A summary of Ofsted's "The voice of the child: learning lessons from serious case reviews"

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NSPCC briefing

April 2011

This briefing highlights some of the key points of Ofsted's report The voice of the child: learning lessons from serious case reviews (PDF).

Ofsted evaluates serious case reviews in England and this report is an analysis of 67 serious case reviews evaluated between 1 April and 30 September 2010.

It summarises common lessons and practice implications as well the characteristics of the children who were the subjects of the serious case reviews.

Lessons and practice recommendations

Characteristics of the children

Lessons and practice recommendations

The report focuses on one theme: the voice of the child. Within this theme five main messages were identified:

1) Seeing the child frequently, and asking them about their views and feelings

Problem areas identified include:

babies and young children unable to express themselves in words
children feeling uncomfortable speaking about their problems in front of other family members or in certain environments
the needs of children with disabilities' overshadowing safeguarding and protection concerns.

Recommendations:

direct observation of babies and young children
see children and young people in places that meet their needs and away from their carers
ensure that the assessment of children with disabilities' needs includes those relating to protection.

2) Listening to adults when they try to speak on behalf of the child

Problem areas identified include:

the marginalisation of fathers and other men living with families
the failure to listen to, or facilitate channels for, grandparents, neighbours and members of the public trying to express concerns about a child.

Recommendations:

routinely involve fathers and other male family figures in assessing risk
improve engagement with general public in safeguarding children.

3) Being alert to parents and carers who try to prevent access to their child

Problem areas identified include:

the failure to make a connection between parents' and carers' aggressive responses to practitioners and the likely exposure of children to the same risk factors
parents' views too readily accepted
parents avoiding authorities by missing appointments or withdrawing their children from school.

Recommendations:

consider the risk to children when practitioners have concerns about their own personal safety
family privacy not to be prioritised above safeguarding children
find ways to provide home-schooled children with the same safeguards as their peers.

4) Focusing on the child's rather than the parent's needs

Problem areas identified include:

vulnerable parents' needs overshadowing those of their children, especially where the child has a caring role for the parent
the failure in domestic abuse cases to consider the implications for children involved, particularly for pregnant mothers' unborn children.

Recommendations:

recognise the needs of young carers
consider the implications of domestic abuse for unborn children
be aware that concentrating on parents' needs can hide the needs of their children.

5) Interpreting what children say in order to protect them

Problem areas identified:

evidence collected from children not always given due attention, correctly interpreted or acted upon
failure to understand implications of children's behaviour
children's wishes too readily accepted at face value.

Recommendations:

take account of and act on children's and young people's views
recognise, understand and respond to children's use of behaviour as a form of communication
balance children's and young people's wishes with the need to safeguard their welfare.

Characteristics of the children

Of the 67 serious case reviews evaluated by Ofsted between 1 April and 30 September 2010:

2 of these reviews were about adult perpetrators
65 of these reviews concerned 93 children.

Age

Of these 93 children:

31 were aged under 1 year
18 were aged 1-5 years
13 were aged 6-10 years
23 were aged 11-15 years
8 were aged 16 years and over.

Sex

47 were female
46 were male.

Ethnicity

73 were White British
9 were Black African, Black Caribbean or Black Other
8 were Mixed
0 were Asian
2 did not state ethnicity
1 did not use a standard census category.

Other characteristics

9 children had disabilities
15 children had special educational needs, 5 of which had a special need statement.

Contact with authorities

70 of the children were known to children's social care services (at the time of the incident)
27 children were receiving services as children in need (at the time of the incident), 12 of which were the subject of child protection plans
4 children were looked after by the local authority (at the time of the incident).

Child deaths

39 children died. 9 of the 27 children in need died and 2 of the 4 looked after children died.

Of these 39 deaths:

22 were the result of homicide
6 were from other external causes, 5 of which were from suicide and 1 from drowning
11 were from accident and adverse events, 1 of which was from concealed birth, 2 from overlaying, 3 from natural and 5 from unknown causes (including sudden unidentified death in infancy (SIDS) and other cases in which young babies died).

Serious incidents (where a child did not die)

54 children were subject to serious incidents.

The most common characteristics of these incidents were physical abuse, sexual abuse or long-term neglect.

From: Ofsted (2011) The voice of the child: learning lessons from serious case reviews (PDF) . Manchester: Ofsted.

This briefing contains edited excerpts from Ofsted's report. It should not be taken as NSPCC policy.

Related NSPCC resources

Serious case reviews
Our pages on the case reviews of child deaths and serious injury collating guidance, research reports and a list of published case reviews.

Disguised compliance (NSPCC factsheet)
London: NSPCC, 2010.

Safeguarding through audit: a guide to auditing case review recommendations
Mary Handley and Richard Green
London: NSPCC, 2009

Communicating with children (training course)
An NSPCC training course on creative communication for practitioners.

Safeguarding children with disabilities (training course)
An NSPCC training course for professionals who work with children with disabilities.

CASPAR news
View the latest child protection news or sign up to our current awareness email that delivers a bitesize summary of all the new developments in research policy and practice to your inbox every Monday.

Contact the NSPCC Information Service for information on serious case reviews or any child protection topic

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