Care order - approval for the final care orders placing the children in the care of the Minister
Before : |
J. A. Clyde-Smith, Esq., Commissioner, and Jurats Ramsden and Ronge. |
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Between |
The Minister for Health and Social Services |
Applicant |
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And |
A (the mother) |
First Respondent |
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And |
Gracie and Amelie |
Second Respondents |
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IN THE MATTER OF GRACIE AND AMELIE (CARE ORDER)
AND IN THE MATTER OF THE CHILDREN (JERSEY) LAW 2002
Advocate P. F. Byrne for the first Minister.
Advocate C. G. Hillier for the First Respondent.
Advocate H. J. Heath for the Second Respondents.
judgment
the COMMISSIONER:
1. In this case, the Court made a final care order placing Gracie aged 13, and Amelie aged 5, in the care of the Minister.
2. Much of the care plan of the Minister was agreed by the first respondent ("the mother"), with the issues being limited to whether Amelie might in due course be returned to the mother's care and to contact between both children and the mother. That being the case, we can summarise the background in relatively brief terms.
3. The mother has a long history of drug and alcohol addiction. Both children were exposed to alcohol while the mother was pregnant, and were born withdrawing from drugs. The mother's addictive behaviour has had a considerable impact upon both children, who now have special needs as a consequence. Quoting from the report of the child psychologist Ms Sharon Beattie at paragraph 2.1:-
"2.1 .....Detailed psychometric assessments have been carried out with [Gracie] and [Amelie], who have both been identified as having specific learning difficulties, as well as difficulties associated with their social functioning. With [Gracie] the difficulties relate to her peer friendships and her home living skills. With [Amelie], the difficulties relate in the main to her motor and health and safety skills. Both children have behaviour and attachment difficulties and this is particularly evident for [Gracie], but likely to become more pronounced with [Amelie], unless appropriate interventions are implemented. These behaviours are similar to that displayed by children who have been diagnosed by ADHD, but in [Gracie's] situation, it is likely as a result of exposure to alcohol whilst [the mother] was pregnant.
2.2 [Amelie's] difficulties have arisen due to her diagnosis of Foetal Alcohol Syndrome (FAS). As well as difficulties in her motor and behaviour skills, [Amelie] has a high pain threshold, again as a result of FAS."
4. The children may well require support with their development cognitively, emotionally and socially until they are around 25 years old.
5. The mother had made unsuccessful attempts at abstinence from drugs and alcohol. Following the death of the children's father in March 2016, her drinking became chronic and in June 2016, the children were taken into voluntary care because she was unable to parent them, where they have remained ever since, Gracie presently at a children's home and Amelie presently with a local foster carer.
6. On 4th April, 2017, the mother was admitted to a mental health hospital to be detoxified from both alcohol and drugs, and on 1st June, 2017 she was discharged from there to a rehabilitation centre, where she remained for three months for follow up care and support. Since leaving the mental health hospital some seven months ago, she has, to her credit, been abstinent of both alcohol and drugs.
7. The mother has been assessed by Dr Tanya Engelbrecht, a consultant psychiatrist, and Dr David Briggs, a psychologist, who both concluded that she did not suffer from a mental disorder. They identified her parenting failures as linked to her misuse of substances and alcohol, and advised that there was a risk of relapse, particularly in the first three years of abstinence although the risk never completely goes away. They both expressed caution as to the prognosis in this case, due to the mother's failure to respond to previous interventions and detoxifications, and past use of alcohol and substances as coping strategies.
8. Specialist provision for Gracie cannot be sourced locally and her care plan was that she be placed in an off Island residential home for her remaining adolescence and young adulthood. The mother and the guardian supported this plan, as did Gracie herself, as she made clear to us when we had a lively meeting with her in chambers.
9. It was hoped that such placement could be identified within three months, and it will require an application for approval under Article 4(2)(1) of the Children (Jersey) Law 2002 for Gracie to live outside Jersey. Assuming proper arrangements and barring unforeseen circumstances, such approval should be forthcoming.
10. The care plan for Amelie at the commencement of the hearing was for the Minister to seek an adoptive placement, in what he said would have to be open adoption, so that she could maintain contact with Gracie. Due to Amelie's complex needs, the Minister did not intend to seek a freeing order until an adoptive placement had been identified. Failing that, a long-term fostering placement would be sought.
11. However Amelie was doing well with her current local foster carer, and the guardian was of the view that staying with the local foster carer would be better for Amelie in the light of her needs. The guardian therefore asked for the Minister to assess her local foster carer as a long-term carer, and to see how that placement could be practically supported. The indications were that the foster carer, with support, would consider fostering Amelie long-term.
12. Ms Beattie also advised that it would be preferable for Amelie to remain with the local foster carer, as it would provide her with stability, and she was coming to an age where adoption could become difficult. At this age it is often better for long-term fostering, with some contact with the family. She said that adoption in the UK would be very difficult for Amelie, because of the impact upon her of losing both her current local foster carer and her mother - that, she advised, would be detrimental. It was for others to advise on the time during which the mother should remain abstinent, but three years was not within Amelie's timescales.
13. It would seem that a previous adoptive placement of another child with the local foster carer had failed, primarily because of the lack of financial support that goes with a looked after child. As the guardian pointed out, taking into account the cost of the UK residential placement, some £70,000 a year, it should be possible, with some imagination, to provide a bespoke package for the local foster carer to look after Amelie long-term.
14. The care plan was therefore amended by the Minister during the hearing to provide for a twin-track approach whereby the Minister would look to place Amelie long-term with her local foster carer and at the same time, seek an adoptive placement.
15. The mother agreed that Amelie's current placement with the local foster carer was working well, and she supported its continuation, but on her understanding that the placement could only last another nine months, she said she would be looking then to apply to discharge the care order and have Amelie returned to her care full-time.
16. There was now a possibility, therefore, that Amelie's current placement could become long-term, but this highlighted an issue between the Minister and the mother in that the Minister's care plan did not provide for the rehabilitation of Amelie to the mother. The mother wanted the possibility of her caring for Amelie kept open.
17. There were a number of reasons why a care plan for rehabilitation of Amelie with the mother would not be in Amelie's interests:-
(i) The mother was in the early stages of recovery from a long history of alcohol and drugs abuse, a history which included previous unsuccessful attempts at abstinence. For up to three years, the risk of relapse was high, and even after that, it never went away completely. Amelie had already been in foster care for 1½ years, and needed certainty now. A period of three years, which would take her to age seven, was way beyond her timescales.
(ii) Because of Amelie's special needs, whoever cared for her needed specialist training, or as Ms Beattie put it, care that was "exceptional". It was for that reason that Gracie and Amelie had not been placed together because of the attention they each required. It is worth setting out in full the advice of Ms Beattie at paragraph 6.4.1 to paragraph 6.4.5:-
"6.4.1 The human brain is not fully mature until age 25 (Wallis, 2004). This is about the age that parents report that they begin to see their adult children with FAS settle down and reach their emotional and social potential. Parents of children who have been affected by the impact of drinking whilst in the womb are advised to provide structure, help with organising their time and scheduling, monitor their social relationships, and guide them through decision making. These strategies are even more crucial in helping children safely make it to adulthood, and throughout their lifetime.
6.4.2 It is critical that the carers of [Gracie] and [Amelie] understand the neurological aspects of FAS and the impact of drinking whilst pregnant in order to implement effective strategies. Given the nature of FAS and the brain damage caused by parental exposure to alcohol, many affected individuals have difficulty controlling their impulses and have such poor judgment, that most will require close supervision or at least frequent monitoring well past their teen years. Carers must come to terms with the possibility of facing a period of never-ending adolescence. The 'terrible teens' could last into the 'terrible twenties'. Their cognitive abilities may not improve with age, but their emotional behaviour and social skills appear to become tolerable and this allows them to engage in social and employment relationships. Their ultimate success will be fragile and will depend on continued guidance and close monitoring that might require a one-on-one mentor.
6.4.3 Another key to successfully navigating through the teen years to adulthood for individuals with FAS or over exposure to alcohol is their having a good understanding of how and why their brain functions as it does and accepting the reality of life with FAS. This measure will ensure their health and safety in a world that can be full of risks for people who have normal adult appearance and intelligence but have child-level decision-making capacity.
6.4.4 It would be prudent to add a third key of understanding, which is the accepting attitude of others in the community, including extended family members, neighbours, teachers, medical professionals, care providers, and others who might have an opportunity to interact with Gracie and Amelie. As Author Dian Smith (1991) wrote 'Parents' accepting attitudes can help children learn to be open and tolerant. Parents can explain unfamiliar behaviour or physical handicaps and show children that the appropriate response to differences should be interest rather than revulsion.'
6.4.5 It is important for both [Gracie's] and [Amelie's] developments, that their carers and professionals are educated about the neurological aspects of FAS, help them understand their own behaviour and enlighten every person in their life about the potential nature of their disability. It would be beneficial if both could work with a professional who has experience of the syndrome, however, this experience is rare and hence the need for appropriate education for those involved in the children's lives."
Ms Beattie then set out some 35 interventions that would be required.
(iii) Ms Beattie went on to say at paragraph 6.7.3 that importantly, both children require consistency in behaviour from their main carer to allow them to develop a more secure attachment base, and to begin to have stronger bonds with their carer. This long-term work, she said, needed to start immediately.
(iv) Dr Briggs agreed that Amelie's special needs and the skills required to care for her were an important complexion in this case and added to the uncertainty of timescales. Even if the mother were freed of any concern of relapse, the question was to how she was to be equipped to parent "this vulnerable child".
(v) Ms Beattie said at paragraph 6.10.5 that the work required in caring for Amelie would be difficult for any parent, not just the mother, and pointed out that anxieties in dealing with challenging behaviour had been a trigger in the past for the mother's drinking.
18. Sadly for the mother, we concluded that, consistent with the advice we have received, it was not in Amelie's interests for the care plan to be for her rehabilitation to the mother because that could not safely be achieved within her timescales.
19. That is not to say that the Court was agreeing that adoption was necessary in this case. As the guardian said, adoption was not the only option at this stage, and before considering it, she would want clear evidence that the local option of long-term fostering had been thoroughly explored.
20. The guardian raised a concern that, given a final care order, and the ending of her role, if the Minister decided against long-term fostering, he might seek to place the child with prospective adopters before applying to free the child for adoption, thus presenting any guardian appointed for the purposes of an application with a fait accompli. The Minister undertook that in that scenario, he would make the application for a freeing order before placing the child with prospective adopters, so that the guardian would have a meaningful role in that process.
21. In approving the care plan for both children and making final care orders, the Court was not approving the severing of the relationship between the mother and the children. Under a final care order, the mother would retain parental responsibility, with all the rights that went with that, continue to have direct and indirect contact with the children, continue to be involved with the Children's Service over their care and would continue to have locus to bring proceedings to intervene should she consider it to be in the interests of the children to do so.
22. The key point on contact, as made by the guardian, is that it needs to be flexible, and driven by the needs of the children.
23. The mother wanted her current weekly contact with Gracie and unlimited contact through social media to continue pending her placement in a residential unit in the United Kingdom. The mother accepted that once in the residential unit, direct contact would have to reduce to not less than four times a year, but working towards six times a year, as recommended by the Minister. Contact would, of course, be led by Gracie's therapeutic needs. The extent of contact through social media once Gracie was in the residential unit would be within parameters set by the unit, with which the mother said she would comply.
24. The Minister proposed that whilst Gracie was still in Jersey, unrestricted contact through social media would continue, but direct contact would start to reduce, to assist Gracie in preparing for longer periods of separation from the mother. The Minister was supported in this proposal by the guardian and Ms Beattie.
25. Turning to Amelie, again the mother wanted her current weekly contact with Amelie to continue indefinitely, whereas the Minister proposed it should be reduced over time to no less than four times a year and working towards eight times a year. Again, the Minister was supported in this by the guardian and by Ms Beattie, who said contact should be reduced to support the placement with the local foster carer, and to build up the attachment between Amelie and the local foster carer. Ms Beattie did, however, express the view that the reduction from contact once a week to six times a year was too great for Amelie for whom stability was important, and that some middle ground should be sought.
26. We accepted the position of the Minister in respect of contact between the mother and the children, which had the support of the guardian and Ms Beattie, save that in respect of Amelie, we agreed that some middle ground should be sought. We thought that the baseline for contact between the mother and Amelie should be six times a year and invited the Minister to reconsider that part of his care plan.
27. Dr Briggs recommended that the mother's direct contact with Amelie should be optimised by the mother acquiring, as far as she was able, the same skills as recommended by Ms Beattie for Amelie's carer, and the Minister agreed to support that.
28. Subject to that, we approved the care plans, and we can now turn to the orders required to implement them. The threshold test must of course be passed before the Court has jurisdiction to make any orders. Having heard evidence from the social worker, Ms Andrea Codrington, the child psychologist Ms Beattie and the adult psychologist Dr Briggs, and the documentation admitted into evidence, we agreed with the parties that the threshold under Article 24(2) of the Children (Jersey) Law 2002 had been met, the relevant date being 16th June, 2016, when the children had to be taken into voluntary care as a consequence of the mother's excessive intoxication and inability to care for them.
29. In terms of the welfare test, we had regard to the applicable principles as set out in paragraph 8 of the judgment of the Court of Appeal In the matter of F and G (No 2) [2010] JCA 051, and agreed with the analysis of Ms Codrington and the guardian that this was a case where the Minister had to be given parental responsibility, so that he could secure the children's placements away from the mother, pursuant to the care plans. The mother, whilst arguing for rehabilitation in the case of Amelie, did not oppose the making of care orders.
30. The Court, therefore, having approved the care plans and the contact arrangements, subject only as set out above, made final care orders placing the children in the care of the Minister.
Authorities
Children (Jersey) Law 2002.