A couple were able to leave their children malnourished, infested with head lice and living in squalor because they played off the authorities against one another, a report has found.
The report, commissioned by Gloucestershire Safeguarding Children Board (GSCB), came after the children's parents were found guilty and jailed for neglecting five of their children between 2007 and 2012.
It revealed that teachers, doctors, health professionals and social workers knew about the family over a 16-year period but did not take any formal action until one of the children was admitted to hospital with severe nappy rash.
The senior case review into the family - who cannot be named for legal reasons - found five "missed opportunities" for the authorities to intervene which were not taken because neglect was not treated as seriously as other forms of abuse.
Weeds growing in through the bedroom window It found 127 recorded contacts between the family and primary health care professionals over a 27-month period.
The children were seen by GPs amid complaints from teachers and health workers that the children were suffering with tooth decay, poor growth and weight gain, delayed development, anaemia, poor hygiene and severe nappy rash.
The review found there was continuing evidence that the parents often turned away health professionals and the mother put her own needs above those of her children.
The children's grandmother admitted her daughter was "manipulative and aggressive" and very controlling, with GPs observing she was very "skilled at playing off one agency against the other".
"One of the most concerning issues in this case is the apparent lack of understanding, at the time, of neglect and its impact by a number of the key professionals working with this family," the report said.
"All of the signs were there, and had been for many years, that these children were suffering or likely to suffer significant harm due to neglect.
The kitchen also shows the dirty conditions the children had to live in "At the time, there were clear difficulties in ensuring that all of the information on all of the children was available to be considered and drawn together in order to ensure a complete picture.
"A child protection conference would have allowed all the professionals involved to share the history of the family and the current concerns in a setting chaired by an independent person, where the parents could not have decided who was involved and who was not."
David McCallum, chair of the GSCB, said the authorities involved had underestimated the impact of long-term neglect.
"For most of the time when children's social care and other agencies were working with this family, they treated the neglect as a 'child in need' issue and that probably underestimated the extent of the harm those children were suffering," Mr McCallum said.
"One of the real points of learning for all the organisations involved is that neglect can be really, really harmful to children, especially when it's long-term."
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