Thread by @MartinBarrow

Today's annual report of the Child Safeguarding Practice Review Panel is a horrifying, must-read for all those with an interest in child protection

gov.uk/government/pub…

The report includes 538 rapid reviews.
- The overwhelming majority concern parents or close family members.
- 244 reviews reported that children had died and 294
reported serious harm (of which 77 involved serious incidents where the child could have died).

Weak risk assessment and poor decision making were identified as a major practice theme within 41% (218) of reviews. Poor information exchange at critical points
between agencies was present in 40% of reviews.

Every two weeks the Panel sees, across England, the circumstances in which things have gone tragically wrong for a child and their family.

46% of children who died or were seriously harmed were NOT known to children’s social care.

32% of rapid reviews were identified as appearing overly optimistic in the practice decisions.

"We were very troubled by the level of criminal activity of some parents and violence witnessed or experienced by children.

"We found that there were several examples where multi-agency public protection arrangements had not worked well."

"Many were in the care system at the time of the
incident. We have heard about ... young lives
characterised by multiple placements during periods of being looked after, lives becoming increasingly chaotic, with frequent periods of going missing & mental
health deterioration."

"Professionals seemed on some occasions not to be able to hear what the young person was saying, even when it was quite specifically suicide ideation, in any practical or
emotionally intuitive way. This was the situation for some young people who then went on to kill themselves."

"Many reviews have raised concerns about the medical response to families not meeting requirements of health plans for children with life threatening conditions. In some cases the capacity of parents or young people to meet those medical needs is limited."

" Children repeatedly not brought to appointments, signs of
disengagement and inconsistent responses to a child’s health needs should be recognised early so that the potential risk can be assessed, particularly in vulnerable children."

There is widespread use of written agreements [which have] little or no protective effect.

In one case involving the sexual abuse of three siblings by
their father over a 15-year period, written agreements were used six times in an attempt prevent contact.

"We have seen several examples where there was serious dispute amongst child protection professionals about what action to take when they had concerns about a child who later died or was seriously injured. "

"The Government should assure itself ... that the design and
function of the child protection operating model is fit for the 21st Century and beyond. "