6.1 Knowsley Graded Care Profile 2

See Guidance for All Managers and Practitioners: Assessing Child Neglect - The Graded Care Profile 2.

One of the priorities for the Knowsley Safeguarding Children Partnership is to assist all who work with children and families in assessing child neglect. Many children with additional needs experience neglect a variety of levels and it is vital that we all recognise and assess this. Research findings from Child Safeguarding Practice Reviews, both nationally and locally, show that neglect is the second highest category for Child Protection Plans and is often the backdrop for physical, emotional and sexual harm.

The NSPCC GCP2 is the validated, recommended tool used in Knowsley which is mandated for use where there are any concerns about the quality of care being provided to a child(ren)

The GCP2 is the updated version of the original GCP tool — building on the NSPCC national evaluation — which retains the core concepts, design and structure of the original GCP but adds value in relation to new, more accessible language. The GCP2 hasn’t lost the weight of gradation but now also includes new ‘items’ such as obesity and online safety. The NSPCC have also enhanced the guidance for the tool to make sure the tool is easier for practitioners to understand and use, and it fits into the current legislative context.

It can be used in early intervention with parents and carers to promote their strengths and recognise the areas in which they need to improve. It can also be used with children at higher levels of need to provide evidence of what must change if the child is to develop and be safe. The Graded Care Profile 2 gives clear evidence of neglect and its impact on children of all ages.

It must be used in early help to families when neglect appears to be an issue, and referrals for Children in Need due to neglect must be accompanied by a GCP2. Where a child protection referral is made there should be no delay in making that referral and the completion of a GCP2 will be agreed as part of the Child Protection process.

Wherever possible, the Graded Care Profile should be used in partnership with parents or carers and completed with them. They are then more likely to recognise and agree the changes needed to help meet children’s needs. The GCP2 can also be used as a reflective tool by practitioners to gain a full picture of neglect and consider the evidence in supervision and reflective practice.

Please ensure that the following guidance is used to assist those using the Graded Care Profile 2.

Training with regard to neglect and the use of this tool will be available via the Knowsley Safeguarding Partnership Training Calendar.

Using the Graded Care Profile 2 to Assess and Review Neglect

When to use the GCP2?

• Whenever there is concern about a child/young person being neglected;
• In Early Help and for children with additional needs related to neglect;
• For children in need, where neglect is at a more concerning level and is starting to impact on the child’s development any referral to another agency should be accompanied by a GCP2;
• Where children are at risk of significant harm and neglect is a feature, there must be no delay in referring to Children’s Social Care. If a GCP2 has already been completed it should be attached to the referral. If not, the Graded Care Profile2 will have to be completed as part of the child protection process after referral;
• The GCP can be used to review progress with a child and family. Once completed the GCP should be revisited in an agreed period of time to assess progress made. (This is usually a period of 6-8 weekly);
• The GCP can be used when a child is returning home after a period of being looked after – this can help establish levels of care on offer and identify strengths and areas for improvement;
• The GCP is suitable for all ages of children & young people, involving young people in the assessment can be beneficial;
• The GCP has been welcomed as evidence in Care Proceedings and courts are increasingly requesting such evidence.

Who can complete the Graded Care Profile 2?

• All practitioners working with children, young people and adults who are carers or parents can complete a GCP once they have completed the training;
• Access to the home and the opportunity to observe parent and child together is necessary to fully complete a GCP;
• Some practitioners will recognise the impact of neglect on a child – for example a teacher, but not be in a position to complete a GCP. In such cases the practitioner should complete the domains in the GCP which are relevant to their concerns and the remaining domains can be completed an allocated Early Help/Targeted Services/Social Care professional as part of the assessment process. (However if the professional has not been trained to undertake a GCP2 the Knowsley Neglect Screening Tool can be used as a pre GCP2 assessment tool to inform decision making);
• The assessment can be co-worked between two workers who have different types of involvement with a family – for example, an adult mental health worker and a worker offering early help could complete a GCP. Joint assessments of this kind have been shown to lead to better assessment and outcomes;
• Whenever it is recognised that a child/young person is experiencing neglect, the practitioner who recognises this must ensure that a GCP2 is completed, even if they are not able to do so.

Engaging parents/carers and children/young people with the Graded Care Profile 2

Whenever there is concern that a child’s needs are not fully met it is crucial to involve the parent fully and engage them in meeting the child’s Parents (as long as it is safe to do so).

Parents will need information about the GCP2 and an explanation of why it will be useful. Explaining that a GCP2 helps to show areas of parental strength as well as difficulty will help with engagement.

The following will also help:

• Providing written explanation about the GCP2 as well as verbal;
• Assuring a parent that they will be involved in the completion of the assessment and will have a copy;
• Being clear about who the information will be shared with and why;
• Working with informed consent – the parent needs to know how the GCP2 will be used to improve life for the child and that they will play the major role in that improvement;
• Giving examples of how using the GCP2 has had positive outcomes for other children and families;
• Carefully going over the format with parents and showing them how it works;
• Completing the assessment via conversations with the parent and observations of the child and parent together, rather than ‘filling the form in’;
• Giving regular feedback to the parent during and after assessment about what is going ok and where work will be needed;
• Using the tool as a working document to assess, implement and evaluate interventions with the family at agreed intervals (usually 6-8 weekly);
• Using the tool to step-up or step-down service provision according to need.

Response and Referral Pathway

The table below provides a descriptive definition of each grade and appropriate action to be taken. This includes guidance on the referral pathway.

What action will be taken will depend on the needs, risks and vulnerabilities of individual children. However, a score of 5 in any domain should at least prompt a consultation with the MASH.

GCP2 Grade	Description	Referral / Pathway
1	No neglectful parenting Consistent good quality parenting where the child’s needs are always paramount or a priority.	Normal universal access.
2	No neglectful parenting Consistent good quality parenting where the child’s needs are always paramount or a priority.	Normal universal access. Further assessment/ signposting as and when indicated.
3	Mild neglect Failure to provide care in one or two areas of basic needs, but most of the time a good quality of care is provided across the majority of the domains.	Support through Early Help likely to be beneficial
4	Moderate neglect Failure to provide good quality care across quite a number of the areas of the child’s needs some of the time. Can occur when less intrusive measures such as community or single agency interventions have failed, or some moderate harm to the child has or is likely to occur (for example, the child is consistently inappropriately dressed for the weather — wearing shorts and sandals in the middle of winter).	A multi-agency intervention is required. This can be through Early help or through a Social Care assessment if a child is in need. Consultation with the MASH advised. Where no improvement (or decline) is evidenced referral to Children’s Social Care required.
5	Severe neglect Failure to provide good quality care across most of the child’s needs most of the time. Occurs when severe or long-term harm has been or is likely to be done to the child or the parents/ carers are unwilling or unable to engage in work.	Consultation with the MASH needed. Referral to Children’s Social Care through the MASH may be required. If child subject to CP plan, repeat tool for each review.

See also:

• Graded Care Profile Leaflet for Parents;
• Knowsley Neglect Screening Tool 2023;
• Decision Making Flowchart.