Assessing Neglect in Social Work: Signs and Documentation UK

Understanding Neglect

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. It is the most common category of child protection registration in the UK, yet often the hardest to evidence and address.

Unlike physical or sexual abuse, neglect is typically characterised by absence rather than action - the absence of adequate care, attention, supervision, or stimulation. This can make it harder to identify and document, requiring careful attention to patterns over time.

Types of Neglect

Physical Neglect

Failure to provide for the child's basic physical needs:

• Inadequate food - insufficient, poor quality, or age-inappropriate
• Inadequate clothing - inappropriate for weather, ill-fitting, unclean
• Poor hygiene - unwashed, body odour, dental decay
• Inadequate shelter - unsafe, unhygienic, or unsuitable housing
• Medical neglect - not seeking or following through on healthcare

Supervisory Neglect

Failure to adequately supervise and protect:

• Left alone or unsupervised at inappropriate ages
• Left with inappropriate carers
• Exposure to dangerous situations or environments
• Failure to protect from known risks

Educational Neglect

Failure to ensure appropriate education:

• Persistent non-attendance at school
• Not providing education (home education not being delivered)
• Not responding to additional needs

Emotional Neglect

Failure to meet emotional needs:

• Persistent unresponsiveness to child's emotional needs
• Lack of warmth, praise, or encouragement
• Ignoring the child or treating them as invisible
• Failure to provide age-appropriate stimulation

Indicators of Neglect

Physical Indicators in Children

• Poor growth or faltering weight (without medical cause)
• Constantly hungry, stealing or hoarding food
• Poor hygiene - dirty, body odour, dirty clothes
• Inappropriate clothing for weather
• Untreated medical or dental problems
• Frequent accidents or injuries
• Fatigue, falling asleep in school

Behavioural Indicators in Children

• Developmental delays without medical cause
• Poor attachment to parent/carer
• Indiscriminate attachment to other adults
• Low self-esteem
• Withdrawn or attention-seeking behaviour
• Poor social skills
• Compulsive stealing (especially food)

Indicators in the Home

• Inadequate heating or utilities
• Lack of appropriate food in the home
• Hazardous conditions (unsafe, dirty, vermin)
• Lack of age-appropriate toys or stimulation
• Child has no safe sleeping space
• Animal faeces, excessive clutter, biohazards

Parental Indicators

• Lack of awareness of child's developmental needs
• Prioritising own needs over child's
• Non-attendance at medical appointments
• Not responding to professional concerns
• Substance misuse affecting parenting
• Mental health difficulties affecting functioning
• Own history of neglect

The Challenge of Neglect Assessment

Neglect presents unique challenges:

• Normalisation: Families and professionals can become used to concerning conditions
• Gradual deterioration: Changes happen slowly and may not be noticed
• "Start again" syndrome: Each visit viewed in isolation without considering patterns
• Disguised compliance: Parents do enough to satisfy professionals without real change
• Optimism bias: Focusing on small improvements rather than overall picture
• Cultural relativism: Uncertainty about different standards of care

Documenting Neglect

Effective documentation is crucial for evidencing neglect. Use the following approaches:

Be Specific and Descriptive

Avoid vague language. Describe exactly what you observed:

• Instead of "The house was dirty" → "There was food debris on the kitchen floor and work surfaces. The sink contained unwashed dishes with mould. There was a strong smell of urine in the hallway."
• Instead of "The child looked uncared for" → "Jake was wearing a t-shirt with food stains and holes. His trousers were too small, with the hem above his ankles. His hair was matted and he had visible dirt on his hands and face."

Record Over Time

Build a picture through consistent recording:

• Document conditions at every visit
• Note improvements as well as concerns
• Track patterns - is the same issue recurring?
• Create chronologies showing patterns over time

Use Measurement Where Possible

• Growth charts and weight monitoring
• School attendance percentages
• Number of missed medical appointments
• Frequency of specific concerns

Include Multi-Agency Information

Build the picture from multiple sources:

• School attendance and presentation records
• Health visitor and GP records
• Hospital attendance records
• Police logs for welfare concerns
• Housing records

Thresholds and Analysis

When assessing neglect, consider:

Impact on the Child

• What is the actual impact on this child's development?
• Is the child's health or development being impaired?
• What would happen if nothing changes?

Persistence and Severity

• How long has this been happening?
• How severe are the conditions?
• Is the situation static, improving, or deteriorating?

Parental Capacity to Change

• Do parents recognise the concerns?
• Have they made changes when concerns were raised?
• Are improvements sustained?
• What support would enable change?

The Graded Care Profile

The Graded Care Profile 2 (GCP2) is a validated tool for assessing neglect. It examines four areas:

• Physical care: Nutrition, housing, clothing, hygiene, health
• Safety: In home, outside home, hazards
• Emotional care: Responsiveness, regard, warmth, interaction
• Developmental care: Stimulation, approval, disapproval, acceptance

Each area is graded from 1 (best) to 5 (worst), providing an objective measure that can be repeated to track change over time.

Writing Neglect Analysis

Effective analysis should include:

• Description: What specifically have you observed?
• Pattern: Is this a one-off or persistent pattern?
• Impact: How is the child affected?
• Context: What factors contribute to the neglect?
• Response: How have parents responded to concerns?
• Prognosis: What is likely to happen if nothing changes?
• Threshold: Does this meet threshold for intervention?

Conclusion

Assessing neglect requires persistent attention to patterns over time, specific and descriptive documentation, and clear analysis of impact on the child. Unlike other forms of abuse, neglect is characterised by absence - the absence of adequate care - which makes it harder to evidence but no less harmful to children.

Effective neglect assessment combines rigorous observation, multi-agency information, validated tools, and professional analysis. The goal is to build a clear picture that can inform decision-making and, ultimately, improve outcomes for children experiencing this most common form of child maltreatment.