Callum Wilson murder by mother Emma Wilson 'preventable'
The murder of an 11-month-old boy beaten and blinded by his mother could have been prevented, a report has said.
Callum Wilson, from Windsor, suffered a detached retina, broken bones and bruising as well as "unsurvivable brain injury" and died in March 2011.
Emma Wilson was jailed for life at the Old Bailey in January for his murder.
Professionals missed chances to intervene before Callum's murder, which were "very likely to have prevented his death", the serious case review said.
It added the risk to Callum had been underestimated by social workers.
The review, led by Royal Borough of Windsor and Maidenhead Council and published on Monday, also said professionals at a GP practice, a children's centre and child health clinic did not comply with the training they had received and did not follow child protection procedures.
Bruises and scratches had been seen on Callum by health workers, his GP and the local children's centre, but due to a series of failings and inexperienced staff, they were not flagged up to the right authorities, the report said.
The review also found there was no comprehensive record linking his family history, social care and medical background.
'Mistakes not repeated'
The report, published by the council's Local Safeguarding Children Board, said: "In the two weeks before his death professionals missed opportunities to intervene, which, if they had been taken, are very likely to have led to the detection of serious injuries, and are very likely to have prevented his death."
The report recommends new guidelines on identifying abuse, sharing information and on how the different agencies communicate with each other.
The agencies involved said they had since implemented all the recommendations to ensure "the mistakes made in Callum's case will not be repeated".
Wilson, who the report said has no history of mental illness, learning disabilities or drug misuse, was convicted of murder in December after a trial.
She became pregnant by a man she was not in a relationship with and kept the pregnancy a secret, giving birth on her own on 23 April 2010 with no medical attention.
Her partner at the time insisted Callum would have to be put up for adoption and the baby spent the first few months of his life with foster parents.
However, Wilson was said to have deeply regretted handing over Callum to the authorities and in November that year he was returned to his mother.
But on 18 March 2011 he was taken to Wexham Park Hospital in Slough suffering serious injuries.
He died three days later after being transferred to John Radcliffe Hospital in Oxford.
The review said when Callum moved back in with his mother he should have been closely monitored because of concerns about how she had handled his birth, along with Wilson's failure to visit him for long periods when he was in foster care.
However, it said the council closed her case after two visits and Wilson was left to take Callum to health clinics herself, and to only seek advice from her health visitor or GP if she wanted to.
The review said the social worker allocated to work with Callum's family from May 2010 was "newly qualified" and did not have the necessary skills and knowledge to deal with the case.
It said the social worker did not visit Callum and his mother before he moved back in with her, instead just relying on the comments of the foster carer. They also did not speak directly to the boy's grandparents to assess what their role would be once Callum went back to live with Wilson.
The report added the social worker's supervisor and other "much more experienced colleagues" failed to identify potential difficulties and to challenge "the superficial assessments that were produced".
Once in his mother's care, Callum stopped putting on weight, the review said.
However, his GP did not have access to his medical records and did not notice the references to weight in his personal child health record.
The infant was found to have a brain injury, rib, arm and leg fractures and bruising across his face and body.
The review said the caseloads of health visitors in East Berkshire exceeded nationally-recommended levels and it found this limited the time staff had "to make visits, to undertake assessments and to practice in a reflective way".
A joint statement was released from the agencies involved - the Heatherwood and Wexham hospitals, the Berkshire Healthcare NHS Foundation Trust, Royal Borough of Windsor and Maidenhead council and Windsor and Maidenhead Clinical Commissioning Group.
In it, they said: "Changes have been made to strengthen our policies and procedures, for example formal reporting of bruising in very young children and new policy on concealed pregnancies."
Wilson's trial heard she had claimed "constant pushing and rolling" of Callum by his 23-month-old brother may have been to blame for the injuries.
She also blamed Callum's brother after health and social workers spotted scratches on the child during visits to Wilson's flat.
The trial also heard Wilson had lied to staff and parents at a playgroup in Maidenhead, claiming Callum was her cousin's son.
She provided a false surname and address for the youngster and claimed on one occasion that bruising on Callum's face had been caused by an older sister who in fact did not exist, the trial heard.