Mom chaperoned daughter’s school dance, then had a baby with her 14-year-old date: police
Robyn Polston, 43, chaperoned her daughter’s middle school dance, then allegedly had a child with the girl’s 14-year-old date and even named the baby after him. (Tazewell County Sheriff’s Office)
- Criminal sexual assault
- Child pornography
- Middle school dance
- DNA test
- Underage victim
- Police investigation
TAZEWELL COUNTY, Ill. (WKRC) – A mother chaperoned her daughter’s middle school dance, then allegedly had a child with the girl’s 14-year-old date and even named the baby after him.
According to a probable cause affidavit obtained by People, the Washington Police Department launched an investigation into 43-year-old Robyn Polston shortly after she gave birth to a child in January 2025.
The investigation reportedly revolves around the newborn child, which shares the same middle and last name as a young boy that Polston’s daughter attended her middle school dance with in May 2023. Polston claimed that the child’s father was “a man in his twenties named Brian” and that she had not seen him since the child’s birth.
Further investigation uncovered that Polston was a chaperone at the middle school dance the alleged victim attended in 2023, when he was 14 years old. Shortly after the dance the boy moved away, but he returned in April 2024 for a short visit, according to the affidavit. Notably, April 2024 was roughly 40 weeks before Polston’s child was born.
The victim returned again in June and then moved back permanently in August 2024 to live with a “friend,” the affidavit said.
Upon investigating Polston’s belongings, investigators allegedly found “a large number of sexually explicit images and videos depicting [the alleged victim] and Polston.”
The affidavit also said a DNA test administered to the newborn confirmed the victim was the father.
30-year-old Texas mom records herself posing as daughter at school before arrest
A 30-year-old mom recorded herself getting onto her teen daughter’s campus, posing as a student, to test campus security. At one point, she even exchanged greetings with the princi
EL PASO, Texas — A 30-year-old Texas mother has been arrested and charged after she performed a “social experiment,” successfully sneaking into a middle school dressed as her teenaged daughter.
Casey Garcia says she recorded and posted video of herself sneaking into the school to test campus security.
Garcia, who according to jail records is 4 feet, 11 inches tall and weighs 105 pounds, dyed her hair and used skin tanner before making her way onto the Garcia Enriquez Middle School campus in San Elizario, about 20 miles southeast of El Paso.
The mother said she provided her daughter’s ID number, was asked if she had signed in and was allowed into the building.
Video posted on social media shows Garcia – who was wearing a face mask – entering the school, greeting people in the hallways, and going to different classes. She made it through all of the morning and most of the afternoon before being noticed by a teacher and turning herself in to the principal.
In a video she recorded moments before her arrest, Garcia has her phone as she walks out of her home to waiting El Paso County Sheriff’s Office deputies.
“I’m just letting you know that I am recording,” she tells the officers.
“That’s okay, ma’am, so are we,” one of the lawmen replies.
The San Elizario Independent School District superintendent reportedly said the district was reviewing and revamping their security measures.
Garcia is facing charges for criminal trespass and tampering with government records.
TV station KTVT contributed to the reporting of this story.
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Recently published case reviews
Last updated: 13 Jan 2026Case reviews published in 2025
Case reviews published in 2025
A list of the full overview reports and executive summaries added to the National Case Review Collection. To find all published case reviews search the national collection.
Case reviews describe babies’, children’s and young people’s experiences of abuse and neglect. If you have any concerns about children or need support, please contact the NSPCC Helpline on 0808 800 5000 or emailing help@nspcc.org.uk.
2025 – Anonymous – Child A
Suicides of Child A (under 18-years-old) and their partner, Adult B (young adult). Adult B was placed in care at 15-years-old and presented with concerning behaviours identified in a forensic psychological assessment, including suicide ideation, violence and sexually harmful behaviour. A few months after the birth of their child, Adult B was arrested and Child A disclosed coercive controlling behaviour by Adult B.
Learning themes include: harmful sexual behaviour; forensic assessment; transfer of information within and between two local authorities (LAs); domestic abuse and coercive control in adolescent relationships; and pre-birth assessment and birth plans for young people experiencing coercive controlling behaviour.
Recommendations include: LA1 partnership: oversee a review of multi-agency practice for children and young people who display sexually harmful behaviour; and conduct development work around young people and practitioners’ understanding of consent where there are also safeguarding concerns; LA2 partnership: oversee practice development between maternity services and children’s social care (CSC) to ensure pre-birth assessments are conducted collaboratively and risk assessed, particularly where coercive control may be a feature; both partnerships: review their systems for managing the transfer of case responsibility from one local authority to another; develop a strategy for dealing with domestic abuse in teenage relationships; and review and raise awareness of their professional escalation process; LA1 CSC: review their transfer of information policy; and undertake an audit of cases of young people aged 14 -17-years-old who are the subject of referrals to MASH/Front Door services; and LA1 integrated care board (ICB): ensure that forensic assessments are overseen and shared appropriately so that risk management plans and support can be implemented.
Keywords: suicide, domestic abuse, harmful sexual behaviour, adolescent mothers, partner violence, local authorities
> Read the overview report
2025 – Anonymous – Child H and Adult H
Death of a 16-year-old girl in February 2023, shortly after witnessing her mother’s death from long-term alcohol misuse. Child H and family were known to services due to concerns around neglect, parental substance misuse, poor parental mental health and domestic abuse. Child H had a diabetes diagnosis, a history of self-harm, and had disclosed abuse by her mother and extra familial assaults in the year before her death.
Learning themes include: a ‘think family’ approach; managing risk in families where there are children and adults with complex needs; identifying and supporting children as young carers; care and support needs of adults with mental health or substance misuse issues; supervision and escalation of concerns; and working together across children and adult systems.
Recommendations to the partnership and board include: undertake a ‘think family’ project, looking at impact of the ‘think family’ guidance, and the development of further toolkits, training and audits across the children and adult systems; as part of the ‘think family’ work, there should be an assumption that where there are family members with support needs, a child will be taking on some level of caring role not expected of a child; undertake an audit of children with complex health needs who are known to children’s social care, who have parents with support needs due to alcohol or substance misuse; look at what joint risk assessment is undertaken when parents are declining support from services; and use the ‘think family’ work to bring agencies together to agree safeguarding supervision principles, develop opportunities for multi-agency critical analysis of complex cases, and establish joint supervision sessions for child and adult cases that are rated as high risk.
Keywords: children who have a chronic illness, children as carers, parenting capacity, alcohol misuse, parental illness and death, risk assessment
> Read the executive summary
2025 – Anonymous – Child J
Suicide of an 11-year-old boy. Child J was placed in foster care at 5-years-old and lived with several foster carers. He experienced significant trauma in his life including emotionally abusive parenting, sibling sexual abuse, self-harm and suicidal ideation, and different forms of discrimination.
Learning themes include: intersectionality and the child’s lived experience; the impact of past harm upon children in care; consistent response to the specific needs of children in care such as trauma, mental illness, and neurodiversity; effective placement planning; management of the dynamic nature of risks to children in care; and the impact of COVID-19.
Recommendations include: support the multi-agency network to effectively identify and respond to children that may be neurodiverse; consider how to embed the concept of ‘intersectionality’ into multi-agency assessment and intervention to safeguard children with complex needs; agree expectations regarding what can and should be systematically shared with key partner agencies and placements regarding a child in care’s history in order to support a trauma-informed approach to that child’s care, health and education; ensure that the multi-agency network around a child with complex needs are included in considering what is important for the child as part of placement matching; and ensure that risk assessment and safety planning for children who have significant histories of trauma and experience self-harm and suicidal ideation is multi-agency in terms of ‘ownership’, child-centred, and responds to newly identified risk.
Keywords: suicide, children in care, intersectionality, neurodevelopmental conditions, trauma
> Read the overview report
2025 – Anonymous – Child Q
Allegations of coercive, physically and sexually abusive behaviour made by a 15-year-old girl (Child Q) against her 15-year-old male partner (Child 1) in January 2023. Child Q and her siblings had been subject to child protection plans under the category of emotional abuse since November 2021. At the time of the allegations, she was frequently missing from home and was not attending school. Child 1 was in the care of a neighbouring local authority and living in an unregulated children’s home at the time of the allegations.
Learning themes include: capturing a child’s lived experience, wishes and feelings; responding to changing risks and needs; thresholds for intervention; educational support; and professional escalation.
Recommendations include: ensure that, especially for children on a child protection plan, limited or no progress in children’s outcomes results in a review and reappraisal of the plans and level of multiagency intervention; review the professional advice available to child protection conference chairs and professionals involved in child protection meetings; ensure escalation protocols are in place for child protection conference chairs concerned about a lack of progress in a child protection plan; consider and research the development of a new practice model for protecting young people from immediate harm and risk; review and update the processes by which professionals raise concerns about the planning and intervention for children; consider how to facilitate a positive culture of challenge and openness; and propose a joint working agreement to other partnerships for cases where there are cross-borough safeguarding concerns.
Keywords: adolescents who go missing, abusive adolescents, children in violent families, partner violence, residential care, sexually abused girls
> Read the executive summary
2025 – Anonymous – Jade and Rosie
Suicide of a 13-year-old girl in 2023. Jade and her sister Rosie had received support from various agencies due to mental health difficulties, Rosie from 2019 and Jade from 2021. Between 2019 and 2023, referrals were made to and from multiple agencies regarding concerns including domestic abuse and child sexual abuse (CSA).
Learning themes include: intrafamilial CSA; the need to consider all the needs of each family member and how these may compound a family’s difficulties; a child’s lived experience; children’s peer relationships; Gillick competency; parental refusal of services; the use of chronologies; intra- and extra-familial harm; domestic abuse; risk-taking behaviour; privately commissioned healthcare providers; escalation and professional challenge policies; and information checks during strategy discussions.
Recommendations to the partnership include: produce a learning briefing on emotionally abusive parenting, offering clear descriptions harmful parental behaviours; consider how to systematically review and respond to patterns of refusal of intervention by a family, taking into account consent, thresholds, and possibility of increasing risk; ensure that, where relevant, assessments and referrals consider and reference the impact of the online world and social media on children and families; develop a communications strategy to highlight to third- and private-sector organisations local pathways for guidance and the referral of safeguarding concerns; ensure practitioner guidance reflects the significance of a decline in a child’s mental health; and consider how to action safety plans.
Keywords: suicide, child sexual abuse, child mental health, self-harm, was not brought
> Read the overview report
2025 – Anonymous – Sophie and Riley
Circulation of a video of sexual abuse of a 9-year-old girl by her 13-year-old brother in 2022. Community members referred their worries about the harm to Sophie on three separate occasions over two months in Autumn 2022. The video became available to the police during the third referral. Both children have special education needs.
Learning includes: accessing services and the role of self-referral; identifying non-verbal clues of sexual harm; managing ‘anonymous’ or confidential referrals; case management and escalation; and relationships and sex education.
Recommendations include: local agencies should put in place practice guidance and systems to monitor and support referrals to relevant services where self-referral is required by the parent or young person; review guidance and training on the recognition of sexual harm to children to ensure that it covers non-verbal indicators; provide a multi-disciplinary protocol to be used by key safeguarding leads on managing referrals from members of the community; review the guidance on strategy meeting protocols with regard to re-referrals; review its escalation policy and consider adding steps to be taken in emergencies; build on the previous work of services with representatives of the local Traveller and Gypsy community to support ways to promote the wellbeing and safeguarding of Traveller children; conduct a multi-agency dialogue when a child with an EHCP is absent for health reasons for more than 15 school days. Also, children’s social care and the police should review the processes for planning conversations with children where there are suggestions of sexual harm and there is not a prima facie need for an achieving best evidence video interview.
Keywords: harmful sexual behaviour, sexual abuse identification, sibling sexual abuse, special educational needs, additional needs and disabilities, social media, travellers
> Read the overview report
2025 – Birmingham – BSCP2022-23/03
Death of a 3-week-old boy in Autumn 2022. The baby’s father caused his son’s death during a sudden mental health crisis. Prior to the baby’s death the family were receiving universal services and were not known to children’s social care or mental health services.
Learning focuses on: services’ responses to calls regarding the deterioration in a person’s mental wellbeing; responses when a person presents at hospital in mental health crisis, and if a person leaves hospital without assessment; the impact of resource and demand pressures on service responses; support or advice provided by places of worship; understanding a family’s response to the decline in a family member’s mental wellbeing; and equity, equality, diversity and inclusion.
Recommends that the National Child Safeguarding Practice Review Panel considers whether this report reflects wider issues affecting the safety of children affected by parental mental ill health, including where the parent is not known to services but there is a sudden and urgent mental health concern. Recommendations to the partnership include: implement national guidance regarding how best to respond to people in a mental health crisis; explore whether gaps in the understanding of professionals regarding different faiths or cultures reflects experiences in other reviews, and develop staff’s cultural awareness if this is so; and consider how the existing programme of engagement and training for faith leaders can be developed to enable all places of worship across the city to have access to and undertake safeguarding training and specifically mental health first aid training.
Keywords: infanticide, mental health services, Muslim people, newborn babies, parents with a mental health problem, psychoses
> Read the executive summary
2025 – Birmingham – Child A
Death of a 3-year-old boy in early 2020. Proceedings were initiated at the end of 2022 to remove 3-month-old Sibling B from parental care due to concerns including neglect and poor living conditions. In December 2022, the parents disclosed that they had buried Child A’s body in the garden of their former home. Both parents were convicted of causing or allowing the death of a child, and of perverting the course of justice. The family had been known to services since March 2015. Concerns included not engaging or engaging late with antenatal care, parenting capacity, homelessness, and neglect.
Learning themes include: working with race, ethnicity, culture and beliefs; understanding parents’ resistance to engaging with professionals; the impact of coercion, control, and grooming; assessing risks to children; relationship-based practice; children’s lived experiences; and access to universal services.
Recommendations include: all partnership areas involved to examine current multi-agency guidance, particularly regarding children who become hidden from professional sight or whose parents choose to live an alternative or off-grid lifestyle; Birmingham Safeguarding Children Partnership (BSCP) to benchmark local strategies, policies, procedures, and practice against all recommendations and questions in the Child Safeguarding Practice Review Panel’s 2025 report on race, racism and safeguarding; and BSCP to review practice guidance and pathways for child at risk of hidden harm, such as in cases involving late pregnancy booking, home births, refusal of routine childhood immunisations or medical interventions, dietary restrictions for both child and parents, missed health appointments, coercive control, and professionals encountering parental aggression.
Keywords: child deaths, child neglect, culture, non-attendance, religion, siblings
> Read the executive summary
2025 – Blackpool – Children B and C
Disclosure of sexual abuse from a 4-year-old boy in October 2023. Child B indicated he had been sexually abused by a friend of his parents, an adult male who was a prolific registered sex offender. Children B and C had older siblings who were removed from the care of their mother and father due to concerns of physical abuse and neglect in another local authority (LA) prior to their birth.
Learning themes include: children’s needs and their parents’ capacity to meet them; hearing the children’s voices; communication within and between agencies; supporting professionals to consistently engage adults; and the efficacy of the child safeguarding system and offender management system in enabling safeguarding interventions.
Recommendations to the partnership include: ensure there is a clear training plan for relevant professionals in the Graded Care Profile 2 (GCP2); ensure that the regional work to improve the identification and response to child sexual abuse informs training, policies and procedures; ensure solo professionals such as child minders who contribute to statutory assessments are informed of the outcome; ensure escalation processes enable issues of concern, including those related to the actions of another LA, to be resolved promptly; ensure strategy discussions are convened where there is cause to suspect that a child is suffering or at risk and that they are recorded as strategy discussions in all instances, even out of hours; ask the probation service to consider that notifications about the movement of registered sex offenders are provided to the LA where the offender currently resides; and ensure that practitioners are suitably skilled to respond to adults who provide false information.
Keywords: abusive men, child sexual abuse, deception, extrafamilial sexual abuse, probation service, sex offenders
> Read the overview report
2025 – Bradford – Adrian, Henry and Sam
Incident involving three adolescent boys. The details of the incident are not included in the review. Adrian, Henry and Sam had all been known to services for several years due to concerns including parenting capacity, disrupted education, and child criminal exploitation.
Learning themes include: the adultification of children involved in criminal activity; the vulnerability to criminal exploitation of children missing education; the impact of child neglect and exposure to domestic abuse; the voice of the child; child development and the impact of brain injuries; risk assessments in families where there are known offending histories; information sharing between and within agencies; protective planning and interventions; engagement with children when familial consent is not given; and the impact of professional hierarchies.
Recommendations include: raise awareness of adultification bias; embed cultural competency into case oversight and reflective learning; ensure age and developmental stage are considered in child assessments; promote understanding of adolescent neglect; implement information sharing mechanisms for identifying and monitoring vulnerable children who are missing from school; provide professional learning and development which focuses on adolescent development and neglect; promote the use of chronologies to aid decision-making; ensure the link between a child being exposed to domestic violence and their own offending and risk-taking behaviour is understood; encourage professional curiosity; deliver comprehensive professional development and training on child criminal exploitation; ensure the supervision policies and frameworks of all agencies are regularly reviewed; and promote a culture of mutual respect and professional challenge across all agencies.
Keywords: adultification, child criminal exploitation, children in violent families, children missing education, contextual safeguarding, young offenders
> Read the executive summary
2025 – Brighton and Hove – Child Zeta
Death of a 17-year-old boy in October 2023. Another adolescent boy was charged with the murder of Child Zeta. Child Zeta was well known to agencies including the police, youth justice service, and children’s social care. There were significant concerns including child criminal exploitation, drug use, and mental health problems.
Learning themes include: understanding knife crime and the carrying of knives as a safeguarding issue; strategically disrupting child criminal exploitation and serious violence; considering a defendant’s safety when exploitation is a potential factor in criminal proceedings; sharing and using information across local authority boundaries; and barriers impacting asylum-seeking and refugee children from racialised backgrounds.
Recommends that relevant national services consider producing guidance for lawyers regarding what to do with information which raises a safeguarding issue for a client who is a child. Recommendations to the partnership include: ensure plans and assessments include information about why a child is carrying a knife and the measures in place to reduce the need for them to do so; review the impact and effectiveness of the local pilot police operation regarding cases involving children at risk of modern slavery; when children and young people are placed out of area, ensure risk assessment and planning remains child-centred and addresses each area’s interpretation of risk; explore, record, and integrate into plans the role of social media in the lives of children involved in or at risk of criminal exploitation; and support practitioners in exploring the lived experiences of people from differing religious, cultural and political backgrounds.
Keywords: child criminal exploitation, child deaths, drugs, gangs, refugee children, weapons
> Read the executive summary
2025 – Bromley – Thomas
Suicide of a 16-year-old boy in November 2023. Thomas had received a range of statutory and private services since primary school for apparent neurodiversity and was diagnosed with autism spectrum disorder (ASD) aged 14-years-old. From summer 2023, concerns increased about his mental health and acute levels of distress, despair and suicidality.
Learning themes include: assessing risk of self-harm and suicide in young people with ASD; safety planning; use of emergency departments for the assessment of autistic children and young people in crisis; use of medication and its monitoring; responding to gender distress; online harm and its impact on vulnerable young people; suicide and self-harm prevention; availability of key workers; and coordination of multi-disciplinary services.
Recommendations include: the integrated care board (ICB) and the health and wellbeing board to review how partner agencies train and support practitioners to undertake assessments of self-harm, suicidality and mental capacity, including differences for neurodivergent young people, and to commission practice guidance on risk assessments and safety planning; the ICB and the child and adolescent mental health trust to review the resources available to neurodivergent young people in mental health crisis; the ICB and the mental health trust to review guidance for ensuring progress of patient treatment plans in the event of unexpected absence of key staff; when there is a high risk of self-harm or suicide by a child, there should be an assessment of the parents’/carers’ capacity to manage the care of the child, including administering medication, and to offer a carers assessment if deemed beneficial; and the Child Safeguarding Practice Review Panel and the National Child Mortality Database should consider commissioning national learning into the impact of online providers which facilitate suicide or serious harm to children.
Keywords: suicide, autism spectrum disorder, prescription drugs, children who have a mental health problem, risk assessment, adolescent boys
> Read the overview report
2025 – Buckinghamshire – Child BB
Death of a 15-year-old boy at his home in March 2021. It is suspected that Child BB took his own life, although the cause or circumstances of his death have not yet been confirmed by the coroner.
Learning is embedded in the recommendations.
Recommendations include: ensure that child sexual abuse strategy meetings consider each child and plans are drawn up accordingly; review the support available and provided to children who are regarded as a perpetrator of child sexual abuse to identify and address any gaps in the services offered to these children; ensure that relevant child protection procedures, guidance and practice reflects the need for cases of child-to-child sexual abuse to include routine consultation with the child and adolescent harmful behaviour service (CAHBS); evaluate how far the relevant key learning from the Child Safeguarding Practice Review Panel has been implemented in practice; understand and recognise that parental conflict can have a negative impact upon children, their physical and mental health, and their wellbeing; services are available to help children, and their parents address the impact of parental conflict; information about sexualised behaviour, and appropriate responses across age ranges, is available and accessible to multi-agency partners including schools; specialist advice is sought routinely to help children with problematic sexualised behaviour as early as possible; and services involved in the care and treatment of a child with an education, health and care plan (EHCP) to provide full information to inform an EHCP to ensure a child’s needs are known and responded to over time.
Keywords: child deaths, harmful sexual behaviour, domestic abuse, reports of abuse, schools
> Read the overview report
2025 – Buckinghamshire – Child CE
Presentation of a 5-year-old boy to accident and emergency in June 2023, with a fractured arm. A child protection medical concluded that the fracture should be treated as non-accidental. When examined, CE also had multiple areas of bruising, and there were concerns around his general hygiene and the health of his teeth. CE’s mother and partner were arrested, and CE was placed in foster care.
Learning includes: child in need plans need to show clear targets, objectives, outcome measures and timescales; safeguarding partners need to fully understand the reasons behind why a parent may have passive or oly occasional compliance with meeting the needs of a child; it is not appropriate to ask a child to provide an account of an injury to another child that they think they may have witnessed; and the financial, emotional and practical care impacts of suddenly becoming the sole carer should be explicit in child and family assessments.
Recommendations include: prioritise the development of a neglect strategy, including an assurance process to monitor completion and quality, from which updates can be provided to the partnership; seek evidence that there is an effective quality assurance process operating around child in need plans; and the partnership may wish to work with the commissioners of the services to see if there is a possibility of there being one continuous record, if this is not possible the situation needs to be outlined to all partners.
Keywords: child neglect, information sharing, parenting capacity, domestic abuse, nurseries
> Read the overview report
2025 – Buckinghamshire – Eli
Death of an 18-year-old in February 2023 following an incident on the M1 motorway. Eli reported a significant history of childhood trauma, neglect, violence, and abuse and had multiple and complex mental and physical health diagnoses.
Learning themes include: understanding of childhood trauma; engagement with family members; agency responses to reporting and disclosures; clarifying the legal status of children under relevant legislation; mental health support for young people and transitions to adult services; and commissioning placements and risk assessments.
Recommendations to the safeguarding partners include: trauma awareness in all commissioned safeguarding training; review the effectiveness and timeliness of family group conferencing; review the effectiveness of the existing escalation, challenge and conflict resolution process and reinforce its use across the safeguarding system, including schools; review the multi-agency responses to children’s disclosures of non-recent sexual abuse; seek assurance that cultural competence, equality, diversity, and inclusion is embedded into the training offer and ensure that gaps in practitioner knowledge are identified and addressed; ensure that practitioners have a working understanding of the Mental Capacity Act and the Mental Health Act, including clarification of case responsibility and accountability when young people aged 16-18-years-old are placed in CAMHS inpatient hospitals; CAMHS and NHS hospital trusts should outline the sequencing of treatments and therapy for children and young people to the wider professional network; 18-25 transitions social workers should have access to the children’s social care IT case record system and ensure that this information is appropriately shared with adult inpatient hospitals. Also makes recommendations specific to Oxford health NHS foundation trust on transition arrangements.
Keywords: adolescents, child neglect, child sexual abuse, disclosure, psychiatric hospitals, trauma
> Read the overview report
2025 – Cambridgeshire – Joanne
Death of a 2-year-old child in November 2023 from a traumatic head injury, whilst in the care of their mother and mother’s partner. Police are investigating the injury as non-accidental. Joanne had significant complex physical and medical needs from birth and was part of a blended family. Joanne’s father and her mother’s current partner had a history of domestically abusive relationships or alleged abuse.
Learning themes include: professional curiosity; voice of the child and their lived experience; understanding of the family dynamics and relationships; language and recording in agency records; frameworks for assessing need; and working across local authority boundaries.
Recommendations include: the partnership board should promote resources and training about assessing men in households, and urge the use of genograms, ecomaps and other assessment tools; the partnership should promote awareness of the professional curiosity guidance and support frontline practitioners and managers to improve their critical thinking skills in day-to-day working; the partnership to promote the safeguarding children and resolving professional differences (escalation) policy to all agencies; the partnership to review and strengthen the collective approach to responding to children who have disabilities, in respect of workforce assessment skills, eligibility for access to services criteria, legal frameworks, and understanding the day-to-day experiences of children who have disabilities; and Cafcass should ensure that safeguarding interviews with parties should ideally be undertaken by the same family court adviser.
Keywords: non-accidental head injuries, child deaths, professional curiosity, children who have multiple disabilities, family dynamics, voice of the child
> Read the executive summary
2025 – Cambridgeshire and Peterborough – Ava
A 2-year-old girl and her 8-year-old sibling were discovered in a neglected condition in March 2022 by police who had been asked to undertake a welfare visit.
Learning is embedded in the recommendations.
Recommendations include: agencies providing ante-natal care and health visiting services should ensure that there is clear communication between the services, this should include significant events; children’s social care should ensure that child and family assessments consider and address all areas of concern and fully consider the relevant history of a case; agencies should ensure that there is in place effective management oversight, which is recorded with clear timescales and where appropriate escalation; ensure that the necessity for timely strategy discussions is re-enforced within their agencies; ensure that the significance of third-party information is recognised in protocols on receiving information, and should audit the theme of cases involving ‘anonymous’ referral to understand how this information was managed; prioritise across its membership the learning from recent reviews which highlight the need to understand and be professionally curious about changes in relationships; and develop a partnership staff induction pack (sway), which includes recent key learning from reviews.
Keywords: child neglect, home visiting, home environment, information sharing, professional curiosity
> Read the overview report
2025 – Cambridgeshire and Peterborough – Children A, B, C, D, E
Considers four significant incidents involving infants aged 7-10-weeks-old. Children A, B, C and D are from different families. Criminal investigations and care proceedings are ongoing regarding the abuse of Children A and B and the neglect of Child D. Child C was returned to parental care after court proceedings determined their injuries were accidental. Similar themes about multi-agency service provision emerged from the four rapid reviews. Outlines learning identified during the rapid reviews and how this learning has been progressed.
Learning themes include: the use of partnership policies, including the pre-birth and bruising in babies protocols; responding to pressures on new parents not previously known to agencies; exploring and responding to the impact of parental learning difficulties, physical disabilities, mental ill-health, and isolation; exploring and responding to the impact of a traumatic birth; exploring and responding to the impact of infant behaviour, including feeding difficulties and crying; child protection medical assessments; the use of skeletal surveys; and health representation at strategy meetings.
Recommendations include: review and evidence the impact of the pathway between midwifery and health visiting services; monitor and consider the revised healthy child programme workforce model; and identify and share good practice examples of identifying and working with fathers.
Keywords: infant behaviour, infants, injuries, neglect identification, non-accidental head injuries, parenting capacity
> Read the executive summary
2025 – Cambridgeshire and Peterborough – Gabriel
Death of a 17-year-old boy in November 2022. Gabriel died during an altercation with two young people, one of whom later pleaded guilty to manslaughter. Gabriel had been subject to substantial agency involvement between 2016 and 2022. Gabriel was sentenced in 2022 for offences committed around three years earlier, when he was 13-years-old.
Learning themes include: the voice of the child; the impact of ethnicity, culture and religion; identifying young people at risk; the assessment of risk; providing support to parents; and the impact of coronavirus.
Recommendations include: emphasise the importance of holistic family assessment as the basis for effective early intervention with families with complex needs; ensure processes are in place for escalating and resolving professional differences, in particular regarding threshold criteria and levels of need; ensure up-to-date case summaries and histories are provided when a case transfers to another local authority; in training on work with vulnerable adolescents, highlight the ease with which risks travel across local boundaries; continue to prioritise the integration and co-ordination of multi-agency arrangements to combat child exploitation and serious youth violence; review processes that involve the application of risk gradings for young people at risk of exploitation and serious youth violence; support professionals in recognising the significance of young people’s experience at school; support professionals in delivering relationship-based work with young people; and ensure frameworks and approaches to whole family work are in place across the partnership.
Keywords: adolescent boys, child criminal exploitation, child deaths, risk assessment, weapons, young offenders
> Read the executive summary
2025 – Cambridgeshire and Peterborough – Princess
Details the care experience of Princess. Due to an escalating pattern of behaviour and missing episodes Princess’s parents said they could no longer cope, and she was placed in temporary foster care with parental agreement.
Learning explores: understanding a child’s need and experiences; the impact of risk; missing episodes and deprivation of liberty orders; the use of restraint; finding and maintaining a suitable placement; unregistered placements; therapeutic and behavioural interventions; and multi-agency partnership working.
Recommendations include: assure that all relevant agencies have policy and guidance in relation to the use of restraint; the local authority (LA) should prioritise ensuring it has access to the full range of placement options, including in house residential care, keeping children closer to their homes and maximising the likelihood of a safe return home; relaunch the resolving professional differences policy, ensuring it is fully inclusive, irrespective of role or status, including the option to commission an independent person as facilitator in complex cases; review the effectiveness of working relationships in achieving statutory goals; agree a process for ensuring a prompt multi-agency managerial response to complex cases resulting in a child’s fundamental needs not being met and include an agreement when, how and by whom this should be triggered; ensure all partners have robust policies and procedures in place for supporting staff welfare which meet the needs of all employees; and explore options for sharing learning, and opportunities for collaboration, across the partnership regarding the support of staff welfare.
Keywords: care orders, children in care, residential child care, secure accommodation, staff welfare, placement breakdown
