England and Wales Family Court Decisions (other Judges)

IN THE FAMILY COURT AT STOKE-ON-TRENT

JUDGMENT 29th May 2014

JUDGE DUGGAN:

1. Yesterday, I conducted the final hearing of the local authority's application for Care Orders. I am concerned with two children, C, born on the 25th April 2011 and L born on 30th August 2013. These children have the same mother, with whom they lived until September 2013. They have different fathers, who have each been assessed as potential carers if the children are unable to return to their mother.
2. The assessment of the father of C is positive and there is an agreement that if C cannot return to her mother, she should be placed with the father under a Care Order.
3. Stoke-on-Trent City Council were directed to prepare an assessment of the father of L, but lamentably they have failed to produce what is required. Once the proceedings are over, there must be an enquiry as to what has gone wrong. The result is that a decision within 26 weeks, which Parliament insists is the entitlement of the child and his family, is not going to be possible. It is not possible in L's case for the Care Plan to be approved. There are live issues concerning this father. The mother is entitled to contest those issues. In addition, the local authority plan for L involves a lengthy period of internal assessment. The delay involved in that is not satisfactory, and by continuing the proceedings for L, it is my objective to reduce the overall delay before a decision is made and implemented for that child.
4. It follows that the proceedings relating to L must be adjourned. I will, with assistance from the parties, turn to the appropriate directions for that part of the case later this afternoon.
5. The proceedings arise from the health visitor's attendance at the mother's home on the 23rd September 2013, when she saw that L had suffered a head injury. It is necessary for me to determine the issue as to the cause of that head injury. The local authority must establish that the threshold under Section 31 of the Act is met in order to allow Care Orders to be made. The local authority have set out their case, and in essence they allege that these injuries were inflicted by the mother and have been concealed by the mother, who has failed to obtain the necessary medical treatment for her son. If the local authority are successful in establishing that the threshold is met, my approach must be to make the welfare of the children my paramount concern, and I have the welfare check list at the forefront of my mind. Any order which the Court makes must be necessary and proportionate.
6. The local authority bring the case, so they must prove their allegations, and the standard to be met is the balance of probabilities. The mother need prove nothing and the Court will not proceed on mere suspicion; if allegations are not proved, my approach is that the alleged event did not happen.
7. The case involves medical evidence, so there is a need for caution. I am aware of the points made by the Court of Appeal in the case of Re U. Here, there is no medical disagreement and the issues do seem to concern mainstream medical science. However, it is important to reflect that human knowledge has its limits and doctors can be wrong. Accordingly, I must consider the medical evidence alongside all the other evidence in the case, including, importantly, the mother's account. At the end of the day, though, the question remains, have the local authority established that the injuries were inflicted by the mother? In my task, I must consider the full range of evidence, including the wider social canvass.
8. In considering the mother's account, there is a further need for caution, as the mother accepts that she gave an untruthful account initially. I must not assume that everything that the mother tells me is untrue. I must not assume that as a consequence of her original dishonest account she did in fact inflict these injuries. I must weigh up any other reason for the mother giving an untruthful account, particularly reasons which would mean that she was not responsible for inflicting the injuries.
9. I turn to the medical evidence. L sustained a skull fracture with swelling and a subdural haemorrhage. There is no medical explanation for these injuries or medical predisposition for them to occur. The cause is a high energy impact to the side of the child's head.
10. The mother's first explanation, given in September 2013, was that she accidentally struck the child's head on a door frame. It is clear that this could not involve enough force. In December of 2013, the mother moved on to her current account, which is that the child fell to the floor when lying on his mother's chest, on the mother's bed.
11. The local authority have persuaded me that this is not a truthful account. My reasons are these:-
12. One, in the mother's favour, it is clear that she loves her children. She shows affection for them. Her contact has been of good quality. She can meet the basic needs of the children and has been committed to the process of assessment. There was some local authority involvement with the mother in the past connected with reports of alcohol use, but the local authority case was then closed and there is no recent sign of problems arising from the use of alcohol.
13. Two, even the mother's second version is not consistent with the medical evidence. The force generated by a low fall like this is, according to the medical evidence, unlikely to cause a skull fracture, although this is not completely impossible. However, with the infliction of a skull fracture one would expect that the child would produce unusual cries of pain, whereas the mother insists that the child produced no more than whingeing. The fracture of a skull could be expected to produce swelling very quickly. The mother says that the swelling only appeared many hours later. In fact, for me, the mother's account was unconvincing. She says that she fell asleep with the child on her chest, but her account indicated that she was still conscious of the movement of the child rolling from her chest. She gave an account of the position of the Moses basket and her apparently deliberate moving of the basket away from the bed. This was a particularly low point in her evidence which for me was clearly designed to avoid the possibility that the fall of the child from the bed would be broken by the position of the Moses basket.
14. Three, the fact that this is a second version is, for me, weighty evidence that it is not true. The mother says that she lied originally because she was ashamed; she did not want to admit that she had let her baby fall off the bed. I do not accept this. There is, surely, no less shame involved in letting a child's head strike the door frame, which of course was the account which the mother preferred to give. It is significant for me that the mother's account changed when it was authoritatively suggested that the force involved in the first version was insufficient to explain the injuries that in fact occurred.
15. Four, the mother failed to obtain treatment for this child. She explains that the injuries occurred in the early hours of the 20th September. She insists that no adverse effects were seen until tea-time, when the swelling became apparent. In fact, the mother's evidence has been hopelessly inconsistent in connection with the swelling. The grandmother reported that the swelling increased in size, but the mother insisted that the swelling remained at the same size. Police records show that the mother claimed that the size of the swelling reduced, which she used as part of her justification for thinking that the child was getting better and did not require treatment. In evidence to the Court, the mother insisted that the swelling remained at the same level and did not change in size at all.
16. The reality is that the impact and the after-effects demanded medical attention. The mother says that she realised this only later, but she accepts that with this realisation, she took no steps because she feared that the authorities would believe that she had inflicted the injury on purpose. They would remove her children. The mother was particularly anxious on this topic, having seen the authorities remove children from other members of her family.
17. My analysis indicates that this motivation which the mother claims came over her later in the day, was in fact present from the time of the injury. For me, this motivation is important evidence that what happened to the child was in fact no accident. If this was an accident, a loving mother would have no reason not to seek treatment. As the swelling developed, as family members expressed concern, the mother's justification becomes even less viable.
18. The eventual discovery of this injury by the medical authorities was not the result of the mother coming forward. The health visitor came to visit three days later on the 23rd September and saw the swelling. The health visitor had to ask the mother, before the mother made any comment on the swelling and on the condition of the child. In fact, the health visitor had an appointment to see the child at noon on the 20th September. The health visitor contacted the mother asking whether it would be possible to come a little earlier for that appointment, but the mother said that she was busy. The consequence was that the appointment was rearranged three days later. I have heard extensive evidence about this. The mother was not busy. She could quite easily have accommodated a visit from the health visitor on the morning of the 20th September. The mother could have been expected to take advantage of this opportunity to have the child checked. Instead, the mother took the opportunity to avoid this appointment, which for me is the clearest indication that she had something to hide.
19. Five, the mother shared her accommodation with her family, but it is clear that she was herself the sole carer of these two small children. There is no realistic possibility that anyone else could have hurt the baby apart from the mother. It is clear that the domestic pressure on the mother was at a very high level. L was not sleeping well. C was suffering a chest infection and the result is that the mother, a sole carer of these two children, was herself sleeping very little. Mother agreed that she was very tired, but she repeatedly insisted that she did not find this period a stressful one. It is clear that Mother was going out of her way to minimise the pressure operating upon her at the time under review.
20. The truth is to be seen in her text messages, in which she made frequent complaints about the children and referred to them in derogatory terms. The mother told the Police in interview that her family were more of a burden than a source of support, and she conceded to the Police that during this period she found that she became quite depressed. This high level of domestic pressure on a sole carer makes it easy to understand that there could be an angry, desperate outburst in the course of which injury was inflicted. The mother's minimisation of the pressure upon her is totally unrealistic and is, for me, evidence that she is hiding the true position.
21. The result, then, is that for these reasons, the local authority have established that the mother's current account is not true, and I reject it. It is clear that there is an alternative explanation for the child's injury. This must involve the application of a greater degree of force and the mother must know what this explanation really is. This was a small, immobile baby in the mother's care. However, the mother is not prepared to tell me what this alternative explanation is.
22. There are two alternatives. Either the baby suffered a different more significant accident than that which the mother is describing, or alternatively, the child has had this injury inflicted upon him by his mother. I have seen the mother give evidence extensively. If this was an accident, she insists that she would tell me about it. I am driven to the conclusion that these injuries were not caused by an accident. These were injuries that were inflicted by the mother, which is clearly the reason that they were concealed by the mother as they have been.

Welfare

23. The starting point is that L has suffered significant harm through assault by the mother. Equally important is the mother's failure to seek treatment for these serious injuries, choosing instead to conceal her own actions. She did not work truthfully with the welfare authorities, and even to this day she does not accept what she has done. The risk of repetition is obvious and extends to these two young children.
24. The fundamental question is whether the mother has changed or whether the Court must expect the likelihood of the same going forward. The mother does not now have family living with her; the plan would be for Mother to live alone. The children, of course, are a little older, but still only aged nine months and three years respectively, so still both demanding and vulnerable. The assessments have revealed positives in relation to the mother, to which I have already made reference and which of course feature highly in this welfare analysis. However, the predominant factor for me has to be the avoidance of the likelihood of future significant harm. The mother does not accept what she has done. Inevitably, therefore, the causes cannot be addressed, and for me there remains the likelihood of future significant harm. That harm in the past was of a serious nature, and the past being an indicator for the future, future harm is likely to be at a similar level. For me, the likelihood of that harm occurring is also at an unacceptably high level.
25. On behalf of Mother, my attention was drawn to the provision of services that would be available to help her. Of course, it is appropriate to take this into account. However, in my judgment, these support services would not begin to address the safety concerns at the heart of this analysis.
26. L's proceedings stand adjourned, but I now turn specifically to the position of C. The only real alternative to the mother's care is the local authority's plan for placement with C's father. This carries the disadvantage that it represents a change for the child from the old pattern of life based with Mother. However, the plan carries the immeasurable advantage of placement with a parent. The father is a familiar figure, and the change from a contact parent to a caring parent would not be unduly disturbing for the child.
27. The father is the subject of an unchallenged assessment with a positive conclusion. The assessment does, of course, identify areas which need attention and will receive attention. No party, including the mother, has been critical of what the father is able to offer. The mother's position is based on her assertion that she could achieve something rather better. However, at the end of the day, my finding that the mother was responsible for inflicting injuries and failing to treat them, drives me to the contrary view, and it is clear that placement in the mother's care would involve an unacceptable risk of harm for the future. In these circumstances, my welfare analysis leads me to the clear conclusion that the best interests of C would be served by placement in the father's care.
28. There is agreement that this is best achieved through the mechanism of a Care Order. I agree. The statutory grounds are clearly met, and it is a necessary and proportionate approach to the case.
29. The local authority's Care Plan overall is largely uncontroversial. There were one or two areas of fine detail which were left for discussion between the parties while this Judgment was under preparation. At the end of the Judgment, I will address any issues that arise, but overall it is clear that the Care Plan can be accepted.
30. I have distributed in draft the order which I propose, and now that my Judgment is at an end, I will invite submissions on its terms and on any additional matters that arise.

Approved 26/6/14

RD