A spotlight on Neglect and Acts of Omission
Neglect and acts of omission are important issues but often overlooked aspects of safeguarding, especially in vulnerable populations such as children, the elderly, and individuals with disabilities.
According to research 1 in 10 children have been neglected.
In a 2018 study, it was recorded that 11.6% of care home residents in the UK reported experiencing neglect in the previous year.
Neglect is the ongoing failure to meet an individual's basic and essential needs, either deliberately, or by failing to understand their needs.
Acts of omission refer to the failure of someone to do something that they are legally required to do. This could be a parent failing to provide basic necessities for their children or a someone in a position of care failing to provide their patients with medication or care.
Within this white paper we will be discussing the complexities of neglect, the impact it has on individuals, and cases where those in a position to help failed to notice the signs of neglect.
Legislation
The Care Act 2014 is the legal framework in England for adult social care. It was set up to improve the quality of care and support individuals, particularly the elderly, people with disabilities and carers. The Care Act supports the personlisation of care services putting the person at the center of the process.
The Adult Support and Protection (Scotland) Act 2007
Adult Safeguarding: Prevention and Protection in Partnership
UK law for children means that it is an offence to neglect children and young people under the age of 16 as detailed below:
England and Wales- Children and Young Persons Act 1933
Northern Ireland- Children and Young Persons Act (Northern Ireland) 1968
Scotland- Children and Young Persons (Scotland) Act 1937
Poverty and Affluent Neglect
There are many different forms of neglect including poverty and affluent neglect, both sharing similarities but can also be very different.
Poverty Neglect refers to the combination of poverty and neglect, which can have a negative impact on a child’s mental health and self-worth. Poverty does not cause neglect, but there is evidence it is a leading factor in abuse and neglect. The children in these situations are more likely to experience poor physical and mental health, low educational attainment, and unhealthy habits. This can be due to a lack of money, food, education and medical attention.
Affluent Neglect refers to the neglect experienced by children in wealthy families. It is often difficult to detect as the kind of neglect children and young people in these circumstances is often emotional.
The children in these situations often have parents who work long hours, leaving children in the care of paid nannies or au pairs. This can create a disconnect emotionally and leave children feeling lonely, with their emotional needs unfulfilled by their parents.
Spotting the Signs
Spotting signs for neglect can be quite difficult to spot. Often having one or two of the signs doesn’t necessarily mean that a child or adult is being neglected. However, if you notice multiple signs that last for a while, this may show that there is a serious problem behind the scenes.
Signs to look out for:
1. Poor appearance and hygiene -
Being dirty or smelling
Being hungry or not given any money for food
Having unwashed clothes
Having the wrong clothing, such as no warm clothes in winter
Having frequent and untreated nappy rash in infants.
2. Health and Development Problems
Anaemia
Body issues – poor muscle tone or prominent joints
Medical or dental issues
Missed medical appointments such as for vaccines
Given the wrong medication
Poor language / social skills
Regular Illness or Infections
Repeated injuries, often untreated
Skin issues, such as sores, rashes, flea bites
Thin or swollen tummy
Tiredness
Weight or Growth Issues.
3. Housing and Family Issues
Living in an unsuitable home environment, such as having no heating
Being left alone go for a long time
Taking on the role of the carer for other family members.
4. Change in Behaviour
Becoming clingy or over familiar with others
Becoming aggressive
Being withdrawn, depressed or anxious
Changes in eating habits
Displaying obsessive behaviour
Finding it hard to concentrate or take part in activities
Missing school
Showing signs of self-harm
Using drugs or alcohol.
If you notice multiple signs of neglect that last a while it is important to report it whilst always maintaining a recoed and chronology of events. This information may be extremely crucial in gathering the right evidence needed to present a case to services that can intervene and support.
If you think a child or young person is in immediate danger, call 999 or your local social care team. Otherwise, you can call NSPCC on 0808 800 5000 or call the police on the 101 non-emergency line.
For adult neglect you can again call 999 if they’re in immediate danger. Otherwise, you can get in contact with their GP or local social work team, or you can reach out to a charity such as Ann Craft Trust or Age UK.
Daniel Pelka and Winterbourne View:
The case of Daniel Pelka:
4-year-old Daniel Pelka was murdered on the 3rd of March 2012 by his mother Magdalena Luczak and her partner Mariusz Krężołek.
Daniel’s death led to a serious case review due to the multiple opportunities that were missed to identify him as suffering from abuse and neglect.
Daniel was starved for up to 9 months and died from a head injury. Daniel had been forced to stay in a small room without being allowed food or to go to the bathroom. The door handle of the room was removed too to prevent him leaving or his siblings from letting him out. Daniel was severely underweight, weighing only 1st 9lbs.
Daniel had been seen by doctor's days before he was killed, and sadly no issue was raised.
Daniel was seen by doctors, health visitors, police and teachers with bruises, rapidly losing weight, unexplained injuries and stealing food from other children or bins. However, there were issues regarding no intervention and not enough record keeping ensuring they could track how often it happened.
Winterbourne View:
Winterbourne View- a private hospital near Bristol for people with learning disabilities and autism could hold up to 24 patients and its sole purpose was to support those in need.
Former Senior Nurse Terry Bryan from Winterbourne View put in several complaints to managers and the health care watchdogs about the abuse at Winterbourne. After not seeing any changes, Terry felt he needed to take further action and got in touch with the BBC.
On 31st of May 2011, an undercover investigation by BBC’s Panorama programme revealed criminal abuse by staff towards the patients of Winterbourne View.
The program showed evidence of abuse, assault, poor restraint methods, bullying and much more. After this broadcast aired, several serious case reviews were undertaken including:
South Gloucestershire Safeguarding Adults Board carried out a serious case review
The police launched their own investigation, with 11 criminal convictions
The Care Quality Commission (CQC) inspected all hospitals and homes operated by Winterbourne View’s owners (Castle beck Care) and conducted a wider health check inspecting 150 learning disability services across England.
In addition, the Government set up its own review, led by the Department of Health to:
Investigate the failings around Winterbourne View
Understand what lessons we should learn to prevent similar abuse
Explore and recommend wider actions to improve quality of care for vulnerable groups.
Both of these cases highlight the serious nature of neglect and the impact that it can have on those involved. Both of these cases highlight the negative affect not acting when seeing signs of neglect can have. From significant abuse, emotional and physical to death.
Both Daniel and the patients at Winterbourne View were looking up to those who were supposed to help them, instead they were neglected and abused. It is devastating that they had to go through this, but it has certainly allowed for the change needed to improve the response systems and their knowledge of signs.
If you have any concerns about the issues raised in the white paper or need any help or advice, please get in touch. Our team offer full support and training around neglect advice and are able to advise and train employers and employees.
If you require a training course that covers or focuses on neglect then please contact us for a consultation about our training courses here
Further Reading: