Graded Care Profile Evidence, impact and evaluation

We’ve evaluated Graded Care Profile, a tool to evaluate family strengths and weaknesses, to see if it can help in the identification of neglect.

How neglect affects children

Neglect is the most common form of maltreatment suffered by children in the UK (NSPCC, 2014). Neglect can put a child at immediate risk of illness, injuries, disability and even death. It can also have long-lasting effects including mental health problems; poor physical, emotional and social development; behavioural problems; and low self-esteem.

Yet social workers are often unsure about how best to intervene. There is often a lack of timely intervention to protect children at risk. Cases can be left to drift when no-one steps back to look at the overall picture of the child's life.

Read more about child neglect.

How Graded Care Profile is helping protect children

Neglect is a common factor in serious child abuse cases, where there is often a lack of timely intervention to protect children at risk. Cases can be left to drift when no-one steps back to look at the overall picture of the child's life.

Research tells us that practitioners feel there is a lack of agreement around what constitutes child neglect and when professionals should intervene (Gardner, 2008).

Helping practitioners to objectively measure neglect and to identify areas where parents need to improve their care should result in better outcomes for children.

The Graded Care Profile scale was developed by Dr Srivastava, a consultant paediatrician in South Yorkshire, to provide practitioners with an objective way of assessing when inadequate care could put a child at risk of harm. It is based on Maslow's hierarchy of needs. Maslow identified the different types of needs that people have. All these needs must be met for a person to flourish.

By providing a clear, objective framework for evaluating a family's strengths and weaknesses, Graded Care Profile aims to:

  • help professionals manage and monitor their caseloads more effectively
  • direct the right support to the families who need it the most
  • protect more children from neglect.

The assessment can then be used to ensure that parents get the support and help they need to improve the level of care the child receives.

How we're evaluating this service

Although the Graded Care Profile is being used by others, we've carried out the first UK-wide evaluation of this tool. We looked at how it is used and how effective it is in helping children and young people.

Our evaluation took place in two stages.

1st stage

We:

  • obtained feedback from practitioners, managers and service users
  • identified facilitators and barriers to effective use of the tool and in what contexts it can be used most effectively
  • explored perceptions of the tool's effects on child neglect practice – the quality of processes, outputs and interagency practice
  • explored perceptions of effectiveness of the Graded Care Profile in helping practitioners to identify potential and actual neglect and assess the care of children
  • explored implementation of the Graded Care Profile by Local Safeguarding Children Boards (LSCBs), local authorities and other agencies.

This stage had two components:

  • quantitative data from Graded Care Profile scores for 137 cases, additional case information and practitioners' views about using Graded Care Profile. Information was collected at two time points to consider changes over time.
  • qualitative data from interviews with practitioners, managers, local authoritiers and a small number of parents.

Interim findings and development of version 2

Interim findings showed that people found the Graded Care Profile:

  • was helpful
  • could promote parental awareness of professionals' concerns
  • helped to target plans
  • presented challenges with some of the language used within the tool.

We amended and updated the tool on the basis of this evidence to create version 2 of the Graded Care Profile.

2nd stage

We tested the reliability and validity of version 2 of the Graded Care Profile.

4 pairs of NSPCC practitioners used the Graded Care Profile with families. We looked at:

  • inter-rater reliability by comparing the Graded Care Profile scores between each practitioner in a pair to see how similar or different they are
  • concurrent validity by comparing Graded Care Profile scores to scores from another tool filled in by the same practitioner.
  • face validity through interviews with practitioners to ascertain the extent to which they feel version 2 adequately assesses neglect and quality of care.

Our stage 1 objectives had an emphasis on measuring the effect of the Graded Care Profile on practice. The design was to compare the use of the Graded Care Profile to 'business as usual' by collecting information on cases where the Graded Care Profile was used and comparator cases where it wasn't used.

It proved difficult to obtain the required number of cases, particularly comparator cases, so we had to change our approach. It was decided to collect only Graded Care Profile cases, and to have more of a focus on perceptions of effectiveness.

This work was carried out internally by the NSPCC evaluation department.

Contact Robyn Johnson for more information.

What we've learnt

Graded Care Profile (GCP) can help professionals identify risks and potential harm more effectively. Practitioners said that the tool promotes a child-centred approach and helps make neglect more visible.

GCP supports practitioners to develop a constructive working relationship with the family. It does this by identifying parenting strengths as well as weaknesses and by helping parents to understand the practioner's concerns.

Practitioners rated the usefulness of GCP highly. On a 5 point scale it was rated as 4 or 5 in over two thirds of cases.

Read the evaluation reports for GCP and GCP2.

What we're doing next

We'll be piloting GCP2, the updated version of GCP, with partner local authorities across the UK.

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References

  1. Gardner, R. (2008) Developing an effective response to neglect and emotional harm to children (PDF). London: University of East Anglia and NSPCC.