Warning: This article contains details that may disturb some people.
A woman had her call mishandled when she phoned 111 concerned about her great-granddaughter in a house with a father who was "off his head", before the toddler was found dead the next day, the Independent Police Conduct Authority (IPCA) has found.
An IPCA probe has detailed how the police didn't send any officers to conduct a welfare check at the house in question that night, despite the woman's concerns.
The authority says on March 20 last year, Niki Sturgess called 111 asking for help to get her great-grandaughter, Nevaeh, out of a house in the Bay of Plenty town of Maketu.
"Nevaeh was at the house alone with her father, Aaron Izett, while her mother was in [the] hospital," an IPCA statement said.
But Sturgess told the 111 call-taker that Izett was "off his brain" and he had attacked her and her husband.
"The call taker advised Mrs Sturgess that police did not have the power to intervene because she and her husband did not have custody of Nevaeh. Police did not send anyone to conduct a welfare check at the house that evening," the IPCA said.
"After receiving further reports about Mr Izett's behaviour the next day, police went to the address and found Nevaeh's deceased body weighed down by rocks in an estuary next to the house.
"Police arrested Mr Izett shortly afterwards, and later charged him with Nevaeh's murder and several other violent offences. In November 2020, a jury found Mr Izett guilty of Nevaeh's murder."
Responding to the IPCA's findings, Assistant Police Cmmr Tusha Penny said dispatchers failed to conduct appropriate checks and pass on relevant information.
Penny said the police let Nevaeh and her family down.
"We will never know whether we could have prevented this tragic outcome, and for this, we are deeply sorry."
Penny believes had the information from the 111 call been shared properly, officers may have been able to intervene.
Officers have met with Nevaeh's family to apologise and discuss the IPCA findings, Penny said.
"The call taker and dispatchers involved are receiving ongoing support and training to ensure they are better equipped to respond to future incidents."
According to the IPCA, police confirmed: "Professional conversations" have been held with the staff involved.
"This is an extremely sad case. While police processes were found wanting, due to uncertainty about the exact timing of Nevaeh's death, it is not possible to say whether police would have prevented her being harmed if they had gone to check on her shortly after Mrs Sturgess' call," IPCA chair Judge Colin Doherty said.
In a statement, Oranga Tamariki deputy chief executive Alison McDonald said it reviewed its work with the family following Neveah's death, which will be considered by the Coroner.
"The death of any child is devastating, and I want to acknowledge the ongoing grief Neveah's family must be feeling.
"We cannot pre-empt the outcome of a coronial inquiry, however we can confirm we received three calls about the family expressing concern for Neveah's safety.
"Since Neveah's death we have made significant efforts to ensure faster intervention for children at risk."
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