Solution Focused
Interventions in
Neglect
The Graded Care Profile
Aims and Objectives
• To enable participants to have working knowledge of GCP
• To support participants to quantify neglect by use of a
working tool to use together with service users
• To enhance or enable communication between professionals
and service users
• To offer a guide to identify a programmed plan of care and
setting of achievable targets, for professionals and service users
• To have an awareness and understanding of how the GCP is used to
support the legislation in regards to safeguarding children.
Introducing a More Objective
Measure of Care
• Judging the quality of care is an essential component of any
assessment but how well do we do it?
• Judgements are subjective and prone to bias
• Intangible: Difficult to capture and compare
• High threshold for recognition
• Cumulativeness and acclimatisation
The Graded Care Profile
• The Graded Care Profile (GCP) scale was developed as a
practical tool in response to the Children Act 1989 to provide a
measure of care in four domains or areas: Physical, Safety, Love,
and Esteem, on a bipolar continuum.
• It is seen as providing practitioners with a common tool or
frame of reference to aid informed assessment of care & neglect
“Every Child Has a Right to Good Enough Parenting”
The GCP Provides:
• A Shared Framework for Assessment/Intervention
• A Reliable Standardised Evidence Base
• A Baseline Measurement Tool
• A Common Measure of Objectivity
• A Framework in Which to Make Judgements about Care –
Highlighting Areas of Strength & Concern
• Opportunity to Highlight Areas not Always Apparent
Cross Discipline Assessment
Tool
• Pre-referral assessments
• Snapshot assessment
• Contribution to Core Assessments /Integrated Assessment
(parenting capacity)
• Monitoring assessments
• Self assessments – parents / carers
• Young peoples assessments of parents / carers
• Identification of areas of strength & weakness
• Tool for setting goals for parenting
• Tool to facilitate discussion
User Friendly
The Graded Care Profile is an assessment tool that can be used
in all cases including the following user groups
• – Parents with learning disabilities
• – Physical disabilities
• – Parents with Dependency Issues – Drugs/Alcohol
• – Adult Mental health
• – Different cultural and ethnic backgrounds
Differentiates Care .....
• Between different carers
• Provides better evidence
Good enough parenting
Good Enough” parents show pride and pleasure in their child’s
progress together with many other positive emotions such as
affection, tenderness, interest, delight and many others, which will
increase the child’s self-confidence and self-esteem.
There are also, at times, negative, feelings towards their children such
as frustration, fatigue, anger boredom, anxiety, fear, disappointment
and many others, which parents learn to accept as normal when
occurring only occasionally.
Professionals need understanding and awareness of when the
negative feelings are becoming excessive and when they may swamp
the positive ones.
When to Use the Graded Care
Profile
• Concerns regarding Parenting
• Child Exhibiting Problems
• Children in Need
• Children in Need of Protection
• Programme of Intervention
• Any Other Concerns
Promotes Greater Objectivity
• 1. Parenting Strength Child focused
• 2. Based on developmental outcomes
Not opinions
• 3. No extrapolation Based on actual
observations
• 4. Captures negative & positive care
Bipolar continuum
• Common language, common reference
• Objective measure – child focussed
• Effective tool to promote partnership assessments and
planning with parents
• User friendly
• Covers all areas of care
• Child and carer specific
Domains of Care (Maslow 1954)
Derived from Maslow’s Hierarchy of
Needs but more specific to compel
holistic approach to assessment &
remove generalised commentary.
Self
Actualisation
Care of ESTEEM
Care of LOVE and
belongingness
Care of SAFETY
Care of PHYSICAL needs
The categorisation of different
grades of care
Grade 1
Grade 2
Grade 3
Grade 3
Grade 4
1. Level of
Care
All child’s
needs met
Essential
needs
fully met
Some
essential
needs
unmet
Most
essential
needs
unmet
Essential
needs
entirely
unmet/
hostile
2.Commit
ment of
Care
Child is
First
Child is a
priority
Child and
parents
needs on
par
Child is
secondary
Child is not
considered
Adequate
Equivocal
Poor
Worse
3 Quality of Good
Care
What to observe…….
PHYSICAL
SAFETY
LOVE
ESTEEM
Nutrition
Housing
Clothing
Hygiene
Health
Quality
Quantity
Preparation
Organisation
Sub areas
1
2
3
4
5
A Quality
Aware and
proactive;
provides
excellent
quality food
and drink.
Aware and
manages to
provide
reasonable
quality food
and drink.
Provision
of
reasonable
quality
food
inconsistent
through
lack of
awareness
or effort.
Provision
of poor
quality
food
through
lack of
effort; only
occasionally of
reasonable
quality if
pressurised
Quality
not a
considerate
on at all or
lies about
quality.
B Quantity
Ample
Adequate
Variable
Low
Starved
C Preparation
Painstakingly
cooked/prepared
for the
child.
Well
prepared
for the
family
always
accommodating
child’s
need,
sometimes
for the
child.
Preparation
infrequent
and mainly
for the
adults,
child
sometimes
accommodated.
More often
no
preparation
. If there is,
child’s need
or taste not
accommodated.
Hardly
ever any
preparation. Child
lives on
snacks/cereals.
D
Organisation
Meals
elaborately
organised –
seating,
timing,
manners.
Well
organised often
seating,
regular
timing.
Poorly
organised irregular
timing,
improper
seating.
Not
organised no
clear
meal time.
Chaotic –
eat when
and what
one can.
NUTRITION
SCORING
• 4 AREAS (A, B, C & D) – Physical, Safety, Love & Esteem
• SUB-AREAS (up to 5 in each Area)
• Each Sub Area is scored from 1 - 5
• Use on Every Child in the Family
• Use with Primary Carer/s & Different Carers
• Make sure information is as factual as possible
• Draw on Information, Observation & Records
• Complete the full reference scheme
• Transpose to the record sheet
• Obtaining a score for a sub-area from score in its items
• Between 1 and 3, when there are more of one score,
record the one with the most. If there is an even split,
the highest score is entered
• However If there is even a single score above point 3,
score that point regardless of mode. / average.
• If there is a score of 4 or 5, go with highest score
Positives of the GCP
• Embraces numerous presenting concerns in adult behaviour
(such as domestic violence, mental health problems or
substance misuse problems)
• Use as referral, initial, core assessment and court tool
• Supports core assessment tool
• Links to conference requirements and core group planning
• Retrospective application possible
• Clarification with criminal justice system about threshold for
police investigation and prosecution via crossing public interest
threshold
• Engagement of adult services
• Use across all families (birth, foster and extended)
• Links across prevention and protection
• Links with existing tools across agencies such as percentiles
• Supports links across information collection, analysis and
planning
• It is evidence-based (linking theory, research and practice
wisdom)
• Links to model of change
• Common language
• Potential to engage
• Identifies strengths and weaknesses
• Allows children to understand own experiences and challenge
parents
• Holistic focus to contextualise concern (e.g. dirty child or
house)
• Picks up patterns of concern over time
• Links to Assessment Framework
Negatives
• Not useful as a child protection tool but can help analyse and
contextualise information collected
• Potentially deskilling
• Language alienation
• Focus is younger children rather than adolescents
• Does not address unborn children
• Unusable unless adopted by inter-agency system
• Does not negate the need for parallel assessments on the origins of
parental behaviour (domestic violence, mental health, substance
misuse)
• Links with emotional abuse and boundary issues between emotional
abuse and neglect needed
• Does not negate the need to use circumstance specific assessment
tools e.g. failure to thrive