Ref. XXXXXXXX
90 Wellington Street Leicester
Before HER HONOUR JUDGE PATEL
IN THE MATTER OF RE: Q (Care Order at Home : Exceptional Reasons)
LEICESTER CITY COUNCIL (Applicant)
-v-
(1) THE MOTHER (M)
(2) THE FATHER (F)
(3) A (by their Children’s Guardian) (Respondents)
MS FRANCIS-BROWN appeared on behalf of the Applicant
MS N MANSFIELD appeared on behalf of the First Respondent
MS R MANANI appeared on behalf of the Second Respondent
MS H READ appeared on behalf of the Third Respondent Child
JUDGMENT
WARNING: This judgment was delivered in private. The judge has given leave for this version of the judgment to be published on condition that (irrespective of what is contained in the judgment) in any published version of the judgment the anonymity of the children and members of their family must be strictly preserved. All persons, including representatives of the media, must ensure that this condition is strictly complied with. Failure to do so will be a contempt of court.
JUDGE PATEL:
Introduction
I am concerned with the welfare of Q who is going to be a year-old next week. When the first interim care order was made, on 18 September 2024, Q was placed into foster care.
Q has now transitioned and returned back to his parents’ care; that happened last week, so he has now been in the care of his parents for just over a week. The mother of Q is M and the father is F. Both of his parents are still very young parents.
The application, when it started, was for an interim care order and care order by Leicester City Council. The application was made on 12 September 2024, and so the matter now stands at 51 weeks. This is a matter that exceeds the statutory time limit of 26 weeks. There clearly has been delay in this case. I consider that the delay in this case, for Q, has been necessary, and to acquire a wealth of expert evidence in order for me to decide the case justly, and in order to make the right welfare decision for Q, in his best interests.
The expert evidence has included a report from Dr Shelmerdine, who undertook a cognitive functioning assessment of the father, and it included an expert neurodivergent assessment by Gillian Merrill who is a Consultant Forensic Psychologist, an expert in ADHD. It has included expert assessment through an independent social work assessment in line with ParentAssess by Bridie Steventon. All of those expert assessments have had to take a pause or have had to be delayed in some way because of the local authority’s experience in, to its credit in looking for a means by which the father can be supported, having been diagnosed with ADHD, to ascertain and gain medication in order to stabilise his symptoms and sequeli that come from such serious diagnosis. So the level of delay, in my view, has been justified.
However, I am very clear today that there is no prospect of me adjourning this matter or sanctioning anymore delay on the basis that despite the fact that I am being asked to make a final order today, there is still, a huge amount of work that these parents need to undertake in order to ensure that Q will be consistently safe and that all of his needs will be consistently met in their long-term care.
So the issue is not whether I should adjourn the matter; I am very clear there is absolutely no reason or justification for the matter to be adjourned. The real issue in the case and what I am being asked to give a judgment on, is whether or not this matter should conclude with Q being transitioned home over the last seven days, with either a final supervision order being made, or a final care order.
Background
The history of the case is this; that initial referrals were made for Q on 23 February 2024. This was prior to Q being born; midwifery made a referral, due to concerns about the mother’s history. She had already had her first child removed from her care, (who lives with his paternal grandmother under the auspices of a special guardianship order) due to concerns linked to M’s likely parenting centered around her mental health and her substance misuse.
Q was therefore placed on a child protection plan unborn from 15 May 2024, under
the category “risk of neglect” and a period of pre-proceedings was entered into. When Q was born he was premature, and so the assessments of the parents had not been completed in their entirety.
Both parents, have had an extensive involvement with social care history throughout their own childhoods. The mother has experienced emotional and physical and sexual harm. She first became a looked after child, subject to section 20, in January of 2012, and then was made the subject of a full care order in March 2019. F also has a history of childhood trauma; he has experienced neglect, physical, emotional and psychological harm. He has experienced sexual harm when he was a child. He came into local authority care around the same time, in January 2012, under an interim care order, with a full care order being granted in respect of him in October of 2012. So both parents have had significant amounts of childhood trauma and it is very clear that they still sometimes struggle with that as they move forward in their lives.
The social care involvement in relation to M’s older child was in 2022, and as well as concerns about her mental health and substance misuse, there were also concerns around domestic violence between M and B’s father, and her leaving B with individuals who present a risk of harm. Sadly, in those proceedings, M’s parenting assessment was negative and so ultimately the local authority sought for the court to approve a plan that placed B elsewhere.
During the parents’ relationship, it is clear that both have had challenges in terms of their mental health. The mother has a history of anxiety and depression and deliberate self-harm. F has struggled with his mental health and to take medication for this. He himself has been diagnosed with anxiety and depression. We now know that he has also been suffering from the symptoms of ADHD. F has a very serious long-term diagnosis of emotionally unstable personality disorder, and it is clear that during the course of these proceedings, it has been incredibly important to pin down and to identify the differential between whether or not some of the symptoms he has were, in fact, linked to an ADHD diagnosis rather than related to his mental health diagnosis of EUPD.
During the pre-proceedings period, the parents had support through the perinatal team. It is clear, and the local authority says through its evidence, that there has not always been a good level of cooperation by the parents. There was a lot of anger felt by both parents; they did not always, at times, cooperate.
The parents, at the time of Q’s pregnancy, were living somewhat of a chaotic lifestyle; they were living in Z accommodation. They were living separately; F, at a Support Centre and the mother was seen not to be always staying at her community accommodation, so she was asked to leave. The parents had a period of time where they were sofa-surfing and in May of 2024 both parents were arrested for witness intimidation which involves a witness that M had previously been arrested in relation to.
During the pre-proceedings period, the local authority was concerned about the parents’ presentation and volatile behaviours. Aggressive and volatile exchanges increased and the local authority became incredibly concerned at the point that Q was going to be born, and so the local authority issued proceedings.
Running alongside the issues of the dynamics between the parents and their own individual challenges, the impact of their mental health on their likely parenting, has also been the way that they relate to professionals, and further, their own substance misuse. Both parents, to their credit, have been open that they have been smoking cannabis on a regular basis. M has smoked cannabis throughout her pregnancy; F has used cannabis as a means of self-medication, and there have been referrals to Turning Point, albeit throughout last year and a period of this year, there has been somewhat inconsistent engagement.
Cannabis remains an issue in this case and the local authority certainly remains of the view that the interplay between cannabis and F now taking ADHD medication, which I will come to in a moment, is something of an unknown quantity in this case.
These proceedings and the assessments
During the course of these care proceedings there have been a number of hearings and those initial number of hearings were really trying to identify whether these parents would benefit from a residential assessment, or whether, in fact, there were other assessments on the ground that would have better suited these parents.
I approved a neurodivergent assessment of F. As I said, that has been undertaken by Gillian Merrill who is a Consultant Forensic Psychologist who is, it seems to me, an eminent expert in this area of diagnosis. She made it clear in her report that ADHD is a neurological condition, defined by a consistent pattern of inattention or hyperactive impulsivity, and for a diagnosis, the behaviours and difficulties associated with ADHD must interfere significantly with an individual’s day-to-day functioning, and she goes on to give a list of symptoms in her report.
It is very clear to me that those symptoms are wholly in line with the kind of presentation that F often has, and the primary intervention, therefore, for ADHD, is treatment with medication. Medication is reliably shown to provide a reduction in symptoms for many individuals diagnosed with ADHD, and at the time, of course, that Gillian Merrill saw F, he was not taking any medication, because he had never previously been diagnosed. He said to Gillian Merrill that he would cooperate with taking medication, and she was really clear in her report that although medication is not a cure for ADHD, it would help F to concentrate better, be less impulsive, it would help him to feel calmer and to be able to learn strategies and practice new skills that would help him regulate his own presentation.
Gillian Merrill was also clear that alongside medication, that F would benefit highly from having education to understand how ADHD affects him, and work to understand how to cope with living with the condition, and skills training, taking part in role play situations to learn how to manage behaviour and how it affects others around him. She also recommended cognitive behaviour therapy; that would help with understanding and changing thought patterns, and for F, she identified specifically that that was the area of work that would assist him in coming to terms not just with the ADHD but managing it as he continues on his life trajectory, and in his commitment to being a good dad for Q, which I accept has always been his and M’s intention, to ultimately to be good parents to their son.
F in his cognitive functioning assessment with Dr Shelmerdine demonstrated that he would benefit from having support to navigate these legal proceedings. However, he has benefited a great deal from having a consistent legal team with whom he has a very good rapport and relationship, and so an intermediary has not been necessary.
Insofar as Gillian Merrill’s assessment is concerned, the local authority has taken on board her recommendations, and this local authority has, in this case, rather exceptionally in my view, gone out of its way to ensure that the recommendations are followed through, not just the ADHD diagnosis itself, but in carrying out the delivery of medication by triggering all of the options that were available to F, knowing full well the likely level of delay that would have occurred to him receiving medication if the local authority simply reverted to relying on standard NHS processes.
What the local authority also did in this case, to its credit, was to agree for an independent social worker to assess the parents. That was, as I said, done through Bridie Steventon. She provided two reports to the court. In her original report, she recommended, having assessed both parents, that there could be transition of Q into these parents’ care, but the caveat for her at that point - and that was in January of this year, not knowing that father also had a diagnosis of EUPD – was this; that she was of the view that ADHD medication for F was likely to have a significantly positive effect on F and that he would need to start that medication prior to any reunification being progressed.
Further questions were asked of Ms Steventon and it is fair to say that there was a point in this case where the local authority had discussed whether, in fact, the ongoing community-based assessment could be taken over by the local authority team. I acceded to the parents’ submissions, in determining that would not be appropriate in this case, given that Bridie Steventon had been the original social worker instructed and had worked with the parents on the ground. It seemed to me that moving into the arena of an ongoing community-based assessment to look at transition of Q upon the medication being given to F, that such assessment could only be done by Bridie Steventon who had already demonstrated an ability to build an excellent rapport with both of these parents.
The local authority yielded to that indication, and Ms Steventon, as I have said, continued to assess both of the parents, alongside the struggles in the delay that was occasioned to ultimately acquiring the appropriate medication for F, through CARE ADHD.
What Miss Bridie Steventon says in her final report is really important. She was able to identify through the process of the parenting assessment that M, had been observed to be a hands-on mother, that she will take over when F needs help, and she will advise him, that she has been under a lot of pressure during the course of the proceedings that she has been caring for Q, however in contact sessions and throughout the extended periods of transition, she has been managing F’s behaviour, and that she does help F with containing himself. On 16 June, which is a crucial period in the timeline for this case because there was a pause to the transition plan of transitioning Q to his parents’ care, the mother had made a decision to take Q out for the day when F had become unregulated. She was not instructed to do that; it was evidence that she could make decisions by herself and in Q’s best interests.
Miss Steventon goes on to say that F is able to complete all of Q’s care needs; he is able to prepare his food, feed him and change his nappy. F knows how to handle Q and he also knows how to interact and play with him, and when F’s behaviours are not managed, however, he is not able to safely manage Q’s care, so what Miss Steventon provides is really the overview of a conclusion that whilst M is a protective
factor and she can act protectively in Q’s best interests in managing F, that ultimately, when F does become dysregulated, he himself is not able to safely manage Q’s care.
The assessor opines that F’s presentation, when regularly taking his medication, at his current dose, is much improved; however, he does require a further medication review and once F’s medication dose has been reviewed and he is referred back to the GP and regular medication is issued at a consistent dose, that he could manage Q’s care individually, and that the local authority professional involved during that period of time should consider F’s presentation in their decision-making. The mother knows F well, and if she feels, at any point, that F’s behaviours are unsafe for Q, it would be her responsibility to keep him safe.
Parties Positions
The local authority, having considered the recommendations of Miss Steventon, having considered the ongoing work and recommendations of Gillian Merrill, and having conceded and accepted, and in fact actively encouraged/promoted, that Gillian Merrill would not only oversee and continue the medication review aspect of F’s symptoms of ADHD but the therapeutic work recommended, sets out in its final evidence the justification for a care order for Q which is really on the basis that there is still a huge amount of work to be achieved by these parents over a longer period of time.
.
The local authority says that there will be support provided by the Family Functioning Therapy team to address the outstanding areas of concern. That includes parental communication, the work that was recommended to be done by Relate, and I pause there to acknowledge clearly there has been a delay in relation to that work being carried out. Both parents have always been willing to do work through Relate, to improve their dynamic and their communication, and to reduce the concerns in relation to any prospect of domestic abuse or unhealthy interaction, and it has not been their fault that that has not taken place, but one of the concerns was that Relate was not prepared to start that work until the proceedings had been concluded. So the local authority says that that is work that will now be undertaken by the Family Functioning Therapy team, albeit, it appears, through Miss Manani, who represents F, that information had not been directly communicated to the parents before today.
Further, there needs to be ongoing work in relation to the parents’ cannabis use and ongoing work and monitoring assessment in relation to the continuing concern that emanates from parental mental health. Gillian Merrill would need to complete her work with the father regarding therapeutic work, and the local authority’s recommendations for work, and all of those factors are the differential between the dynamic factors that have existed in this case versus the static risk factors, meaning the static risk factors remain high because they are ones that have not been addressed in the longer term through embedded work being identified and being able to be implemented on a consistent and sustained basis, and simply because of the fact that Q has only been home for the last seven days.
The local authority argued that there should be a care order, and the parents’ response to that has been entirely fair but is has also been stark. They both say to me that Q is a little boy who they love dearly. They have done everything in their power to cooperate with all of the professionals, albeit, at times, they have not necessarily agreed that the local authority need to be involved. They accept that social workers have had to be involved because of the history of concerns, but they want to be the best parents for Q and that now is the time, given that he has been successfully transferred to their care, and the risk has been reduced - it must have been reduced, otherwise why has he been returned to their care – and on that basis, that the right order for Q is in fact a supervision order, because all of the work that is left over is work that can be carried out whilst Q remains in their care under the auspices of a supervision order, which is still a public law order, and is still an order which has teeth and which the local authority would be able to review and continue to monitor Q’s safety and progress, and if the local authority wanted to up its attendance to the home, it could do so without the need for having a care order.
The children’s guardian has filed a full and final analysis, and the guardian, in reality, agrees ultimately with all the points made by the local authority. The guardian says that the local authority should and does need to have a final care order, and it is clear, says the local authority, with which the guardian agrees, that the reasons for the care order are not for the purposes of delivery of the work, it is because both social workers agree that the risk that emanates from the likely parenting of these parents is one that still remains high on the ground and has not been sufficiently reduced over the last 51 weeks for the local authority to simply step away under the auspices of a supervision order.
Discussion and analysis
Threshold
Insofar as the making of a public law order, of course, I can only make any public law order if there is a basis for doing so, and within the bundle is a final threshold document which, to the credit of both parents, they agree. It is set out at A198 in the bundle and the facts that are agreed are as follows: The mother’s older child who lives with his paternal grandmother was removed under previous proceedings, because of concerns due to domestic violence associating with risky adults and M’s poor mental health, and the parents, these parents did not fully engage in the assessment process during the proceedings, and have, on occasions, displayed aggression and hostility towards the social worker which could place Q at risk of emotional harm of witnessing his parents’ aggression and neglect due to the parents’ inability to engage with professionals.
That there had been concerns that the parents’ relationship has been volatile, including verbal altercations, which places Q at risk of emotional harm of witnessing this, and there was previously a non-molestation order made against F by his own mother, in 2023, pursuant to pleading guilty to punching her in 2020.
That the mother has a history of depression, anxiety and self-harm, that she is suffering with poor mental health. If it remains untreated, that may impact on her ability to care for Q and puts him at risk of emotional harm and neglect.
That F has poor mental health and has suffered from depression and struggles with anger. He has received a non-molestation order referred to in 2023. That expired, I have to say, to his credit, in July 2024, with no extension. That the father has been abusive towards emergency ambulance staff on two different occasions between 2022 and 2023 with threats to damage an ambulance and a result of him receiving community resolutions for public disorder offences and being found in possession of cannabis, and that places A at risk of emotional harm if exposed to the father’s aggressive behaviour and/or his poor mental health.
Further, that the father has a diagnosis of emotional unstable personality disorder, and that he is, at times, unable to differentiate between social communication informally or formally with professionals. He can be extremely abusive, threatening and demanding, manipulative, or completely polite and reasonable, and his behaviour at times is described as unpredictable. That places Q at risk of emotional harm if exposed to his father’s unstable mood.
That both parents have misused cannabis; the tests in this case have proven that, and
the mother’s use of cannabis during Q’s pregnancy put him at risk of physical harm by exposing him to harm in utero. Finally, there is a concession that both parents had housing issues, that they were in temporary accommodation and that their eviction would not provide stability for Q.
I am satisfied that those concessions, as a matter of fact, cross the threshold criteria within section 31(2) of the Children Act and allow me to open the door to give consideration of a public law order being made for Q at the conclusion of these proceedings. I am satisfied that the risks on the ground are proportionate to a public law order being made, and the question that I have already highlighted is whether or not there is justification for a final care order being made at home or whether, in fact, the risk is sufficiently able to be managed under the auspices of a supervision order with the local authority befriending, advising and assisting Q and his parents.
I ought to say this about Miss Steventon’s assessment. What she said about F working with the psychologist Gillian Merrill is this; that F does contact Gillian Merrill and speak to her about his emotions. He seeks support and often seeks advice. He has praised the support that he has received from Miss Merrill and he does implement strategies that she has taught him at times.
The journey of ADHD support and medication for F has been a learning curve and he has found parts of it very helpful, but other parts of it very difficult to manage. His presentation greatly improved when he was on 30 and then 40 and then 50 mg of the medication, which is Lisdexamfetamine. However, when his dose was increased to 60, she describes him as presenting as heightened and aggravated and unable to regulate his emotions.
Miss Steventon points out, and I appreciate this is a totally disputed fact, that F did not report his symptoms to CARE ADHD during that period, and attempted to continue with the 60 mg dose, and it was her opinion that from the discussions with F, that he thought that the higher dose was better and that he would feel better if he tried to persist through those symptoms, and that is why he carried on taking it at that dose. Miss Steventon said that in her opinion, F had been smoking cannabis also, to try and manage his heightened feelings, and it was only through communications from his solicitor that it was evident that he accepted that he did smoke cannabis in the early hours before her visit on the day of the concerns that were noted, when the transition time had to be paused, on 16 June of this year.
Miss Steventon goes on to say this:
“It is my opinion that F is likely to improve further in his presentation when the stresses of the proceedings have ended. Gillian, the psychologist, has also noted the high level of pressure that F feels in relation to these proceedings and she advised that F can be fixated on important dates and the end of proceedings and important stages, and when that is getting
nearer, he becomes emotional and he becomes stressed.”
I take from the above that it is really important for Q and his parents, and in particular F, is that these proceedings are concluded today. I accept that there is obviously a level of stress that has been caused to these parents by the nature of these proceedings; the fact that they are adversarial and that they have been at risk of losing their baby. Despite this, they have worked incredibly hard to confirm that they are able to cooperate, and what I am concerned about is that they are still at the very beginning of their journey, with Q only having been returned to them over the last seven days.
So the local authority has, to be fair, and to its credit, taken on board the criticisms of the parents, raised in relation to the local authority’s plan, and in addition to the final evidence and in fact, the allocated social worker, on 13 August, filed an updated statement setting out, in accordance with the case of Re JW why it is the local authority says that the case for Q means that the ‘circumstances are exceptional’ to warrant the court making a care order.
In the case of Re JW (A Child) [2024] Fam. 25, the court looked at whether or not a first instance judge who made a care order at home, sufficiently reasoned that decision and whether it was a proportionate order to make when looking at the risk on the ground.
Of course, the facts of Re JW are entirely separate and different to this case because the risk that emanated from the mother’s likely parenting came from a third party who presented a risk of sexual abuse. That is not the facts of this case, but the relevant paragraphs of Re JW are these, and of course, they are allied with the Public Law Working Group’s recommendations about the differential between care orders being made at the conclusion of proceedings when a child is being returned home.
Paragraphs 29 and 30, in effect, are the relevant paragraphs, and in summary it says this:
The making of a care order on the basis of a plan for the child to remain in the care of her parents is a different matter. There should be exceptional reasons for the court to make a care order on the basis of such a plan.
That if the making of a care order is intended to be used as a vehicle for provision of support and services, that is wrong. A means or route should be devised to provide these necessary supports and services without the need to make a care order. Consideration should be given to making a supervision order which may be an appropriate order to support the reunification of the family.
If the risk of significant harm to the child are either adjudged to be such that the child should be removed from the care of her parents, or some lesser legal order and regime is required. Any placement with parents in the interim or final order should be evidenced to comply with the statutory regulations for placement at home.
It should be considered to be rare in the extreme that the risks of significant harm to the child are judged to be sufficient to merit the making of a care order, but nevertheless, the risks can be managed with a care order being made in favour of the local authority with the child remaining in the care of the parent or parents at home. A care order represents a serious intervention by the state in the life of a child and the lives of the parents in terms of their respective Article 8 rights. This can only be justified if it is necessary and proportionate to the risk of harm of the child.
Both the mother and the father in this case made really strong submissions that a care order was simply not justified. Ms Mansfield, on behalf of the mother, sought to argue that the facts in this case are not exceptional and that there are no exceptional reasons. She has sought to argue that the fact that these parents are previously looked after children and the fact that there is a neurodivergent parent in this case with the issues relating to mental health, substance misuse and parental unhealthy dynamics, are standard facts that happen every day in care proceedings. What she says is ‘exceptional’ in this case is the way in which the assessments have been carried out and the exceptional amount of work that has been done with the parents on the ground to achieve a transition and rehabilitation of Q to the parents’ care. She has asked me the question “What would a care order achieve for Q and the parents on the ground?”
She argued that it would have the retrograde effect of causing further anxiety and distress to these parents, because, for the mother, co-parenting with this local authority has been extremely difficult. There is a level of criticism raised about lack of communication which, at times, has been justified, for example, not telling the parents that FFT were going to take over the Relate work. There is a level of criticism raised because M wanted her grandfather to see Q whilst he was in foster care and that decision was not made before her grandfather died. Ms Mansfield argues that a care order simply heightens the anxiety and stress of the parents and that would be, in fact, not helpful or conducive to their ability to now try to normalise their roles as being safe parents to their little boy.
Ms Mansfield argues that all the evidence points towards a supervision order being made because the reality is that Gillian Merrill has confirmed in a professionals meeting on 19 August that F continues to engage with her very well, that M agreed for Gillian Merrill to continue her work with F, the foster carer has reported that both parents have been incredibly responsive to her and that the parents have listened and wanted to learn anything she tells them about Q, that Bridie Steventon has described both parents as being ‘open’ to parenting advice, that the parents agreed to the Family Functional Therapy team continuing their work with the family, and that the mother has expressed gratitude for the work and the advice that is being offered, therefore in reality there is no evidence that either parent would now resile from the level of cooperation that they have given to this local authority.
Ms Manani, on behalf of the father, expands on that. She says that as far as F is concerned, the reality of the situation is that he has had to cope with a very serious diagnosis, that both diagnoses, that is for the ADHD and the EUPD, are ones that are not going to go away. He recognises that, which is why he wants to continue undertaking the work. The criticism of the lack of the relationship work is not their fault, that the local authority suggestion that there is some sort of advantage to Q by having a care order is contradictory when the evidence on the ground is that there will still, in any event, be a level of multiple professionals working on the ground with the family. That father finds it difficult to work with the professionals, especially if they do not have a proper understanding of ADHD, so transferring the case under a care order to the social work team post-proceedings is actually a detriment and not an advantage, and that in reality again, as Ms Mansfield said, she agreed that the exceptional reasons for the making of a care order are simply not substantiated in this case.
In relation to the ongoing need for the local authority becoming involved, of course, I have already identified that both in Gillian Merrill’s report and in Bridie Steventon’s report, they identify a series of recommendations that need to be followed through, and Ms Manani’s point to me is that they, to a large extent, have been followed through and the pathway for the further work to be completed is clear.
What Ms Steventon says is that F needs to continue to attend his CARE ADHD review, that his medication does need to be confirmed. He will, of course, say, well that has now been confirmed and the calibration is clear at 50 mg and that he has been now taking that for in excess of eight weeks, which is the period seen to be suitable for stabilisation, that the local authority have committed to continuing its work through the therapy, and that, in reality, the local authority seeking to share parental responsibility for Q is simply not justified; the level of risk on the ground will continue to be managed, by the continuation of professionals working with the family on the ground in effect on at least a weekly, if not multiple weekly intervention basis.
The local authority’s counter arguments are set out by Ms Smith, the allocated social worker, in her updating statement. In order to justify the ‘exceptional reasons’ for a care order, she says this; Firstly, that the local authority still considers that there is an increased level of risk around Q being at home. The reason for that is the local authority does not consider that in the last three months, that F is entirely stabilised on his ADHD medication. There has not been the total transfer of that to the GP and there have been occasions where it is suggested that F has been late in ordering his medication and the local authority has had to step in to support that. There have been concerns about F not taking his medication at the correct time of day to make it effective, and that he had himself, as Ms Steventon said, not raised concerns about the increased dosage affecting him, and instead, tried to continue to take that, and then self-medicated by using an increased level of cannabis. Further, that insofar as the management of those behaviours are concerned, she says the local authority needing to continue to share parental responsibility for Q is not just a question of simply providing support, it is indeed about monitoring it and continuing to oversee the issue of risk.
Secondly, she says that in addition to those concerns around F’s ADHD medication that there are still concerns about heightened presentation, that the parents also have not yet completed the relationship work that was recommended by Ms Steventon, and thirdly, that F has not, in fact, completed all of the ADHD therapy in full, which would give him the full picture, as it were, to learn how to manage the whole range of strategies to deal with his ADHD symptoms. Further, that the use of cannabis remains a concern and the local authority, in effect, wants to see this properly addressed and reduced. The fact is that 51 weeks into proceedings, that simply has not been resolved.
What Ms Smith goes on to say is that the outstanding work is not the reason that the local authority is proposing a care order, it is because of the local authority’s analysis in relation to the remaining significant vulnerability and that the outstanding work adds to the current unknowns and known risk factors in relation to the likely parenting that Q will receive.
The local authority has agreed with me that extension of the proceedings is not realistic at this time, and so the list of work that needs to be done is work that needs to be done in any event, whether it were under a care order or a supervision order.
Ultimately, what she says is this; that the local authority, under the auspices of a care order, would want to see a significant improvement in F’s presentation, with him demonstrating an increased ability to regulate his emotions and impulses through the work with FFT and with Gillian Merrill, the confirmation that he is able to manage himself ordering and taking his medication daily, and for the parents to have completed work around their relationship, so that they will have strategies in place to avoid conflict, and also strategies to work on reducing, if not completely eliminating, their use of cannabis.
What the local authority’s analysis points out and makes clear is that one of the unknown risk factors is also the interplay between F’s use of cannabis and the use of his ADHD medication, which I am satisfied, on the current evidence, is not clear to me what the interplay is to the issue of risk i.e to what extent does the taking of cannabis on top of ADHD medication impact its effectiveness?
So that is really what the local authority says is the justification for a care order. I
have, of course, considered the children’s guardian’s, very extensive report, and she, I am satisfied, has also undertaken an excellent analysis of the risks that she identifies. She really breaks it down into two areas; there is static risks in this case that are linked to the parents’ mental health needs, to F’s neurodivergent needs and the history of anxiety and depression and self-harm for the mother, and of course, more importantly, the very serious emotionally unstable borderline personality disorder that has been identified for F in 2022, so those static risks relate to how the parents relate to one another, how they manage their own mental health and how they manage, now, being able to move forward in terms of therapeutic intervention of F, the management of his ADHD which goes alongside his mental health diagnosis.
The dynamic risks that the guardian identifies are those that are linked to both of
the parents’ parenting capacity, bearing in mind that F is a first-time dad, bearing in mind that M has a history of negative parenting capacity, both of their adverse childhood experiences, of increased substance misuse, associating with risky adults, their volatile behaviours and the risk of homelessness, and what the guardian says, really, in a nutshell, is this; that in terms of the dynamic factors in this case, the level of work that the parents have done and the level of cooperation that they have given to professional involvement, has resulted in the dynamic risks in this case being reduced, and that really is the very foundation upon which she, as the guardian, despite the fact that there was a pause in June, which Ms Read for the guardian reminds me, took an enormous amount of professional involvement and engagement to get that transition plan back on track, but nevertheless, says those are the dynamic risk factors that have been capable of being reduced through a high level of professional monitoring and intervention, and yet it is the static risk factors in this case that remain an ongoing concern.
At paragraph 29 of her report, she says this:
“The dynamic risks appear to have reduced. The parents self-report that Turning Point have ended their involvement, that is positive – and that there has been a reduction in the use of cannabis, that the parents now better understand how to store cannabis in the home, how to make sure that it is not a direct risk to Q. They have indicated that they want to become free from cannabis. The fact that F’s work with Gillian Merrill in relation to his diagnosis of ADHD, the fact the parents now have been able to look at some of the wider relatives, the network of family that have now been identified, who are able to step-in and provide support, and also the fact that the parents have now been living in a home that has been consistent and they have addressed previous concerns about a rather transient chaotic lifestyle, albeit they remain in somewhat of a temporary accommodation situation.”
But insofar as the static risks are concerned, what the guardian says is this:
“They are more longer-term risks. The mental health needs of
the parents and F’s neurodivergent needs are likely to fluctuate.”
That is a fact. With life stresses, they are likely to go up and they are likely to come down. Caring for a child is going to add to that. The concerns about both parents becoming heightened and struggling to manage their emotions when challenged, and also having to still deliver a huge amount of work means that those are risk factors that are going to have to continue to be managed to see if they can be brought down in a way that will then allow the local authority to step back.
Often, these parents’ volatility has been triggered when they have faced challenges, when they have faced difficulties, when they faced unexpected changes or views that are not aligned with their own, and what remains a risk factor is whether or not they are able to implement, on a longer term basis, the strategies that they have learnt through these proceedings to reduce the risks that emanate from those static risks.
So it seems to me that the guardian, Ms Walters, has very fairly, proportionately and in balancing both the huge number of positives the parents have demonstrated in their commitment to care for Q and what they have achieved so far, what she has done is a very realistic and genuine assessment of the two different aspects of risk factors in this case for .
It is clear that she has a fundamental concern that if the local authority were to step away and not have parental responsibility for Q, that there is a risk that his parents could choose not to engage. What she expresses as a worry is that during her discussions with the parents, they have said that they do not want the local authority to be involved, based on their own life experiences, and they did not want to feel pressured to accept the advice that differs to their options and their own beliefs. How would a Supervision work in those circumstances.
I understand that the parents may have said this but may not actually be active in doing that because they do want to continue with the work that is being offered, but there is a risk and that is the risk that Ms Walters identifies, and I find it very difficult, on the evidence before me, to depart from that being a valid and justified conclusion. I have struggled to find any flaws in her analysis.
Decision
I am satisfied that I have to consider Q’s welfare as being my paramount consideration. I have to consider the advantages to a care order and the disadvantages to a care order, and I accept that the huge disadvantage to Q of being under a final care order is that he will be at home but he would still be a looked after child. There will be an element of stigma. He will have to continue to see a social worker, his parents will have to continue to make him available to social workers, and I accept there is a huge burden and potentially a negative response from these parents in having to co-parent with the local authority, in light of their own childhood and lived experiences.
I accept that the advantages to a supervision order is that the local authority would somewhat step back, they would not just be able to remove Q under a care order, but in any event, I do not view the local authority as having the power to simply remove Q. They would have to give the parents notice. They would only be able to remove Q in any event, if circumstances were tantamount to an emergency protection order. So the advantages to the supervision order are that the local authority could just continue to provide the work that has been identified that needs to be competed, but in a way that means that Q would not be the subject of continued looked after processes.
I consider the disadvantages to a supervision order amount to this – and they, in effect, are the reasons for the advantages of a care order. The risks on the ground, to Q, remain at a level that is somewhere between medium to high. I appreciate this is not a criminal case, we have not had a probation officer give us an analysis on that type of scale, but the reality is the threshold is crossed, the risks are clear and they exist in a two-fold manner. They exist in the dynamic factors that have been identified and the static risk factors that have been identified, and for Q, in my judgment, agreeing on the totality of both social workers, who are unanimous in their assessment, the risks on the ground for Q at home are internal risk factors.
They do not emanate from a third party outside of the parental home; they emanate from within the home, from the parents’ own challenges, and that is what differentiates this case between the circumstances that existed in the case of Re JW.
The reality is that the reason why the local authority has to have a care order and the disadvantages of a supervision order, and therefore, as I said, the advantages of a care order, really amount to this; i) it is the ability and the need of the local authority to manage the calibration of risks that is going to go up and is going to come down over the course of the work that still needs to be delivered to these parents, and ii) the only way that that risk, in reality, can be managed, is if Q continues to be subject to a care order and the local authority is fully on board and fully engaged in monitoring and ensuring that the safety expectations for Q are implemented in his day-to-day life.
It is not, iii) on the current analysis of risk, acceptable for the local authority to step away under a supervision order which would simply allow the parents to engage or not engage, albeit, I accept, it is likely that they will continue to engage. The risk is too high to allow that to be an option, and whilst the care order remains in force, the parents will know that in order to get through this next stage, which in effect is a stage which will allow them to demonstrate that they can consistently and safely parent Q on a day-to-day basis and on a long-term basis into the rest of his childhood, that this has to be done under the auspices of an order that will engage the local authority’s responsibility to provide oversight and monitoring. It is not a case of simply having support that is the reason that a care order is justified in this case.
I have asked myself the question, “Where does the level of risk sit at?” and it is clear to me that the level of risk, as I have said, still sits at somewhere between medium to high, and on that basis, the risk has not been sufficiently reduced to allow a lesser public law order to be considered. I have asked myself, “What are the exceptional reasons for a care order being made in this case?” and my conclusion is this. The static risk factors remain so high that the chance of this shifting towards the risk being increased in a short period of time remains if there is a trigger or if there is an unexpected change for these parents, and so the parents will need ongoing support through professionals, through monitoring, through the auspices of a care order, to ensure that shift and/or increase in risk does not happen. They will have to show that they can embed consistently and apply new coping mechanisms and strategies through the work of FFT and Gillian Merrill, to actively reduce that risk before the local authority can step away and have anything less than a care order.
The reality of this case is that the local authority is seeking to manage this child’s safety, who has been rehabilitated to his parents, each with a complex profile; two parents who have had huge childhood trauma that still needs to be addressed, and a complex neurodivergent parent who need to continue to be carefully managed and supported. I consider that there are really clear exceptional reasons to making a care order at home in this case. This is a case where neurodivergent expert assessment of the father has revealed that there has to be a very clear strategy of monitoring and support that will allow a child to safely be rehabilitated to his care, so ultimately it is the calibration of how to manage that risk and that risk still needing to be reduced before the local authority steps away, that justifies a final care order being made.
I have, of course, balanced the family’s Article 8 right to a private family life and I have balanced the level of intrusive interference that a care order brings, but my priority is Q and I am satisfied that this is the only way in which Q can continue to be safely cared for by both of his parents and have all of his welfare needs met under the auspices, as I have said, of a final care order, with the local authority being utterly transparent that in the event that over the next six months, which can be recited in the final order, that the level of risk is analysed as coming down and the parents have demonstrated those changes and implemented those strategies in a way that supports, benefits and makes Q safe, then the local authority, after six months, is likely to apply for discharge of the care order and the issue of the need of a care order can be reviewed wholesale.
I am not going to end this judgment without observing this. Q was rehabilitated to his parents’ care full-time on 27 August. I have no doubt that the Service Manager who has granted Placement with Parent Regulations approval will be disappointed to know that the local authority did not put in an updated safety plan to set out the clear expectations of both parents under the existing interim care order when he was rehabilitated to the parents’ care. I am clear, it is not my role to micro-manage how the local authority delegates or exercises its parental responsibility under the auspices of a final care order, but I am very clear that if there is to be a safety plan that regulates that, which there must be under Placement with Parent Regulations, then that safety plan must be in place so the parents are totally aware of the expectations of them in caring for Q under a final care order before both of these parents leave the court today.
That is my judgment.