Developing and implementing an appreciative ‘Quality of Care’ approach to child neglect practice

Abstract

Child neglect has a higher incidence than child abuse. Many practitioners and services are challenged by the ambiguity of determining what constitutes adequate care. In a strategic approach to child neglect, Blackburn with Darwen implemented appreciative working practices to support the introduction of the Graded Care Profile (GCP) − a tool for supporting judgements about child neglect. Alongside this initiative, an independent evaluation study using Appreciative Inquiry was undertaken to explore existing practice and to investigate what, if any, changes occurred in practice. Qualitative data were collected at two time points (a) during the training workshops and (b) in the implementation period. The target population was all workshop attendees (n = 200). Iterative thematic data analysis was undertaken. Despite some initial reservations, both appreciative practice and the GCP shifted the focus from a review of neglect to a consideration of care. The GCP added greater criticality to the practitioners' observations (in situations of both mild and intense neglect), illuminated the parents' strengths and particularly helped less experienced practitioners. Concerns raised about the tool were generally overcome through increased familiarity, although embedding is ongoing. The resulting appreciative discourse has engendered more meaningful ways of engaging with families and other practitioners.