Neglect or forgetfulness?

[Justanotherday]

I look after a child with a problem with her foot, in the last 4 weeks it has got rapidly worse and the child's balance when walking is being affected. I have asked parent every week for the last 4 weeks to take child to doctors to get refer to specialist but every time I ask the answer is 'I know I must get it checked out' but still nothing is done. Parent has a couple of days in the week free to go to drs so no problem with times. As a CM what do I do? I am getting so worried about the child's walking and the damage that could be done if it is not sorted soon. Please advise.

Could you speak to the health visitor?

I don't know - it is a very awkward situation.

What is in your professional code of conduct about this sort of situation? there must be some guidance as to what to do if you suspect a child needs medical attention and parent is not seeking advice.

I work in Early Years but not as a CM and in my opinion after a week (and 2 or more reminders) of not attempting to seek medical help for something this serious I would have serious concerns and would be explaining to the parent that I would be obliged to record it as a safeguarding concern (and would do so within the safeguarding book). This would usually be enough to get a parent to make a GP appointment/go to walk-in clinic.

I'm with odd boots, I din't work in children's services but closely with adult services and this with a carer and a vulnerable adult would trigger a protection of vulnerable adults alert, ie, we'd contact the social worker or GP and raise an alert, in your case you could speak to the HV

Thank you for your replies, I don't feel there is a CP concern but more that parent is wrapped up in her own life and child tags along. It is only a feeling not fact. If I say that I need to pass the info onto a health visitor, do you think it will cause tension between us. I feel like I am forcing her to do this.

I would still say this is is a safeguarding issue, a parent wrapped in her own life to the extent she has not sought treatment for what sounds a potentially serious health problem is at odds with the government definition of safeguarding (see below)

"The process of protecting children from abuse or neglect, preventing impairment of their health and development, and ensuring they are growing up in circumstances consistent with the provision of safe and effective care that enables children to have optimum life chances and enter adulthood successfully."

I'm not too sure you can pass things on to the health visitor unless you already have a working arrangement with them. It does vary from area to area but generally speaking a safeguarding concern would be taken from an early years worker to the initial assessment team of the local social services if it got to that level, along with that would be the associated paperwork.

I understand your concerns about upsetting the parent but as the professional I believe you have a duty of care to the child that means you need to talk in serious terms to the parent and document the situation giving her the chance to sort it before you are required to contact the initial assessment team.

Are you in a CM network or have access to a helpline you can call to support you in this?

You are doing the right thing, if she fails to seek medical attention after she is aware of the problem it is possibly neglect.

I have done quite a bit of safeguarding training through work.

One time the preschool asked me to take DD to the GP as she had been wetting herself and they felt she might have a water infection. Do you know what - I am an HCP and I felt quite happy she didn't have an infection. But I took her anyway because I knew that if I didn't it would look bad Mad, isn't it.

But any caring parent, if the person looking after your child says I am worried there is something wrong with LittleJohnny, and the parent consistently does nothing, they are not acting in the childs best interests.

I think you sound like a great childminder. Follow the advice given here and be persistant.

Once I sent my daughter to my cm with a sore eye (I thought it was a stye coming up). Childminder called later that morning insisting she thought it was more than just a stye and was very insistent in me taking my daughter to the doctors. I made an appointment with the doctor later in the morning and when we got there he took one look and sent us straight to the hospital. It was something far more serious than a stye and I was glad the childminder called me and it never affected our relationship. The problem is you never really know how serious these things are and they really should be addressed as quickly as possible. But how can a parent not take their child to the doctors for a problem that is starting to affect their childs walking and balance. Crazy

You should talk to your local safeguarding board, or representative at the council. It may be nothing, but what you don't know is whether other responsible adults in the child's life have also reported minor concerns and these may all add up to a bigger picture. Failing to seek medical attention for something that's clearly a problem is definitely neglect and as such is a CP issue. But as a CM it's not your responsibility to decide whether it's neglect, it's just your responsibility to report it. You say you have mentioned it to the mother - tell her you are legally obliged (because you are) to mention it to social services if it continues to be ignored.

I have asked Mum if she took child to drs last week on her days off and she said she needs to call again this week as if she tried calling them last week. Can I ask her to let me know when the appt is when she books it so I can put in down in my records. Maybe that would ensure she def does it this week. She cries a lot as well and how do we know whether the child is in pain with them!!!! I am getting more and more upset about this. If it was my child I would have been down the drs the moment I saw the toes turning outwards.

Yes, you can ask her when the appointment is. Apart from anything else, if there's ongoing treatment you will probably have to be involved.

This is a safeguarding issue and you need to record it. Even if the mum does now take the child to the Dr that fact that she has left it so long is a concern. I would second contacting the safeguarding children board for advice.

After speaking to Mum today, she said she would call drs for an appointment this week so watch this space. I will be furious if that appt does not happen.

Is she working full time in a job where she cannot take any time off?

Is she a single parent with no support?

Is the GP one of those where you can only get an appointment if you ring at 8.30 on the dot, and the appointments are all gone by 08.35?

Just trying to see if there might be logistical difficulties.

I wonder if she might look into going to the walk in centre - usually open till 10pm, no need to book, perhaps you could suggest this?

I have done this a couple of times in desperation when I couldn't get an appointment for my dc. We just turned up at the WIC and were seen, diagnosed and treated within 40 minutes. The WIC can write to the GP to arrange further follow up.

There is no job in this country where you are not permitted to take 'dependent' leave for exactly such things as children's doctor appointments. Also, you said in your first post that she has two days free per week - if it's not mission-critical then she could easily make an appointment for a week's time. You do need to record all this, OP, in case it comes back at a future date. If in doubt, ring Ofsted.