England and Wales Family Court Decisions (other Judges)

THE SINGLE FAMILY COURT
SITTING IN MILTON KEYNES.

		12/10/2014

Before Her Honour Judge Brown.

Before me are care proceedings in respect of K, a boy born on 11^th. April 2013. His mother is Ms. P and his father was Mr. B who died in May 2013 of a drug overdose. (In her first statement Mother writes that his death was caused by consumption of a bottle of methadone.) Throughout this judgment I shall refer to them as mother and father. I shall refer to the child as K.

Present in court are the parties, Northamptonshire County Council, Mother, the paternal grandmother Ms. B and the Children's Guardian Ms. Parker.

K lived with his mother until 27^th. January 2014 when he was accommodated by the local authority. He was placed in foster care where he remains to date. K had one foster placement before being placed with his current carer on 15^th. April 2014 where he has settled. Mother seeks return of K to her care. The local authority issued care proceedings on 12^th. February 2014. The local authority and Children's Guardian support the paternal grandmother (who I shall refer to as Ms. B) in her application for a Special Guardianship Order.

Mother will support K being placed with Ms. B if the court takes the view that K cannot be returned to her care. Mother and Ms. B have also agreed the level of contact that K should have with mother namely 12 times a year (as set out below.)

The history and events leading to the proceedings.

The Local Authority became involved with the family prior to K's birth. Historically Mother has had a very difficult childhood, experiencing neglect and emotional abuse within her birth family. She was a "Looked After Child" and suffered sexual abuse within a foster family and by a teacher when mother was placed in a children's home. She sadly experienced a very unsettled childhood with many placement moves ( in her statement mother states up to 60 placements, a local authority document states 40.) Mother has been diagnosed as suffering from a personality disorder, more about which will be said in due course. There have been ongoing concerns about Mother's lifestyle including her abusing alcohol and drugs. There were concerns before K was born that Mother struggled to keep herself safe at times and that she would not be able to manage to meet a baby's needs.

K was born on 11^th. April 2013 and was discharged from hospital on 16^th. April 2013. At first K and Mother lived at Mother's home which was a one bedroomed flat with Mother's grandmother Ms. C. However the accommodation was extremely cramped and by 1^st. May 2013, Mother and K had moved in to live with Ms. C in her property. By mid May it appears that mother had moved out of her grandmother's home and was back in her home living alone with K.

I note that a pre proceedings letter was written to mother on 5^th.June 2013. I have also seen a document which sets out the concerns of the local authority at that time. A 6 week plan of support had been introduced from 28^th. May 2013 under a revised family agreement. In particular, the local authority were concerned that mother was at "high risk" when she was under the influence of drugs or alcohol.

However despite those concerns K remained with mother and clearly mother was providing a level of basic care for K.

K's father died of an overdose in May 2013. This was a further deeply traumatic event for Mother and for the paternal grandmother Ms. B.

However, after the Christmas/New Year 2013/14 period, Mother's mental health deteriorated significantly. This appears in part to have been triggered by the loss of all Mother's photos of K's father and K as a baby – they were on her mobile phone, which was stolen. Despite increased support from professionals (including Mental Health Support Worker) and her friends, Mother's mental health continued to deteriorate, to the point where it was affecting the care offered to K. Mother felt unable to get up, follow a daily routine, or leave the home. She experienced increasingly emotional and volatile outbursts when she became distressed, angry and was unable to control or manage her emotions or behaviour. Mother harmed herself and put others at risk though her actions. Mother made threats to hurt anyone who tried to remove K from her care and she disengaged from professional support. K witnessed a number of these outbursts and on occasion presented as very distressed.

The immediate events leading to K's reception into care occurred when a case conference on 27^th January had to be abandoned when Mother became agitated. Mother was seen walking up the central reservation of the very busy road outside the venue. Professionals were concerned for mother's safety and went to mother's home. When they arrived Mother was outside of the home and became angry and agitated, stating that she would kill herself if anyone tried to take K from her. Mother then walked into the road in front of a moving car which struck her. Fortunately mother was not badly injured. Mother needed to be restrained by Police for her own safety. K was taken into Police Protection and placed in foster care. I have read an account of this incident by the previous social worker Ms. Carmichael (E36) and I am in no doubt that it was a very distressing incident for all concerned.

Mother agreed for K to be accommodated, accepting she was not well enough to care for him at that time and the local authority issued care proceedings.

I am grateful to the parties who have agreed the threshold criteria between them as follows;

The agreed threshold criteria.

1. K (the child) has suffered and is likely to suffer significant harm. The harm and the likelihood of harm is attributable to the care given to the child or likely to be given to him is the order was not made, not being what it would be reasonable to expect parents to give him.
2. The relevant date for determining the existence of the threshold criteria is 27 January 2014 when protective measures were initiated and K was placed in the care of foster carers under section 20 Children Act 1989.
3. The Local Authority asserts and it is agreed by mother that:
   (a) K had suffered significant emotional harm as a consequence of his mother's deteriorating mental health during which she was unable to meet all of K's needs on a consistent basis; in particular his development needs due to her to her inability to interact with K.
   (b) K was at the time protective measures were initiated, likely to suffer significant emotional harm as a consequence of his mother is continuing emotional/mental health problems. Mother's presentation can manifest in aggressive episodes and self harm, with the risk that high could, conceivably be at risk of indirect harm [E 84].
4. The following findings of fact are agreed by mother and are relied upon by the Local Authority to satisfy the threshold:
5. Substance misuse: the first respondent mother [M] has a history of substance misuse including cannabis, non-prescription benzodiazepines, ecstasy (MDMA) and alcohol which impact on her mental health and ability to provide consistent parenting to K [Chron: 4, 11, E 64 5.6 and 5.7, E 65, 66, 67, 79, E90, 92, E89, C57]
6. By her own admission M continued to use cannabis and MDMA after K was removed from her care [E96, C57]. Ongoing cannabis use may significantly affect M's daily functioning [E98] and MDMA may significantly exacerbate M's impulsivity and aggression [E79].
7. On 06.08.13 M was diagnosed with emotionally unstable personality disorder and Post Traumatic Stress Disorder [Chron:25], together with M's difficult upbringing and abuse within the care system has led to a mistrust of professionals. This has manifested in M presenting as confrontational and unwilling at times to work with mental health and social care professionals attempting to help her [Chron: 12,67, see medical notes [E87]. M has not completed DBT to address her difficulties but has indicated that she would like to undertake that therapy in the future if it is deemed appropriate.
8. M suffered panic attacks which affected her ability to go out on her own [A (i) 6, E96]. Feeling that everyone is plotting against her, she hence had limited social contact outside of the home whilst K was in her care [E 91 (33)]. Mother attributes panic attacks to her drug taking at the time.
9. At times M is unable to regulate herself, is prone to verbal outbursts and/or aggression and behaviour which may cause her physical harm and emotional harm to K if such behaviour were ever witnessed by him [Chron: 34, 36, 39, A(i)7,E92,E89,E90].
10. On 11-12 .01. 14, M was taken home by police following a night out where she consumed alcohol "intending to get drunk and forget about everything"[E91 (33)]. M was so distressed that she intentionally head-butted the inside of a police van and needed to be handcuffed for her own safety. Crying hysterically on return to her home, this woke K who was also distressed and screaming [Chron: 38, C2-3, G 64].
11. 23.01. 14, during a consultation with her treating psychiatrist, M became distressed, swearing and making threats to kill herself and anyone who tried to remove K out of her care. At this time M refused to engage in services in order to assist her [Chron: 39, A 92 (36)].
12. 27.01.14, M suffered an emotional crisis and significant decline in her mental help. She became agitated, aggressive and threw herself in front of a moving car. M was restrained by police to prevent her from harming herself further, K was in the vicinity at this time [Chron 40].
13. By her own admission when unwell, M is unable to interact with K in the same way as when she is well.
14. Since K was placed in care, M has continued to become involved in risky/volatile situations which have resulted in her being injured. On 27.05.14 M was involved in an incident whilst out in town. This resulted in M sustaining injury. M was observed to attend contact with a swollen left eye and scratch on her eyebrow [Chron: 61, C 57 and contact note].
15. On 02.06.14 , M was involved in an incident whilst out with friends and reported that her friend had attacked her and she fought the girl off. The police were involved and intervened. M attended contact with a scratch on her right cheek approximately 6 cm long and scratches to her throat [Chron: 62, C 57 and contact note 02.06.14].
16. LA submits that on the facts pleaded the threshold criteria are met.
17. Mother agrees that on the basis of the facts set out above the threshold criteria is met.

The issues.

The local authority has identified the four key issues as follows;

1. Does Mother's current mental health and/or parenting ability impact on her capacity to provide safe, consistent care for K now and in the future?

2. Can mother, with appropriate support in place, provide K with consistent parenting?

3. If Mother is not able to care for K in the short or longer term, should he be placed with his paternal grandmother, and if so, what legal order should underpin the placement?

4. In the event K is placed with his paternal grandmother, what is the appropriate level of contact and/or supervision?

The agreement in respect of contact between K and his mother in the event an SGO is made.

I am grateful to the local authority which, in discussions with Mother, grandmother and the Children's Guardian has filed and served an amended care plan setting out the agreed proposals for contact as follows;

"Should the Court grant a Special Guardianship order to paternal grandmother in respect of K his contact with his mother will be gradually reduced. The Local Authority believes that, at this stage, supervised contact at least six times per year with Mother is an appropriate contact plan for K. However the Local Authority is aware that an agreement has been reached between Ms. B and Mother for contact to take place 12 times a year between K and Mother. The Local Authority is willing to support K under the Supervision Order with this level of contact and will provide funding (by way of refunding mother's travel costs) to facilitate this contact. The Local Authority will work with Ms. B with regard to supervising contact and will supervise the first 7 weeks of contact alongside Ms. B. The Local Authority will then, in consultation with Ms. B, assess the need for the Local Authority's continued involvement in the supervision of contact. It is hoped that after the initial 7 week period Ms. B will be able to take on the responsibility for the supervision of contact either by herself or by an agreed family member or friend."

The evidence.

I have read the entirety of the trial bundles. I have evidence from;

Dr Coffey – Adult Psychiatrist

Ms. Chi Chi Ezeh- social worker

Mother

Ms. Sarah Parker- Children's Guardian

Of the four issues identified, the key issue in this case is Mother's mental health and personality difficulties and how those difficulties impact on her ability to care for herself, lead a stable lifestyle and in turn her ability to meet the emotional and physical needs of K in particular his need for a safe, secure, stale and nurturing home environment.

I make it plain that I approach this case with nothing but sympathy and compassion for this young mother.

I have read in the papers of the deeply traumatic and damaging childhood that Mother suffered. Mother was placed in care from the age of 18 months due to her mother and her family's chaotic lifestyle. Mother has been the victim of childhood sexual abuse on two occasions. The first occurred within her foster home. The second, abuse from a teacher, resulted in a criminal trial and the abuser was convicted. Mother has had over 40-60 placements throughout her childhood and has therefore suffered from a chronic lack of stability. Mother has used cannabis since she was 14 years of age and there have been concerns about her misusing alcohol since she was 15 years old. Mother has also taken Benzodiazepine tranquillisers purchased, "on the street". Mother reported to Dr. Coffey that she has snorted powdered cocaine 10 – 20 times in her life. She has also taken MDMA (Ecstasy.)

Mother has been convicted of ABH. The offence occurred when Mother was involved in a fight with a man in a town. The PNC record notes,

"30th June 2012. Assault on a Mr X dated 30th June 2012 from Police National C states;"IP is out with friends celebrating an 18th birthday. Unknown female walks up to IP and punches him 3 times in the face. Unknown male then walks up to him and punches him once in the face. Knocking him

unconscious. Female then punches iP to the face whilst he is unconscious on the floor. Ambulance attends and conveys male to hospital in an unconscious state where he remains until the morning. Injuries of two black eyes, swollen nose, cuts and scratches to the face and a large bump to the back of his head"

The expert and professional evidence.

I have been greatly assisted by the expert evidence of Dr. Ian Coffey a Consultant Psychiatrist working in private practice in adult psychiatry and addictions. He was instructed as a joint expert. He has provided a main report and two addendum reports. He first saw mother on 21^st. March 2014. He sets out in detail the relevant aspects of Mother's past including her traumatic upbringing, her alcohol and substance misuse and her forensic history. Dr. Coffey has reviewed Mother's medical history and noted that mother has had extensive past input from psychiatric services. In August 2010 a consultant psychiatrist diagnosed her as having difficulties with Substance abuse, "complex Post Traumatic Stress Disorder", auditory hallucinations and a recent overdose. He advised stopping substance abuse, sleep hygiene measures and Dialectical Behavioural therapy. Mother took an overdose of medication in November 2011 and April 2012 and in July 2012 presented at A and E with a head injury incurred from banging her head against a wall.

Dr. Coffey notes,

18. 1 "Mother saw a Dr Carintero psychiatrist with CAMS in July 2012 (Row 25). The interview abruptly terminated when Mother threw her mobile phone at Dr Carintero and then left the room after shouting and banging her head against a wall. Dr Carintero concluded; "Diagnosis; emerging borderline personality disorder drug misuse disorder Deterioration of her aggression, difficulty regulating her emotions. ...serious risk to her own health due to the fact that Mother is asthmatic and is abusing Diazepam and concerns about drinking alcohol. Risk to others as she is very aggressive. Risk of further deterioration of her levels of aggression if she continues misusing Diazepam."
19. 2 Mother was psychiatrically reviewed again twice in January of this year.

(Rows 34 and 35). 8.2 Ms Mother saw Dr M on the 23rd of January 2014 (point 35 of her statement). She had met Dr M twice before. She asked Dr M for Diazepam but he (appropriately) refused to prescribe this. Mother told me that she had walked out of this assessment because she "had felt stressed" and because she felt that Dr M wasn't listening to her. In her statement (Point 36) she comments "I do accept that I then became upset and cried. I do not recall shouting but may have sworn. I felt that I needed to leave the meeting as I felt that I wasn't being listened to and I did leave and Mr. B, the nurse who was present at the meeting asked me to re-arrange it. I did walk out but I never said that I was unwilling to work with them; I just felt that they could have prescribed Diazepam which had helped with my panic attacks".

Dr. Coffey sets out the information he had available to him in respect of an incident on 11^th. January 2014 when Mother has an argument with her friend Mr. Samad in Northampton town centre. Dr. Coffey notes the PNC report,

20. 3 "The PNC Record describes the incident thus; "Late Friday night the 11th and early hours of Saturday 12th July police attending incidents in Northampton town took Mother home having lost her phone and being extremely upset and volatile. She was experiencing panic attacks in the van with officers stating she had lost everything relating to Father and last pictures of him on her phone. Mother became uncontrollable and began head butting the van window and door. She was compliantly handcuffed to the rear for her safety and supported back to her flat. She continually shouted, "don't rape me, don't rape me". Mother was hysterical…. She said she had not taken any drugs or drank any alcohol. This is highly doubtful.".

Of the incident on 27^th. January 2014, Dr. Coffey notes in his report Mother's account of that incident namely,

21. 4 ""it was around this point that the Social Services turned up and said they had come to take K from me. I then had a really bad panic attack. I saw a car being driven towards me and I just jumped in front of it and the next thing I was on the windscreen. I then got up and was chased by the Police".

Dr. Coffey concludes his first report as follows,

22. 5 "The mental disorders that Mother arguably may or may not suffer from include Personality Disorder, Post Traumatic Stress Disorder, Substance Misuse issues, and Depression. In my opinion Mother fulfils the criteria for Borderline or Emotionally unstable Personality disorder. She may fulfill the criteria for Antisocial Personality disorder or some other form of personality disorder. Mother also has historical difficulties with abuse of various substances including Benzodiazepines, Cocaine, and Alcohol. I am concerned that by her own admission that she continues to smoke Cannabis. I am concerned that she may have ongoing issues with substance misuse and I am particularly concerned about possible undisclosed ongoing use of Benzodiazepines. I will address these various possible disorders suffered by Mother below."

"Personality Disorder and Chronic Post Traumatic Stress Disorder"

"Mother has been assessed now by 4 psychiatrists (Dr Fernandes paragraph 8.3, 8.4; Dr Carintero Paragraph 8.6; Dr M paragraph 8.7; Dr Kelly Row 36 and myself; we agree that Mother has personality difficulties rather than an acute mental disorder such as psychotic depression or Schizophrenia. We all concur that she has emotional instability or Borderline personality."

"There is a close association between childhood abuse and adult manifestation of Borderline Personality Disorder. Studies have shown a strong correlation between childhood abuse, especially childhood sexual abuse and the adult development of a Borderline Personality Disorder. Mother describes a traumatic and difficult upbringing including a history of sexual abuse and this is typical of the histories of those suffering from emotional instability."

"Unfortunately the evidence for effective treatments for personality disorders is anecdotal and patchy. There is some evidence that some forms of psychotherapy including Dialectical Behavioural therapy ("DBT") can be helpful to people suffering from borderline personality disorder. However these benefits only accrue after intensive long-term therapy. When Mother was offered this therapy in 2010 she disengaged from it (See Section 8 including paragraph 8.3 where there is a detailed description of efforts made to engage Mother in DBT). Unfortunately Dialectical Behavioural therapy is time consuming and lengthy and is therefore expensive. DBT may take several months or a year or two to complete. There is no evidence that I am aware of that Antisocial Personality is amenable to treatment either psychological or pharmacological."

Dr. Coffey concludes that,

"My impression is that Mother's own difficulties can make it difficult for her to prioritise K's needs over her own at times." Dr. Coffey was careful not to give clear recommendations about Mother's ability to parent as he states that he is not an expert on parenting and such questions would be better directed to other experts. However he writes that K could be at risk if mother relapses in terms of her substance and alcohol abuse, or involves herself in risky relationships.

In his first addendum report Dr. Coffey sets out his contact with Dr. M and Mr. B (Mother's CPN.) He learnt of the progress that mother was making and writes,

"It is encouraging that Mother is being monitored regularly and that her psychological needs are being addressed. I feel that Dr M and Mr B are offering Mother a good standard of care . This ongoing input may help to reduce the likelihood of further outbursts similar to the incident in January."

Dr. Coffey's second addendum report is dated 13^th. September 2014. Dr. Coffey is specifically asked about the timescales required if Mother were to engage in Dialectical Behavioural Therapy (DBT.) He states that DBT usually lasts for a minimum of one year and involves both group and individual work. Dr. Coffey also notes that Mother's treating psychiatrist Dr M in his letter dated 26^th. June 2014 does not think mother is suitable for DBT at that time. Dr. Coffey stood by his original report about the evidence in respect of how effective therapy is for someone suffering from personality disorder. He also comments that, "in my view it would be challenging and difficult to look after a small child and also undertake intensive psychotherapy."

In his oral evidence, Dr. Coffey confirmed that he had read all of the updating documents, including the report of the Children's Guardian. Asked about the effect on Mother of suffering from this form of personality disorder, Dr. Coffey stated that the effects can be wide and varied but include emotional instability and a tendency to react in an extreme way. There are particular problems with impulsivity and anger management. Dr. Coffey accepted that some improvement in mother may occur simply through the process of maturation as she is only 19 years old. There may be significant improvements by the time mother is in her mid to late twenties.

Dr. Coffey told me that were mother to embark on DBT it is likely to be weekly therapy and quite intensive and he believes there would be "emotional fallout" whist the work is undertaken. He accepted that Mr. B's suggestion that mother undertake some form of grief counselling first is not "unreasonable."

Mother has undertaken hair strand testing for the 3 month period proceeding August 2014. The test did not detect substance misuse. A further test for the 3 months preceding November also did not detect substance misuse.

Dr. Coffey made the point that the two sets of hair strand testing together do not rule out any use of cannabis but they indicate a dramatic decrease in her consumption and only irregular if any use.

Under cross-examination the improvements in Mother's life were put to Dr. Coffey. Dr. Coffey accepted that it is encouraging that Mother has a good network of professional help and is engaging with that support. Dr. Coffey also accepted that it is encouraging that mother was able to contain her emotions during some stressful events, for example when mother learnt of aspects of the abuse of her as a child that she has no memory of but have been recorded within social service records. Dr. Coffey also accepted that Mother now acknowledges her difficulties and has some insight into the warning signs as to when her mental health may deteriorate. Dr. Coffey was taken through the medical records which are attached to his report. It was pointed out to him that mother sought assistance on 29^th.November 2013 from her GP stating that she needed to see a doctor and requesting sleeping tablets. There is an entry on 12^th. January 2014 when mother informed the Crisis Resolution Home Treatment Team that the previous evening she'd had an "episode" when she was unable to breather, passed out several times, pulled her hair out and was intentionally banging her head against the wall and floor. Dr. Coffey accepted that Mother reported an increasingly difficult situation to mental health workers in December and January 2014 and that they have that information because mother was prepared to report it.

However, the key message that Dr. Coffey gave was that Mother's improvement and progress is extremely fragile. Her personality disorder is severe. He told me that there are encouraging improvements but they are not, "set in stone." There is a definite risk of relapse which remains a "significant concern." He pointed out that parenting is stressful and is an added risk factor to mother's mental wellbeing and stability. In short he told me,

"Mother has made improvements but they are too fragile and too soon to rely upon."

I have read the letter dated 20^th. June 2014 from Mother's community mental health nurse Mr. B who has worked with Mother since October 2013 on a weekly basis either 1:1 or by telephone. Mr. B writes,

"Over the last few months Mother has made significant changes and has maintained this. These being better management of her emotions, appropriate use of sessions to discuss her concerns constructively and her decision to stop using illicit substances. Also Mother has repeatedly stated that she is aware her previous use of drugs and being highly emotional was not helpful to herself or K."

"Mother has shown she is capable of making changes and continuing these, being able to provide a stable home environment."

It is clear from the evidence, in particular the oral evidence of Mother that Mother has formed a good professional relationship with Mr. B with whom she has worked from October 2013 until August 2014. Regrettably, Mr. B has been on sickness leave since August 2014 and Mother has not had the benefit of a worker from this team for support on a regular basis. Mother has had access to this team through another worker Ms. J, Occupational Therapist from the East Community Mental Health Team who has prepared a letter dated 24^th. November 2014 which has been filed in the bundle. Ms. J met with mother and her worker from the leaving care team, Ms. Pat I on 17^th. November 2014.

Ms. J writes in that letter,

"At our meeting Mother presented throughout as very settled in her mental state. She appeared calm and was communicative. She discussed past difficulties and feelings about the progress she has made to date. She reported that she has not taken any illicit drugs since February/March 2014 and I believe testing has evidenced this. She stated that prior to working with Mr. B she used to struggle to talk about how she was feeling or even to understand what she was feeling resulting in her "locking things up inside," which she said effected the way she coped with situations and managed herself. She admitted that prior to her son being taken into care she didn't engage stating, "I had never before really spoken about problems and didn't know how to." She said things became overwhelming and "blew up."

Overall this letter is extremely positive about the changes and progress mother has made.

Dr. M is Mother's treating psychiatrist and she has been his patient since August 2013. I have read a report from Dr. M dated 26^th. June 2014.

Dr. M sets out that at that time Mother had regular psychological input through her care co-ordinator Mr. B. He writes,

"The focus is on emotional regulation, coping with distress and gradually addressing the consequences of her previous experience of abuse. She is not currently prescribed any medication although in the past I have suggested mood stabilizing medication to her. This did not help substantially with her symptoms."

Dr. M also notes,

"I think the incident in January 2014 was the end point of an emotional crisis which had been developing since December 2013. The Community Mental Health Team was already involved at this point but I think that what has changed is that Mother is more trusting of our staff, has been more able to participate in her own care and negotiate appropriate treatment plans. She has also stopped taking illicit substances. I think all of this means that I can say that the risk of a repetition of the incident in January 2014 has reduced substantially."

In answer to a question about the appropriate treatment plan Dr. M writes,

"I think she has an emotionally unstable personality disorder. She does have some dissocial personality traits but I do not think these are sufficient to warrant a separate diagnosis. I have already outlined the current treatment that she is receiving. In the longer term we do have specific treatment available for people with severe personality disorders in the form of dialectical behavioural therapy. I do not think she will be appropriate for this kind of treatment at present but it is something that we can work towards."

In respect of Mother's ability to work with professionals Dr. M writes,

"In the past my major concern has been that at a certain point in time Mother indicated that she was unwilling to work with other professionals in relation to either her mental health or in terms of parenting her son. She did make this statement at a time of very heightened distress and perhaps without realising the full ramifications of what she was saying. At present I am convinced that she has changed her stance on this matter and I think her recent behaviour has demonstrated an ability to take responsibility for her decision, to take on board other people's views and to compromise with others in practical terms. On the occasions that I have seen her directly interacting with K I have had no specific concerns however a detailed assessment of her ability to parent is outside the boundaries of my expertise."

Served just before the commencement of the proceedings, are some typed notes by Ms. I. One entry, the entry dated 4^th. November 2014 was not created by Ms. I.

These notes were created and by Ms. I and put onto Mother's file. Ms. Engle was unaware that these notes were to be disclosed. I am sensitive to the position Ms. I found herself in. She was present at court as a support to mother. Clearly she wishes to continue in that role. I do not criticize Ms. Ezeh for disclosing the notes, quite the reverse, the court needs all relevant information, but I understand the sensitivities for Ms. Ingalls in working with mother given this disclosure.

The notes are relied upon my the local authority and the Children's Guardian as evidence that mother is not as calm and stable as she maintains and as portrayed in particular by Ms. J in the letter to which I have referred. There is concern that as recently as 26^th. November 2014, Mother has asked for food parcels. Mother told Ms. I that she is having nightmares and experiencing high anxiety in respect of the court case.

There is a record that on 24^th. October 2014 mother was suffering from a pelvic infection and from an STI. The local authority also relies upon this to suggest that mother has not been as open with the court as she has tried to portray.

A parenting assessment was undertaken of mother by a social worker named Sib Carmichael. This assessment was carried out between April – May 2013 and January – February 2014. Ms. Carmichael appears to have been off work between July 2013 and January 2014 due to sick leave. Ms. Carmichael writes,

"In summary, professionals feel Mother is able to provide K with his basic care needs; however, it is felt that K is likely to be at risk of significant harm if Mother is not able to manage her mental health. The impact of Mother's recent fluctuations and historical background indicate that there are serious concerns for K's wellbeing if he is returned to her care. Due to Mother's unpredictable nature, intense reactions to situations and inability to manage her own emotions, professionals are concerned about the ongoing impact that this will have on K's emotional development. Additionally, Mother has demonstrated she is less likely to remain consistent when engaging with professionals unless it is based on her terms. Mother does not like to be challenged and can present as being intensely argumentative when things do not go her way."

Ms. Carmichael adds,

"The risks to K in his mother's care come from the extreme nature of Mother's behaviour when her mental health deteriorates. Because the onset of this is unpredictable and rapid, it is not possible during a crisis in Mother's mental health to manage this risk safely with K in Mother's care."

Ms. Carmichael adds,

"K has already suffered emotional harm. If he is returned to the care of Mother at present, he would be at risk of emotional harm and the possibility of physical harm from Mother when her mental health becomes poor. The local authority does not feel that at present Mother can provide the consistent level of care required to meet her own needs in addition to meeting the needs of K. It would appear Mother has not been able to engage with the previously recommended work to help her with her own issues and this does raise the question of does she want to change? Even if she did and even if such change was possible, it is not clear if this could be achieved within a timescale that would serve K's best interest."

The overall recommendation was,

"The local authority considers that K should remain in long term foster care until a full Connected Persons Assessment has been completed. To avoid delay for K, the local authority will continue to parallel plan for permanence through family placement and through adoption."

I heard the social worker Ms. Ezeh give evidence.

In short Ms. Ezeh accepted that mother had made improvements but her concern remains that she cannot be confident at the present time that these changes will be sustained. Ms. Ezeh is concerned about mother managing her finances and maintaining a settled lifestyle, particularly if K is returned to her care.

Ms. Ezeh told me that initially her relationship with mother was not positive but it has significantly improved and mother has tried to co-operate with her. She felt that the impression mother gave to Ms. J was rather rosier than is the case. Ms. J told Ms. Ezeh that there is nothing more that can be put in place for mother and that if there is another crisis the intervention will have to be reactive.

Ms. Ezeh told me that the local authority now supports the recommendation of the Children's Guardian that there be a 12 month supervision order. In particular Ms. Ezeh considered that a Supervision Order is necessary to assist the parties in agreeing ongoing contact arrangements and to support Ms. B in particular if any issues arise between her and mother over contact.

Under cross examination a series of questions were put to Ms. Ezeh that really amount to criticism of Ms. Ezeh's handling of this case and her consultation with mother. I see no real purpose in setting those criticisms out in detail. In my judgment Ms. Ezeh presented as an extremely caring and conscientious social worker who had balanced mother's right to be consulted and involved in these proceedings with her extreme vulnerability and with the management problems mother presented earlier in 2014.

One issue that Ms. Ezeh was particularly questioned about was the sufficiency of any assessment of mother. It was put to Ms. Ezeh that she had not carried out a specific parenting assessment and that the parenting assessment carried out by Ms. Carmichael was dated 20^th. March 2014 and did not take account of the changes that mother has made since that time. Ms. Ezeh told me that she had seen mother three times at her accommodation and has observed four contacts. However she pointed out that she has read with care the expert psychiatric evidence, the historical case notes and the contact notes. Ms. Ezeh felt she had a great deal of information. She has also been involved with mother's family as she was the social worker for mother's brother but she was clear that she has considered mother in her own right and not judged her due to her involvement with other members of mother's family.

Ms. Ezeh takes the view that Mother is isolated and has little support. She has not met any of mother's friends but is aware mother states that she is supported by friends. Mother has no or little contact with her family. Mother has been clear with Ms. Ezeh that she is not currently in a relationship.

Ms. Ezeh was asked why there had been no specific assessment of Mother as the main carer for K but with Ms. B as an ongoing respite carer, perhaps with regular periods of respite. Ms. Ezeh pointed out that Ms. B was a support for mother in December and January when mother's mental health declined and this did not protect K. Ms. Ezeh was also concerned about the stability of such an arrangement for K and mother's ability to have the insight to recognize that she would need to place K in Ms. B's care if her mental health was deteriorating. Ms. Ezeh did not believe that such an arrangement would meet K's needs for stability and security.

Mother has filed three statements within these proceedings and I have read them all with care. Mother also produced a letter setting out her wishes and feelings. Her Counsel, Miss Murphy read that out and it is in the bundle. I have also taken account of the contents of that letter. I also heard mother give oral evidence.

In mother's first statement, she sets out the events in January 2014 when K was removed from her care. She accepts that there was a disagreement at the review case protection conference on 27^th. January 2014. She says of the chairwoman,

"I have had really bad experiences with her. She speaks down to me and makes me feel tiny. I felt like I was being talked to as if I was in a children's home." There was clearly a disagreement about mother having her phone out although mother states it was on silent mode. There was a verbal altercation between mother and the chairwoman resulting in mother being asked to leave which she did after swearing at the chairwoman. Mother then went to the home of her friend Anthony who was caring for K. She writes,

"It was around this point that the social services turned up and said that they had come to take K from me. I then had a really bad panic attack. I saw a car being driven towards me and I jumped in front of it and the next thing I was on the windscreen. I then got up and was chased by the police down the road; they grabbed me."

Mother confirms in that statement that she has been a regular cannabis user, maybe two to three times a week, mostly at night "which helps me to chill out."

Mother writes of Ms. B,

"I have put forward Christine B, Billy's mum, as a potential carer for K and I would certainly wish him to be with her rather than in care. Billy's mum used to visit on alternate weekends after Billy died in May 2013 but then stopped for a period. I think she was suffering from the effect of Billy's sudden death. More recently Christine has seen K and K would stay overnight there, maybe one or two times a month. K has a half sister as well by Billy who is about three years of age and lives with her mother in Milton Keynes."

Attached to mother's first statement are letters from Mr. B and from Ms. B (Gateway Support Officer.) I have read both and taken the contents into account.

In mother's second statement dated 15^th. August 2014, she sets out that she moved to new accommodation in about June 2014. I should say that I have seen photographs of that accommodation which is a two bedroomed house. It appears to be in good condition and would be suitable for a young child to live in. Mother's case is that she has made significant improvements. Mother writes,

"As the Court will know, I did accept that in January 2014 my mental health deteriorated. This was before I had therapy from Mr. B about things that have happened to me and how to control my outbursts and anger. I believe that since January with the help of Mr. B and Dr. M together with the support from Pat and Heidi, I have managed very much to control matters and my mental health is stable as is confirmed by Dr. M in his recent e mail. I am no longer on any medication although I do not feel I need it any longer and will continue to see my CPN as and when needed. I will also be doing some counseling as well as the work that I have done with Mr. B."

In mother's third statement dated 11^th. September 2014 mother once again emphasizes the changes she believes that she has made. She writes,

"The court will be aware from my previous statement that I maintain that I have made very significant changes in the way I deal with people and my lifestyle and I put this largely down to the work that Mr. B has done with me through the mental health services."

Mother has attached a letter from Ms. I from the leaving care team to that statement and a further letter from Ms. B, both of which I have read.

Within the contact notes there are two observations of mother attending contact with physical injuries to mother's face. On 28^th. May 2014 Mother had scratches on her face and on 2^nd. June 2014 she had a bruised/swollen eye. Mother reported to the Children's Guardian that she had been "glassed" during a night out when she attempted to intervene in a dispute between her peers which caused the eye injury.

In evidence mother told me that she is taking no drugs at all at the moment. She told me,

"There is no future for me at all with drugs." She said that her main priority was to stay well. Mother don't me that she only drinks alcohol if out with friends and on a "rare occasion." Mother accepted that in respect of the two incidents when she received injuries to her face she was drinking on both occasions. On the first occasion mother told me that she tried to break up a fight and was hurt in the process. On the second occasion mother states that an associate (friend of a friend) was extremely drunk and mother told her to go home because she was so drunk, the response by this person being then to attack her. Mother maintained that she did nothing wrong but she would not have intervened and put herself in that position if she had K with her.

Mother told me that the death of father had affected her deeply, in particular she went to see his body the day after his death. Mother became very distressed during this part of her evidence.

Mother is seeing a lady called Ms. Hobbs from the adoption team who is providing a form of counseling. Mother has seen her three times and can see her up to six times on a weekly basis. Mother would like to see her for longer which may be possible. Mother told me that she accepts that there are different things in her life which she needs to "fix."

Mother was asked about how she presents to other people. She told me,

"The reason I am defensive with social services is because of what I have been put through – I have been abused in care – I can come across as quite rude and aggressive and I don't mean it that way – I put a wall up to protect myself – the wall is coming down and I am starting to trust a lot more." Mother credits Mr. B with helping her to learn to trust. Mother told me that by the end of 2013 she had, "lost the plot." Mother told me that she recognizes when she is becoming unwell, she cannot sleep and has very specific nightmares linked to her childhood abuse. Mother told me that she believes that she has a good network of support including Ms. B, Ms. Hobbs, Dr. M, Ms. I and her friends. She will work with whichever worker replaces Mr. B.

Asked whether mother believes that she poses a risk to K mother told me,

"I think I did at the beginning of the year – I've had therapy, I can talk and trust people – I am not so much of a risk as I used to be. If I thought I was a risk to K I wouldn't want him back – I wouldn't want to traumatize him."

Mother was clear in her evidence that she believes that she is stable enough to care for K.

Asked about being able to put her socializing to one side mother told me,

"I would much rather be a mum."

Mother was asked about any difficulty with finances. Mother told me that there had been a problem with her council tax but she managed to pay those arrears off in August 2014. Mother told me that she asked for food parcels because two bills for Sky were erroneously removed from her bank account in November 2014.

Mother was asked about relationships. She is adamant that she is not in a relationship. She was asked why she went to a clinic to be checked for a STI. Mother told me that "If I'm having sex with someone it is not a relationship at all." Mother told me that she has never taken a man back to her house to have sex and "very few people know where I live." Mother told me that the man she'd had sex with was a friend she had known for some time.

Mother told me that she accepted K could not be placed immediately back into her care but he would have to be re-introduced slowly.

The last witness I heard from was the Children's Guardian. Ms. Parker has filed two reports. Her recommendations as set out in her final report are as follows,

"In my summary, which can be read in conjunction with the attached balance sheet, I have significant concerns that Mother has not demonstrated the capacity to work co-operatively with the Local Authority and she still has a considerable amount of work to undertake regarding her own mental health; however it is encouraging, even at this early stage, that she appears to be building a close relationship with her current CPN given her extensive history with psychiatric services. She did not engage meaningfully with her treatment when she was under the CAMHS. She has only been abstinent from drug use for four months and prior to this there were enduring concerns about the impact her drug use had on her everyday functioning and mental health and the risk this presented to K whilst he was in his mother's care In my summary, which can be read in conjunction with the attached balance sheet, I have significant concerns that Mother has not demonstrated the capacity to work co-operatively with the Local Authority and she still has a considerable amount of work to undertake regarding her own mental health; however it is encouraging, even at this early stage, that she appears to be building a close relationship with her current CPN given her extensive history with psychiatric services. She did not engage meaningfully with her treatment when she was under the CAMHS. She has only been abstinent from drug use for four months and prior to this there were enduring concerns about the impact her drug use had on her everyday functioning and mental health and the risk this presented to K whilst he was in his mother's care.

23. Given K's age and current stage of development he deserves and needs a secure and permanent family environment offering future stability and nurturing throughout his life. I consider a placement with his paternal Grandmother is the only option that could meet his needs following consideration of all of the documents filed within these care proceedings and through my own independent investigations. This option will afford K the opportunity of a permanent secure relationship, with a sense of belonging and security that a placement with Mother could not offer within K's timescales due to the concerns I have raised within this report and the attached balance sheet.
24. In conclusion it is my firm view that a decision about K's future cannot wait in order to avoid any further impact on his opportunity to live within a nurturing, stable environment and within his own birth family whilst achieving his optimum life chances. I have carefully considered the Local Authority's final evidence and I endorse the final care plan to achieve permanency for K with his paternal Grandmother, under a Special Guardianship Order, and to reduce any impact of remaining in foster care for any further length of time. (See attached Balance Sheet).

RECOMMENDATIONS

25. A Special Guardianship Order is granted to Ms B in respect of K with a Special Guardianship Support plan agreed with the Local Authority pending satisfactory DBS checks.
26. A Child Arrangement Order in respect of the time K spends with his mother is agreed.
27. The Local Authority may want to consider whether a Supervision Order would assist Ms B in regulating and supporting the arrangements for K to spend time with Mother."

In evidence Ms. Parker told me that her views have not changed from her report since hearing the evidence. In particular she was impressed with the evidence of Dr. Coffey and his opinion resonated with her concerns that the progress mother has made is welcome but very fragile. Ms, Parker told me,

"In terms of mother's journey and recovery it is very early days in terms of fragility and mother's maturity. She's had a hugely traumatic upbringing – only now is she starting on her journey and onset of treatment when the mental health team feels she is healthy." Ms. Parker also made the point that mother needs to remain abstinent from drugs.

Ms. Parker accepted that there were "definite positives" in mother's contact with K.

Ms. Parker remains concerned about mother's ability to accept advice in respect of K and is concerned about the level of co-operation from mother with child care workers as opposed to workers who are in her life to support her. Ms. Parker referred to difficulties with one set of foster carers and mother's difficulty to accept advice within contact about the appropriateness of giving K a drink which specifically was not for a child under three years old. Clearly mother has trust issues with child care professionals stemming back from her childhood.

In short Ms. Parker accepted that mother genuinely loves K and desperately wants him returned to her but she simply does not believe that mother is sufficiently stable to take on the care of such a young child and that the risks are too high.

I have read the Special Guardianship report in respect of Ms. B. Given that no issues have been raised, Ms. Barloe is actively supported by the local authority, the Children's Guardian and perhaps most importantly by Mother (in the event that the court does not approve rehabilitation of K to her care), I simply note the positive report of Ms. B.

ANALYSIS AND FINDINGS.

I am grateful to the advocates for the local authority, mother and the child for their careful and considered submissions. The local authority submits that mother has long standing and deep seated personality difficulties which have been diagnosed as an emotionally unstable personality disorder. She has yet to start any formal therapy to address this and her psychiatrist Dr. M does not consider her to be ready to start DBT at this stage. Whilst the local authority accepts mother has made improvements, the local authority relies upon the evidence of Dr. Coffey to submit the improvement is too fragile.

Ms. Murphy set out with great skill and care the improvements mother has made. She pointed out that despite her background, mother had the care of K for 9 months before he was removed and she was meeting his basic care needs. She submitted that mother had insight into her deteriorating health and that is why she went to see her GP in December 2013. Mother has tested negative for cannabis since April 2014 and now has stable accommodation (although she may lose this if K is not returned to her.) Mother has a professional support network around her and is co-operating with professionals. Ms. Murphy submitted that there should be an assessment of mother's ability to care for K with Ms. B as a regular respite carer. In short Ms. Murphy submitted that there should be a plan of rehabilitation of K to mother's care.

On behalf of K Ms. Meara pointed out that K is now 19 months old and has been the subject of care proceedings for half of his life. His pressing need is for stability and security. The Children's Guardian relies upon, in particular the psychiatric evidence that Mother's progress is too fragile and she needs to demonstrate that she can maintain a settled lifestyle and remain abstinent in order for there to be confidence that she can maintain these changes.

Even by the standards of the care courts, this is an extremely tragic and distressing case. This young mother had neglectful and damaging care within her birth family from which she was removed only to suffer sexual abuse from two individuals within the care system. She had at least 40 placements. She has no real family support. The psychiatric evidence in this case is of no surprise to anyone. I accept the diagnosis of Dr. Coffey that Mother suffers from an emotionally unstable personality disorder. In my judgment Mother is an extremely vulnerable young person and will remain so for the foreseeable future. I accept that mother has tried extremely hard in the last few months to lead a more positive life. I accept that she is either abstinent from cannabis or her use has dramatically reduced. I accept that she has suitable accommodation which is kept in good condition. I accept she has benefitted from her work with Mr. B and that she is co-operating and benefitting from the support of Ms. Ingalls, Ms. Hobbs and Ms. Br. Mother appears to co-operate with Dr. M and would very much like a replacement for Mr. B. All of these are positives.

However the reality of this very sad case is that mother's difficulties are long standing, deep seated and not amenable to rapid change. It is unsurprising that Mother has very real trust issues. She was abused and was not protected by people who should have protected her within the care system. She is not assessed as ready for DBT which may assist her. Even if she embarks on such therapy, it is likely to take 1 – 2 years before it assists mother to make effective changes and the journey through such therapy can be distressing. Mother may make changes over time without such therapy through the process of maturation, by abstaining from alcohol misuse and drug use and from making appropriate life choices an avoiding risky situations. Mother may also benefit from continued counseling even if not of the expertise and intensity of DBT with a qualified professional.

I am not entirely convinced that mother is leading quite as stable a life as she wishes to present. I am concerned that she became embroiled in two altercations this year involving alcohol in the town centre, both of which resulted in injury to her face. Mother portrays herself as in the right on both occasions. However, on at least two occasions she was with young associates, alcohol was consumed and physical altercations broke out. I am concerned that mother required a food parcel in November and that she has retained none of a large settlement she was awarded last year as compensation that she received due to the abuse she suffered in care. I am concerned about mother's attitude that she will have sex but it is nothing to do with a relationship. I of course pass no moral judgment about that but I was concerned about mother's evidence in term of her putting herself in a risky situation. If she has sexual contact with a man who is separate from any ongoing relationship and she will not take that man back to her home, she must feel able to go to that man's home. Whilst she told me that the man she was talking about had been a long standing friend, I was concerned by this evidence, which I did not find wholly convincing.

In my judgment, the improvements that mother has made are commendable and I sincerely hope that she continues on her journey of leading a more stable life, of accepting professional help, remaining abstinent from drugs and keeping herself safe from risky situations both in terms of sexual contact with individuals who she does not know well and in terms of public altercations in the street.

I have of course to consider section 1 of the Children Act 1989. Throughout my deliberations I have applied the principle that K's welfare is my paramount consideration. I have considered the welfare checklist. Looking through the factors, in my judgment, K's pressing need is for a stable, secure and permanent placement as soon as possible. In my judgment, K cannot wait to see whether mother can sustain the changes she has already made. In my judgment the progress she has made is fragile and I remain concerned about some aspects of her lifestyle. Only time will tell whether mother can keep abstinent from drugs, keep herself safe from associates be they sexual contacts or not. I sincerely hope that mother can reach a stage in her life when Dr. Mt recommends that Mother commence DBT and that such therapy can be accessed and mother is able to engage with it. For all the reasons set out above, in my judgment the risks of placing K back with mother are simply too high. I have no doubt that Mother genuinely loves K. I know she was heartbroken by my decision. However, considering all of the evidence in this case, in particular the psychiatric evidence, in my judgment, the risks of placing K back in mother's care are simply too high.

I am delighted that a family placement is available for K. Furthermore I am delighted that this is a placement in which mother places trust and there is a good relationship between mother and Ms. B. Ms. B supports contact at a rate of once per month. I have been asked by Ms. Murphy to consider making a defined Child Arrangements Order setting out the contact between K and mother. I decline to do so. In my judgment the amended care plan is clear and I sincerely hope that the monthly contact agreed between mother and Ms B is successful. However, in my judgment it is in K's best interests for such contact to remain flexible. I hope that mother and Ms. B can work together to agree ongoing contact for K. However, I accept that this may be difficult and mother may find regulating contact to monthly contact sessions only very stressful. It is for that reason that in my judgment a Supervision Order is in K's best interests and I place K under the supervision of Northampton County Council for twelve months. In my judgment it is in K's best interests for the local authority to advise assist and befriend K and his carer and mother in this new situation. Mother and Ms. B may need the assistance of the local authority to negotiate any changes to the contact regime.

My orders are therefore;

The court finds that the threshold criteria are satisfied in respect of K as set out in the agreed document.

A Special Guardianship Order is made in respect of K in favour of Ms. B.

K is placed under the supervision of Northampton County Council for 12 months.

My sincere thanks to all of the advocates in this case. In particular I thank Ms. Murphy for the careful, sensitive but tenacious way in which she represented this vulnerable mother.