Neglect

Working Together 2023 defines neglect as:

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 caregivers)
ensure access to appropriate medical care or treatment
provide suitable education It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs

Neglect is the most common type of child abuse in the UK and the most common reason children are placed on a Child Protection Plan. It can have a significant and long-lasting impact on a child’s wellbeing and development. It is better to respond to neglect at an early stage, but it can be difficult to identify and assess. This means that neglect can be missed or noticed at a much later stage where it is harder to intervene. The consequences of enduring childhood neglect will likely impact throughout a person’s life, hence why identification and intervention is essential.

Categories of neglect

Neglect can be categorised into four main types:

physical neglect occurs when a child’s essential needs—such as food, shelter and clothing are not provided, or when the child’s safety is compromised
emotional neglect happens when a parent or caregiver fails to offer the love, support and stimulation a child requires
educational neglect takes place when a parent or caregiver does not ensure the child receives appropriate education
medical neglect involves the failure to provide necessary healthcare and dental treatment to a child

Neglect puts children and young people at risk and can lead to lasting effects on their physical and mental health. Often, neglect arises when parents face complex challenges, which may include domestic violence, substance abuse, mental health struggles, financial hardship, or having experienced poor care themselves. These difficulties can directly affect a parent’s ability to meet their child’s needs. Despite these challenges, parents are responsible for caring for their child or seeking support if they are unable to do so adequately.

Signs of neglect

The following list explains some of the common signs of neglect, but should be considered an exhaustive list.

Physical signs

poor hygiene (e.g. consistently dirty, unwashed clothes)
inappropriate clothing for weather
hunger or stealing food/money
untreated medical, dental, or vision problems
poor growth or weight gain (failure to thrive)
repeated infestations (e.g. lice, scabies)

Developmental and emotional signs

delayed speech, language, or learning development
low self-esteem or lack of confidence
withdrawn, anxious, or clingy behaviour
lack of trust in adults or authority
overly compliant, passive, or attention-seeking
difficulty forming relationships

Environmental and situational signs

home is consistently dirty, unsafe, or lacks heating/basic amenities
poor school attendance or repeated lateness
regularly left alone or unsupervised, especially for long periods
living in a chaotic or unsafe household (e.g. exposure to drugs/alcohol/domestic abuse)

Behavioural indicators

aggression, disruptive or risk-taking behaviour
running away or going missing
taking on adult responsibilities (e.g. caring for siblings)
frequent tiredness or falling asleep in class

Healthcare and professional observations

Professionals should suspect neglect if:

a child does not attend essential medical appointments
concerns are raised repeatedly across different settings (school, GP, social care)
there are patterns of neglect rather than one-off incidents

Identifying and assessing neglect – Day in my Life Tool

Both national and local Child Safeguarding Practice Reviews into child neglect emphasise the importance of understanding a child’s lived experience. To effectively meet a child’s needs, practitioners must learn what a typical day looks like for them, including variations during weekends, holidays and times when different carers are involved. This insight is crucial to understanding how neglect impacts the child.

The original ‘Day in the Life of the Child’ tools, developed by Jan Horwath, support practitioners in gaining a clearer picture of what is happening within families affected by neglect and identifying actions that can improve outcomes for children. Practitioners should use these tools with parents or carers separately to the child, working through each stage of the day to understand the child’s daily experience.

There are different versions of the tool tailored for specific age groups (as listed and linked below). These tools serve as conversation starters or question guides to assess the day-to-day care a child receives, highlighting strengths in parenting as well as areas needing improvement.

In addition to the age/need specific ‘Day in my Life’ tools, the following links should also be used to help identify and respond to neglect.

Signs of wellbeing map

Signs of Wellbeing Map (DOCX , 75KB)

Signs of Wellbeing Map - blank template (DOCX , 44KB)

Chronology template

Chronology Template (DOCX , 62KB)

Day in my Life - game cards

The following resources can be used by practitioners to help speak to children and young people around different elements of their life. The cards complement the Day in my Life tool and there are different cards according to need/age.

Cumbria neglect strategy

The CSCP Neglect Strategy 2023 to 2026 (PDF , 6KB) has been developed to set out the strategic aims and objectives of Cumbria's approach to tackling neglect.  It identifies the key principles underpinning work with neglect and priority actions to improve the way we work. 

WFSCP are keen to ensure that we are able to identify children and young people, whose needs may be neglected by their care givers, at the earliest point so that appropriate services can be provided to address this and prevent the need for statutory intervention.

Health - neglect guide in decision making

The Neglect guide to decision making has been developed for practitioners who have concerns that a child or young person may be neglected but only have contact with the child or Young Person for a short period of time. Whilst the guide was developed for health practitioners providing episodic care, partners and colleagues can adopt and use the guide within their own scope of practice to complement and inform their own decision making in line with internal policies/procedures.

The guide aims to support health practitioners to recognise the different types of Neglect, including comprised parenting that can lead to neglect and respond at the earliest opportunity, decide what “Next Steps” need to be taken to support the child/YP and to make a referral to services if it is felt appropriate. The completed guide can be used to provide supporting information for a referral and submitted with a single contact referral form.

Neglect Guide to Decision Making (DOCX , 40KB)

Neglect Guide to Decision Making (YouTube video)

The guide can be utilised within reactive or planned supervision, multi-agency discussions and safeguarding meetings.

The guide was developed with the support of health providers across the Cumbria footprint:

Lancashire & South Cumbria ICB
Northeast & North Cumbria ICB
Morecambe Bay Hospital Trust
North Cumbria Integrated Care NHS Foundation Trust
Lancashire & South Cumbria Foundation Trust
Cumbria, Northumberland, Tyne, and Wear NHS Foundation Trust

Please note that the guide is to be used initially and in conjunction with the identified tools within the Neglect Strategy, as these tools will lead to a more in-depth assessment and greater understanding of what life looks like on a daily basis for the child or young person.

age/need specific “day in my life”.
chronology
signs of wellbeing mapping and analysis

Useful links and resources

The NSPCC has published helpful information and guidance on neglect.