by adults within the household. You might want to think about the level of emotional warmth Child(ren) and / or young person is not encouraged to paint, draw, play imaginatively, creatively either alone or with others. This could relate to whether the child is getting their educational and developmental needs met Child(ren) and / or young person are left for long periods of time in their highchair, pushchair or playpen or alone in a room with little appropriate attention, stimulation or inappropriate stimulation. Child(ren) and / or young person regularly absent from school, nursery or childcare due to reported illness. Education would be able to provide evidence. Look at patterns in absence Child(ren) and / or young person regularly arrives at school, nursery or childcare tired or irritable. Child(ren) and / or young person does not have appropriate equipment for school (including school uniform) , nursery or childcare, even if offers from school or other professional(s) have been made to provide this. Child(ren) and / or young person does not have / has few, age appropriate toys / books. Child(ren) and / or young person do not have / wear clothes appropriate for the weather. Child(ren) and / or young person does not have / wear adequate fitting clothing (including shoes). Child(ren) and / or young person lacks at least one clean change of clothing.

Child(ren) and / or young person’s home environment is inadequate / potentially hazardous (including lack of heat, clutter, animal excrement, broken furniture etc). You might want to look at sleeping conditions/overcrowding, are they sharing a room – if so who with? Is this appropriate given their age and development. This also includes the outside space. Please indicate observations: Child(ren) and / or young person present as unkempt, dirty / unwashed or with an strong odour. You might also pay attention to head lice Child(ren) and / or young person does not have a bed, there is no bedding or it is soiled and unwashed. Is this bed age appropriate? Evidence of insects / rodents is regularly present in the house.

There is no evidence of personal hygiene products accessible to child(ren) and / or young person (eg soap, flannel, sponge, shampoo, or deodorant etc) Child(ren) and / or young person are left alone / unsupervised (ie. at home, in the community, in cars) or caregivers spend little time with them. Please specify frequency: Evidence for this may come from more than one source Young child(ren) have been found wandering unsupervised outside of the home. This will be relative given their age/development/proximity to home. Was it next door or was it some distance away? Child(ren) and / or young person is locked in their rooms or cupboards for punishment. Is punishment excessive for the behaviour Child(ren) and / or young person’s whereabouts when they are outside playing are unknown.

Child(ren) and / or young person thrives away from the home environment.

Page 4 of 6 Child(ren) and / or young person has insufficient / no safe space to play within the home.

Part 2: Assessing Caregivers Protective Capabilities

Caregivers are specifically those adults in the home who are responsible for providing the primary care to the child(ren) and / or young person; including their safety and wellbeing. Directions: Identify and indicate the presence of absence of [each] the Caregiver’s Protective Capabilities on the information that is recorded on files, your direct knowledge / observations and that of other professionals involved with the family.

Caregiver Family Name First Name Agency unique Date of Relationship to Number ID Birth / Age child(ren)

1 2 3 4

Protective Capabilities (please record with a Y where it applies and an N where it does not): 1 2 3 4 Recognises the risk to the child(ren) and / or young person. Is the caregiver able to recognise risk? Can identify appropriate plans to ensure safety of the child(ren) and / or young person.

Has a history of taking appropriate action to safeguard / protect the child(ren) and / or young person and is prepared to do so at present. Are they willing to make change and sustain change? Willing to engage with services and Agencies Is this meaningful engagement? Do they have a motivation to change? Has appropriate and realistic expectations of the child(ren) and / or young person. Note the child’s age and development Has the cognitive capacity and adequate knowledge to safeguard / protect the child(ren) and / or young person. Does the caregiver understand how to keep their child safe? Has the capacity to learn from an experience and apply it to future situations. Are they able to reflect on previous situations and where they led to successful and unsuccessful outcomes? Is resilient and adaptive. Is the caregiver emotional robust and able to adapt their parenting style where required Has the resources necessary to meet the child(ren) and / or young person’s basic needs. Are they able to provide good enough parenting by giving the child food, warmth, medical care etc... Prioritises the needs of the child(ren) and / or young person above their own. Is the caregiver prepared to make sacrifices should they need to in order to prioritise their child Is able to emotionally regulate their emotions and behaviours. Is the caregiver able to act appropriately in given situations? Caregiver and child(ren) and / or young person have a positive relationship and secure emotional bond.

Part 3: Overall Assessment & Next Steps

Summary of Risk Assessment: Page 5 of 6 What are we worried about? (past harm, future behaviour, complicating factors)

What ‘s working well (existing strengths and safety)

Danger statement

Next Steps

What do we still need to know (grey areas, unknown information)

What needs to happen (for future safety)

What pathway should the case take? Does it require an Early Help Assessment and Early Help services? Does it require a MARF to be forwarded to Surrey Children’s Service? Do you need a consultation with Surrey Children’s Service? ***For Health only – does this case require discussion in safeguarding supervision?***

Worker’s signature: ______

Manager’s signature: ______

Agency/organisation: ______

Contact details: ______

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