England and Wales County Court (Family)

Neutral Citation Number: [2010] EWCC 33 (Fam)

22^nd April 2010

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Re:  P

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JUDGMENT

Approved

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THE JUDGE: 

1. The child in this case is AP who has been referred to throughout and indeed in most if not all the documents simply as A.  He is aged three years and three months now. 
2. Mother is AP.  Little is known about his father, even apparently by the mother.  The maternal grandmother is Mrs. P who is the third respondent who has two other daughters and five other grandchildren. 
3. There is an application by the local authority for a care order in relation to A and an order that he be placed for adoption, with the mother’s consent being dispensed with. 
4. Mother opposes both applications. 
5. Mrs. P made an application herself for a residence order for the child but has not pursued it. 
6. The family comes from W.  Mother’s parents were separated when she was three years old.  She was with her father until she was 14 and then at 14 she went to her mother.  At that time grandmother was into hard drugs and mother was somewhat neglected.  She was accommodated by the local authority until she was 17 years old and then went to a hostel for two years, a bed-sit for six months and then back to her mother’s.  She then went to a flat in W and became pregnant in 2006 when she was 20.  It was unplanned.  She did not attend any antenatal classes and social services were concerned even then about her ability to care for the child and so A, who was born on the 24 ^th January 2007, was placed on the register under the category of ‘Clearly at risk of neglect’.  Mother and baby were sent to a foster home where they remained for three months until mother fell out with the family. 
7. There was a parenting assessment by B social services in March and they found mother’s care of the two month old baby to have been satisfactory -- she had, I suppose, not presented too badly while she had been in residential care with the child -- and so she resumed care in her own flat and the case was closed. 
8. In October she went back to her mother’s.  In December she moved to her father’s.  He was violent to her.  She then went to a refuge in Bournemouth with the child and there she showed for the first time -- that is recorded at any rate -- psychotic symptoms.  She was detained in hospital in Poole under sections of the Mental Health Act in January of 2008.  The child was taken into foster care.  Mother was diagnosed with paranoid schizophrenia.  Her symptoms seem to have been quite florid and pronounced (see Dr. K, D16/17). 
9. There was a second parenting assessment of her in February 2008.  I have not seen that but a summary of it records that there was found to be inconsistent stimulation and physical and verbal warmth, concerns about her ability to keep the child safe, she not accepting that she was ill, she refusing to be guided by professionals.  But the child was returned to her on the 24 ^th April 2008. 
10. On the face of it that seems a quite remarkable decision, particularly when one adds in, in addition to the factors I have just mentioned the fact that she was suffering from a serious mental illness.  One wonders how social workers at that time assessed the likelihood of a relapse in her mental condition.  At any rate that is what they did and it had fairly predictable results. 
11. She came back to W in April.  She went from sister’s to father’s then to a hostel.  In May and June there were worries about child development (see page D55). 
12. Then mother’s mental health declined.  Until that time she had, it seems, been taking her anti-psychotic medication via a monthly depot injection and not showing symptoms and she was considered to be showing quite good insight into her condition, but she stopped taking her medicine in the summer.  It does not seem to have been any particular event which precipitated this.  Undoubtedly she was taking cannabis at this time so that may well have been the trigger for her decline. 
13. She was causing worries at the hostel by leaving the child on his own in his room for longish periods -- not that she went off into the town or anything but just leaving the child unattended -- which was certainly frowned upon, and sometimes she seemed groggy and incoherent (AL, B65.)  We of course know what the cause of that was.  She was undoubtedly taking a drug. 
14. The child went on the register in September 2008 again.  She left the hostel.  She moved between various addresses, including one that she described as a crack house.  She still had the child with her of course.  She was not cooperating with mental health services and on the 3^rd October she asked social services to take the child, so the child was taken into foster care and there he has remained; one family for five months and then the second family now for just about a year. 
15. The first interim care order was made on the 24^th October 2008.  There is no doubt whatsoever that the threshold criteria are and were fully satisfied and the document setting them out in the bundle is agreed. 
16. Mother was effectively homeless.  The child was then 21 months old, had already had seven moves and was showing delayed development because of a lack of stimulation by and a proper attachment to his mother, as we will see. 
17. After a period of increasing chaos (Dr. K, D15) she was sectioned in January 2009.  Her condition was again serious.  It revealed she was smoking cannabis daily.  She was paranoid, abusive, with no insight into her condition (D18-21).  She was in hospital until the 13^th March.  On discharge she was under the care of the mental health social worker (AL) and went to live at her mother’s.  When Dr. K saw her in March she had no symptoms and was cooperative and, I suppose one could say, normal in her presentation. 
18. In her report of the 19^th May, D127, Miss L says that she was cooperative to some degree and was taking her medicine but she was reluctant to attend appointments, hence it was difficult to resolve the question of where she should live.  She was hard to contact.  She did not want to discuss her mental health.  She did not attend an appointment to help her with her cannabis use and Miss L thought, undoubtedly rightly, it was quite clear she was still using the drug.  It was doubtful if she could cope in ordinary accommodation on her own as she would be vulnerable to exploitation, presumably a reference to the people she encountered through her drugs use and the necessity of purchasing drugs. 
19. Subsequent reports in November and March from Miss L at B153 and 183 record a stable period in which mother was taking her medicine and was acknowledging her mental health problems.  She did attend the drug treatment project and was apparently very keen to get proper accommodation and to get her son returned to her.  As we know, however, she continued using cannabis on and off until at least February of this year. 
20. Miss L said in evidence that the mother had made great improvements from 2009 to date, both in her behaviour and her cooperation and also in her awareness of her condition.  I accept she had made improvements, though whether they can rightly be described as great is perhaps a matter for debate. 
21. As Dr. K makes clear the keys to her stability were and are:  one, taking her medication, because without it she becomes psychotic, cannot cope and is wholly unfit to care for a child.  Secondly, staying off cannabis.  Cannabis can have a severe effect on people with psychoses, causing the condition to flare up, and in people who have not yet developed a psychosis but are vulnerable to it; it can cause a psychosis to develop.  This is something that is either unknown to or glossed over by many people, including the mother in this case, who tend to think of cannabis as just a nice, gentle, relaxing substance which does not do you any harm.  Dr. K gives an overview of the statistical chances of a relapse but the mother’s history makes it clear that in her particular case she is firmly in the category of people for whom a relapse does indeed occur if her medication is not taken and still more so if cannabis is used. 
22. The social work perspective on this period since her discharge from hospital is in the statement of MK of the 28^th October at B130.  Among other things Miss K did not feel that contact went particularly well on a number of occasions.  There were appointments that were missed.  There were occasions when mother was tired and sleepy, occasions when she was (inaudible) or irritable of both, and again we know the cause basically of that.  She was continuing to use cannabis. 
23. How has this history left this little boy?  We have the report of IB and the statement of the foster mother who was herself interviewed by Miss B in the course of researches in order to prepare a report.  The foster mother’s statement is B157 and the report is D172. 
24. The child went to this particular foster placement in March last year, then aged two years two months.  He was a delayed and disturbed little boy presenting as a baby.  He did not know how to play, he had little or no speech and he had to be treated like a very much younger child. 
25. By the time of the psychological report, when he was aged three, he was normally developed physically; otherwise, despite considerable improvement and the efforts of a clearly good foster carer, he was still 12 to 18 months delayed in other aspects of his development, but he was and is generally a cheerful and friendly little boy.  One of the keys to his improvement seems to have been his developing ability to speak, at least to a small but measurable degree, and hence he did not become so frustrated and aggressive when he wanted something but did not know how to express himself in words. 
26. The psychologist was of the opinion that his severe delay was related to his early experiences when with his mother and what she describes as the insecurity in his attachment to her (D194). 
27. The psychologist sets out what she believes to be the quality of care the child would need in order to overcome the disadvantages of his early years.  She sets them out at D194-5.  She follows this with a list of the child’s specific requirements at D196.  In her view if a family placement is not possible the best alternative would be adoption with indirect contact or, if feasible, perhaps some limited direct contact. 
28. To obtain an independent opinion therefore on whether the mother or, as was then being considered, grandmother would be able to give the child the care which he needs there was a joint instruction by the guardian, mother and grandmother of Miss SJ, who is an independent social worker who reported on the 15^th July of last year (D49).  In short she was unable to regard mother or, as it happened, grandmother as suitable people to care for A.  Grandmother has accepted her view and that of the guardian but the mother has not. 
29. Miss J’s report and evidence can be summarised in this way, that although mother accepted she had a mental illness she refused to accept that it had affected her ability to be a good parent and also seemed to be unwilling to accept the diagnosis of her illness and refused to discuss it.  She was not prepared to give up cannabis despite being told that it exacerbates her condition, and indeed smoked it before one of the interviews and also before a one hour supervised contact session, causing her to be inattentive and drowsy and even during the contact to all appearances to actually fall asleep, although she says she did not actually go to sleep.  She refused to accept that this was in any way wrong or that smoking it would impair her ability to look after A if she had him with her full time. 
30. She was at that stage living with her mother who seemed to be her only real support and clearly hoped that her mother would continue to do all the cooking and cleaning and so on and a lot of the childcare too, which mother seems to have been willing to do in the past.  Her mother and other family members have all said, insofar as their views have been recorded, that mother did no cooking or housework of any kind when she was living there, letting her mother do it all. 
31. Miss J concluded -- inevitably, I think -- that the mother was really looking for the grandmother to do most of the caring for the child as well.  Although mother was able to give some account of how she would care for the child herself her answers tended to lack any depth or real conviction.  Although it was plain from the interviews and the contact that she loves the child and that he responds to her with real warmth this did nothing to deflect the genuine concerns which Miss J had. 
32. The grandmother and mother’s sisters expressed the view that she was not responsible enough to look after the child full time. 
33. One of the matters which concerned everyone was her association with other drug users and inevitably with some drug suppliers; in conjunction with her lack of any real support from her extended family at the time Miss J was interviewing her. 
34. The independent social worker concluded at D78 that what would be needed would be a demonstrable willingness over a considerable period to reform her life, stop taking drugs and to realise the seriousness of her mental health problem.  I am paraphrasing it but I hope accurately.  What Miss J saw was a lady unable to put her child’s interests above her own. 
35. The witness maintained her views in the evidence which she gave.  She believes that the mother will start to use cannabis again and would do so once she had, as it were, got what she wanted, and that carries with it the risk of inducing the onset of symptoms.  She commended her rightly for the progress which she made in at least taking her medicine consistently since March 2009 but Miss J believed that much more time would be needed in order for one to be confident that this is a permanent improvement and that any resolution to remain drug free was also permanent.  The child, she rightly said, has particular needs, special needs in that sense.  He is a very demanding, lively little boy and in the expert’s view mother would simply not be able to cope on her own. 
36. Mother gave evidence to me amplifying her written statements under cross-examination.  I did not find her presentation reassuring in any way.  Having been taciturn with Miss J she was, in court, often unstoppably garrulous, frequently losing sight of the point that she had been asked to deal with.  She emphasised frequently she had never physically harmed her child or been unpleasant to him and that he was always clean and well dressed.  I have no reason to doubt this.  She agreed that she did not talk to him much as she would watch television a lot and she said she also used to talk to herself a lot as she felt she was going mad in the flat.  But her view clearly was that there really had not been all that much wrong with his upbringing until she became ill.  Having spoken of being ill, however, almost in the next breath in her evidence she denied having any mental health issue, to use her words, “although people say that I have.”  She continued at that point in her evidence with statements about believing in God but nobody knowing who God is and other phrases which I must say I found difficult to follow, making several references to a letter she had written to the Prime Minister. 
37. I am bound to say that her evidence at this point seemed to me to stem from a disordered process of thought.  It is wholly unclear what it had to do with the case or with anything that she was actually being asked about. 
38. She denied throughout her evidence that smoking ‘weed’ -- that is cannabis -- was bad.  Indeed she said it was good as it helped her to relax.  Did not interfere with caring for the child in any way.  If people told her to stop she would but if left to herself she would carry on.  She did take it before a contact session .....  (Tape changeover) In this passage mother accepted that she took cannabis before contact but denied that it sent her to sleep or made her drowsy.  I accepted on balance, her evidence that she had abstained from cannabis since the end of January up to now, but I am wholly unable to accept her assurances that she will continue to abstain “if you say ‘don’t’,” to use her words.  First, many people have been saying “don’t” for a long time but she paid little attention to them until very recently.  Secondly, the fact is that if she has stopped she has done so only until she gets what she wants, as illustrated by her account to the guardian at D209 of stopping before the first date for the final hearing and when that was vacated going back to the drug in order to use the time “to enjoy myself with my mates,” but that she would now stop again when a new hearing date was set in order to get A back.  That is all at D209. 
39. I suppose on one view she should be commended for her honesty over this, an almost guileless frankness, but it clearly shows that she has learnt nothing about the damage that cannabis can do to her.  Never mind anybody else, it is the effect on her that is important. 
40. She tried to convey a seriousness of purpose in her present abstention by saying that when interviewed by Miss J she was young and immature as opposed to now.  I am afraid that is simply not a credible statement.  We are only talking about an intervening period of nine months in the life of a 24 year old woman.  If she was not mature at the time she was seen nine months ago she is certainly not significantly more mature now. 
41. The mother presented herself as better integrated in her own family, particularly with her sister Sarah who has three bright and active children with whom A could be, as it were, integrated.  This is in contrast to the picture painted to Miss J.  I notice that when giving details of the people to whom she could turn for support now she did not actually mention her mother, although she told Miss J that she had wanted to live with her mother.  No relative has provided any statement in these proceedings to support her contention that she now has the support of her sisters and I have some serious doubt as to the reality of this. 
42. Mother was also adamant in her evidence that having the child full time would not be stressful for her or beyond her capacity and that she could be a good, indeed perfect, mother. 
43. The guardian’s view is that in order to correct or compensate for the significant delay in this child’s development he needs to be in the care of someone who does indeed possess the qualities set out in the psychologist Mrs. B’s report at internal page 23 of the report.  What would normally be good enough in parents, in the view of the guardian, will not be good enough for A in the light of his particular disadvantages.  The guardian is of the view that the mother lacks these qualities.  Not only was A in fact set back in his development by her lack of proper care but the guardian was struck by the mother’s continuing refusal properly to acknowledge this and likewise by her refusal to acknowledge the dangers of cannabis and her rather cynical attitude -- those are my words -- to when and why she was prepared to stop using cannabis for, as it were, tactical reasons.  The guardian believes that the child would be at significant risk if he was returned to the mother. 
44. What are my conclusions from all this?  They are as follows. 
45. First of all, the first two years were a very unsatisfactory time for this child, showed very unsatisfactory care, frequent movements of residence, the child finally landing in local authority care at the request of the mother herself who could not cope. 
46. Secondly, time is moving on for this child.  He has become used to stability and constant good care.  In such a regime he has made significant improvement, but he cannot stay where he is.  He has the capacity to move and adjust to another stable and this time permanent home with the care which his special needs and best interests require, but that is what it must be in my view if possible, the final move to a permanent and stable home as far as is humanly possible.  There is no time left in my view in this child’s life for any form of experiment with him.  If the mother is not capable of giving him that care now then the timetable of his life cannot accommodate any substantial delay in order to test incrementally whether she could become capable, involving as it would not only delay but also a refocusing of his attachment away from the fosterer to the mother.  If the plan failed, if the rehabilitation plan failed, then that would be likely to involve considerable further emotional upset and insecurity while the child was weaned away from any fresh attachment to the mother and back to those who could more adequately care for him. 
47. All the evidence on this point, which I accept, is that a considerable period of time would be needed to see if the mother could effect sufficient change in those areas of her life which the expert witnesses believe she would need to demonstrate change. 
48. So the question is in my mind:  is the mother able now to offer this child care which is sufficiently good for him?  I emphasise “for him” because I accept that his developmental problems require a carer who is above average in the respects set out by the psychologist and the guardian, rather than care which would be good enough for many children but not good enough for him. 
49. I am not easily convinced that it is right to take any child away from his family but in this case I believe that the evidence is overwhelming that the mother could not offer the standard of care that is required in the child’s best interests. 
50. First of all, she could not or did not before she showed signs of mental illness.  She seems to have been unusually and childishly dependent upon her mother who cooked and cleaned for her whilst she did nothing.  She was extremely immature and has remained so.  Even when seen by Miss J she was expressing the hope that her mother would continue to look after her in that way. 
51. Secondly, her mental health is a tragedy for her. She is of course in no way to blame for an underlying condition regardless of the cannabis, but no responsible court or local authority could give this child back to the mother unless they had far greater assurances that she will not relapse.  She had a history before 2009 of failure to cooperate with those who were trying to help her and of consequent relapses, with serious results for the child. 
52. Has she demonstrated a consistent sense of responsibility towards her own well being and shown that she could do what is necessary to make her a good carer for the child in the long term?  The answer, I am afraid, is no.  She has taken her medicine consistently for a year but her use of cannabis has continued and that was in the circumstances selfish and irresponsible and demonstrated a continuing immaturity in her outlook which has been characteristic of her over this period of her life with which this court is dealing.  It affected her contact, it affected her interviews with the independent social worker, whom she herself had joined in instructing.  She continued to associate with drug users.  She now claims to be free since January.  As I have said, I proceed on the basis that she probably is, but she is drug free for the wrong reason.  The reasons are entirely tactical.  It is quite clear that she actually sees no harm in taking the drug at all.  Mrs. S is quite right to say that she would go back to the drug once these proceedings were over and with it would return or would remain her network of drug taking friends and expenditure of cash on drugs which ought to go towards the care of her child.  It would increase her chances of a psychotic relapse but quite apart from that, whether or not she developed a psychotic relapse, it would also impair her care of the child as we have seen in a sort of microcosm at contact.  This is a very demanding child who requires lots of hard work.  Of course she would find it stressful and her claim that she would not shows that she has a very frail grasp of reality in this respect. To counter the stress would come the cannabis and with cannabis would come serious deficiencies and even positive dangers in her care of the child when she for example succumbs to drowsiness and sleep at a time when she ought to have been looking after him. 
53. Moreover I am afraid to say that even if the mother remained mentally stable I do not believe that she has the inherent qualities necessary to provide what is now, as a result of earlier neglect, the care which this child needs.  I find the evidence of Miss J and the views of the guardian convincing on this.  I do not doubt she would get help from her mother.  The attitude of her sisters is much less clear to me, as I said.  The only recorded views of theirs, which are second-hand but from reliable recorders, are to the effect that they thought she was too irresponsible to look after A. Her mother, who obviously knows her well, does not believe that she can offer what is necessary for the child at the present time. 
54. My own impression of her in evidence, as I say, was not in the least reassuring.  She had a wholly unrealistic opinion of her capacity.  I do not believe she really thinks that she failed to care properly for A in the past.  She does not even fully accept that she has any mental health issues and she certainly does not regard cannabis as a problem.  It seems to me, as I said, that she is still the same immature person and has not essentially changed over the course of time. 
55. If the child was in her care therefore I think there is an overwhelming likelihood of history repeating itself, to put it shortly. Hence the only option in this child’s paramount best interests in my view is that he be placed elsewhere and that a care order be made for the local authority and that they have leave to place him for adoption.  This offers the best chance of a good, permanent, stable home. 
56. I approve the care plan.  I make a care order and placement for adoption and I dispense with the mother’s consent because the child’s paramount interests require it.  Those are the orders I make.

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