THEY were a catalogue of damning failings that let a little boy down so badly that he is no longer here to tell the tale.

Blake Fowler should today have been like any other boy – on the cusp of starting senior school and looking forward to a new chapter in his life.

But instead he led a short life in which he endured shocking neglect at the hands of those charged with his care.

Even the authorities who had the power to intervene missed all the warning signs – not to mention the 18 separate opportunities that may have saved his life.

Today Blake Fowler is a legacy to other children – he is at the heart of sweeping changes that are set to ensure, as far as possible, this can never happen again.

How the years of abuse and neglect suffered by Blake while in the care of his mother Sarah Spacagna and stepfather Peter Meek could have been allowed to go on is at the heart of the recommendations contained in a Serious Case Review (SCR) published this week.

Daily Echo: Sarah Spacagna.

Daily Echo: Stepdad Peter Meek.

Each agency who between them let the youngster down so badly have now faced the press and public and delivered their apologies.

But, more importantly, they have outlined how they will make sure this never happens again.

Daily Echo:

Chairman of the Local Safeguarding Children’s Board Keith Makin (above) told the Daily Echo: “It is an impossible question to answer whether Blake would still be alive had those missed opportunities been acted upon.

“What I can say is that things are very different now, those serious errors should not happen now and there should be proper investigation and a better communication between those agencies.

“But it is important to stress that we have been learning from these lessons for some time now. The situation we now have in Southampton is very different to the period covered in the Serious Case Review.

“We react much more quickly now.

"If problems come to light as they were in this case then they are acted upon that day. We also work to make sure that a child is kept safe while those investigations are going on.”

The report that was commission by his board – itself criticised for the delay in starting the review – contains no less than 12 recommendations that were taken from a wider set of reports issued to each authority.

Due to the length of time the report has taken to be made public, in part as a result of its own delay in being commissioned, but also in waiting for the completion of criminal proceedings, many of the recommendations have already been made.

Practically the whole department of social services at the city council has been overhauled on the back of events of 2011.

As well as Blake, three other children who either should have been or were in the care of children’s services in the city died that year.

Those children all subsequently became the subject of serious case reviews.

Inquests into the deaths of Blake Fowler, Nico Maynard and brothers Jayden and Bradley Adams (pictured below) all identified how agencies could have worked more closely to share information.

Daily Echo:

It was also the year in which an Ofsted inspection of how Southampton City Council looked after vulnerable youngsters branded the service “inadequate”.

As a result a new “nerve centre”, was established, which allows key agencies to literally work under the same roof when dealing with the most serious cases of safeguarding children in Southampton.

Called the Multi AgencyMultiAgency Safeguarding HubHub (MASH), the facility now allows for better communication between agencies including social services, the police, probation service and health agencies.

Educational welfare, children’s centres and social services care have all been brought under one team so families can be offered a single package of support rather than having to go through different departments.

Daily Echo: Southampton City Council HQ.

Alison Elliott, the city council’s director of people, said it was as a result of all the events of 2011 that sparked the major changes to the department.

She said while they acknowledged the work they had done, they could not be complacent about what still needed to be achieved.

“We can never be complacent, but I am confident that as a result of what we are doing and continuing to do that we have reduced the risk of cases like Blake’s happening again in Southampton.”

According to Ms Elliott about 1,500 families are now being helped who would not have even been on their radar in the past, through an early help scheme.

Families who need of support have been identified and are working with the services provided by the council and partner agencies before their needs become critical.

Cutting the number of temporary staff was also at the top of their priority list and now 90 per cent of children and families work with permanent staff.

Across the city 150 social workers are helping the families in need of support.

Caseloads have also been reduced from 50 children per social worker to around 15 to 25.

The fact the department was taking on too many cases and as a result relying too much on agency staff was a key criticism of why the children’s social services department was struggling to cope.

At one point Blake’s case was being run by a student social worker.

Training has also been a key factor in improvements made to both the police and health services.

The first inadequate probe into the death of Blake, who was found with head injuries while in the care of his stepfather Peter Meek, prompted an apology and a fresh investigation into what happened.

However, no charges have been brought.

According to the SCR, the case should have been passed to the force’s Major Crime Team and not left to an officer who had not been trained specifically in child deaths.

Extra training has now been put in place to address that, along with ensuring that national guidelines regarding child death post-mortems are also adhered to.

Similarly Southampton City Clinical Commissioning Group has also embedded a series of improvements, mostly around improvements to how they respond safeguarding local children and tackling the need for early help for domestic violence.

Chief Nurse Stephanie Ramsey said: “We are determined to ensure that such failings do not happen again in Southampton.”

Daily Echo:

Right from the outset, questions were being asked of the circumstances in which Blake Fowler died, with his death making headlines in the Daily Echo and nationally.

It was days after the seven-year-old passed away in December 2011 that the youngster first appeared on the front page of this newspaper as we reported how two men were being quizzed by police.

One of them was his step dad Peter Meek - a man who should never have been left in charge of him due to an order imposed concerning his contact with the schoolboys mother Sarah Spacagna.

The other was Peter’s brother Philip.

There were further developments in April 2012, four months after the tragic death of Blake, when we revealed how nobody would face criminal charges.

In November 2013 the story of Blake reared its head again, as an inquest into his death finally took place – after almost two years of waiting.

It was one of four inquests to take place during the space of one week into the deaths of four children in Hampshire, all in 2011.

Coroner Keith Wiseman condemned the “plethora of lies” told by those who should have been caring for Blake, while his grandmother Jane Extance revealed she had raised the alarm with social services two months before the youngster lost his life.

Ever since then the Daily Echo has kept the story of a battle for justice for Blake alive, as police reinvestigated the case which led to fresh arrests of Ms Spacagna and Mr Meek in April 2014.

Days before Christmas last year we reported how the Crown Prosecution Service had decided there was insufficient evidence for a realistic chance of prosecution in the courts – and the pair were released without facing any charges concerning Blake’s care and death.

But the failures of all those involved in ensuring the Holy Family pupil was safe from harm have now been laid bare in a damning serious case review published this week.

CPS: Why we decided not to prosecute

THE Crown Prosecution Service (CPS) has defended its decision not to prosecute the mum and stepdad of Blake Fowler in connection with his care and subsequent death.

Bosses said they considered all options – including whether it was in the public interest to prosecute anyone for murder, manslaughter, failing to protect the seven-year-old, child cruelty and neglect.

But ultimately they say they felt there was insufficient evidence that would lead to Sarah Spacagna or her partner Peter Meek being convicted in a court.

The decision not to put either of the pair before a jury has previously drawn criticism from some quarters.

Blake’s grandmother, Jane Extance, said: “Although the CPS feels there was insufficient evidence to bring a conviction, I believe the evidence provided is enough for a jury to decide weather to convict the accused for the charges at the time of arrest.

“I believe in a fair and democratic judicial system, and feel totally let down by yet another agency in the Crown Prosecution Service to bring justice for my grandson’s life.

"We are currently gathering information and will be presenting representations to the CPS for a review of their decision.”

Despite their arrests in connection with Blake’s death in 2011 – including a more recent reinvestigation by police last year after they admitted their initial enquiry was not good enough – neither will face any criminal charges.

In a statement released to the Daily Echo, a CPS spokesman said: “Following a careful review of all the available evidence provided to us by Hampshire Constabulary it was decided that there was insufficient evidence to provide a realistic prospect of conviction for any offence in relation to any person.

"This decision was made on December, 18, 2014.

“In reaching our decision we considered whether there was sufficient evidence and whether it was in the public interest to prosecute anyone with the offences of murder; manslaughter; causing or failing to protect Blake from death or serious physical harm; and the offence of child cruelty which would include the wilful neglect or abuse of Blake.”

The spokesperson said the decision was explained to Blake’s grandmother, who was offered the right to ask for the decision to be reviewed – something, as the Daily Echo reported this week, she now intends to do.

It comes after both a family court hearing and the Serious Case Review looking in to what failings occurred leading to the death of Blake, both found evidence of neglect.

The CPS statement continued: “The evidence present in the Serious Case Review, the Family Court proceedings findings, the inquest into Blake’s death, as well as the statements from the different agencies and witnesses had been provided to us by Hampshire Constabulary for us to take into consideration in deciding whether Peter Meek had committed any offences in relation to Blake.”

But, the spokesman said, in order to prosecute the CPS must prove that a person had wilfully assaulted, ill-treated, neglected, abandoned or exposed Blake in a manner that was likely to cause him unnecessary suffering or injury to health.

Despite Blake “living in an environment where domestic violence was prevalent” and the fact he was encouraged to box with his brother, the CPS concluded there was no evidence to suggest Peter Meek had deliberately intended for Blake to come to harm.