X and Y (Children) (Costs and Funding of Therapy and Long-Term Foster Care), Re

These proceedings concern two young people, X, who was born in 2012 who is 13 years old, and Y born in 2015; he is 10 years old. They are full siblings. Their mother is M, her last surname following her marriage to her long-term partner, G, who sits in court with her. The father of the children is F. He has not played any part in either of the children's lives since Y was a few months old when the parents separated and he has not played any part in these proceedings either. The two children have an older sibling, Z. She is now approaching 17 years of age; she is accommodated by the local authority and has not been a subject of this application.

These proceedings are now approximately a year old. The local authority invites the court to make care orders in respect of X and Y under which the plan is for them to remain in long-term foster care. The current situation for them is that following care orders made at the end of last year, X continues in what might be termed a reasonably orthodox placement and Y, because of his particular needs reflective of challenging behaviour and the like, lives in a residential placement in Norfolk where he has been now since approximately March.

Coming into this hearing, the mother opposed the local authority's plans and proposed, possibly over a period of time, a return of the children home. At the start of the hearing and for reasons that will follow in this judgment, her position is now one of neither opposing nor supporting the local authority's proposal. Her position in particular rests on a combination of the conclusions of clear, thorough and comprehensive expert evidence in the case about the therapy in particular that she and wider members of the family require before it might be considered safe for the children to return home and the local authority's steadfast refusal either to fund or to contribute to the funding of that therapy.

In short, evidentially, she has been left with nowhere to go. It is a credit to her that she has come to acknowledge that. It is in particular a credit to her that on a day when the local authority filed a significant amount of new material supporting, it says, its plans in respect of contact, and my being told at the start of what was to be day three of a three-day hearing that there was provisional agreement that the court could indicate it will make court orders but adjourn for a further one-day hearing to determine the question of contact that the mother, with no doubt considerable assistance of her counsel, has taken the time to go through that document and to have made the brave decision not to seek that separate, further hearing.

The terms of what are, as I say, either an agreed or at least a non-opposed order include that contact between the mother and the children will not reduce to a frequency of less than monthly at least without a return of the matter to court. That does not, I make clear in this judgment, operate as some sort of limit on the contact but rather a minimum below which it should not, save for very good reason, go.

The children's guardian, Ms M, supports the local authority's application for care orders but does so in the context of expressing, at this hearing and at previous hearings through counsel, a measure of frustration and sadness at the local authority position in respect of the funding of the therapy that the mother requires.

The background is that this is a family known to social care since around 2015. That is to make clear the year of Y's birth. There were concerns around neglect, physical and emotional harm and the exposure of the children to mother's vulnerable and at times poor states of mental health. F was physically violent and domestically abusive to her, and the children were exposed to that, making them victims too. There was also, it is very sad to say, sexual abuse perpetrated initially by F on Z and then latterly in the nature of inter-sibling abuse between Z and at least one of the younger siblings.

It is a complicated and sad dynamic in which the individuals involved, including the mother, have experienced trauma. The parents separated when Y was some 3 months old. In the time that has elapsed since, there have been periods of local authority involvement and at times the provision of extended and targeted support. There have been child in need plans on four separate occasions, two of which were in 2022 and 2023 respectively. There have been periods of improvement which have not been sustained in the longer term.

In June 2024, matters reached crisis point when the mother again sought out help and support from the local authority at a time when she described her family as ‘broken’ and made clear her view that the children could not be expected to live together. At that time, they were accommodated under the provisions of section 20 of the Children Act. Around two months later Y returned home. His placement had already broken down because of his challenging behaviour and there was a prospect of his moving some distance away. At that stage, the mother considered that was too far away and both she and Y expressed a wish that he should be reunified to her care.

The following month, X also returned, reflective of both her and her mother's wishes. In the autumn there then followed a period of pre-proceedings work under the Public Law Outline during which the mother was evidently struggling and was saying to the local authority that the children needed to go into care.

This case was issued in November 2024 and within a week or two the mother had signed agreement under section 20 and since then the children have been accommodated in separate placements. Interim care orders were made on 20 December.

For Y, there was a search for an appropriately therapeutic placement. His placement, which was an initial emergency placement, seemed to work. In March 2025, however, the foster carers looking after him gave notice as a result of being unable to manage his complex needs and challenging behaviour and it was then that he moved to where he remains now. He seems to have settled there to a large extent and the local authority's plan is for him to remain there for at least the short to medium term.

X's first placement broke down amidst concerns around the foster carer's behaviour towards her which was properly investigated by the local authority. She moved, initially in early February and then again in the middle of March 2025. There are more recent concerns that that placement is very fragile. It is suggested but I do not find, not having heard any oral evidence, that there are elements of the mother's behaviour possibly in tandem with a plan developed with X to undermine that placement in the hope that X returns home. The written evidence about those concerns, at best, is inconclusive. The local authority's own documents, for example, have clear examples of the mother seeking to support and shore up the placement including removing X's phone from her, suggesting that her video contact with X should be supervised and being heard to support the foster carers looking after X.

There have been a number of assessments during the proceedings, a number of which I do not need to go into in any detail given the parties' positions as they are now. A number have been obtained from Dr H, a consultant psychologist, which included cognitive assessments of M and G, together with a psychological assessment of the family undertaken in early May. Both M and G are vulnerable. The mother had borderline IQ scores. G had what was described as an uneven profile of skills with his verbal IQ falling in the extremely low range and his non-verbal IQ in the low average range. He has limitations of memory.

The vulnerabilities of both were reflected in the need for a parenting assessment of them being undertaken using the Parent Assess model. The assessment of the family undertaken by Dr H was detailed, comprehensive and in my view, appropriately nuanced. I will not quote from it at length but it is important that proper respect is paid to that evidence given the conclusions that Dr H came to in her main report and developed in her later answers to questions.

The summary of her opinion begins with the important observation that both parents, that is the mother and G, love the children and want the best for them. Dr H went on:

"A striking feature of M's profile is her emotional unresponsiveness. The pervasive and long-term nature of her emotional disconnection suggest that it may have become an intrinsic part of her personality structure. She presents with significant limitations in empathetic mentalising and only a surface understanding of the needs of her children struggling to take their perspectives. M has a low tolerance for parenting stress and limited coping strategies for dealing with stress. She has a history of relinquishing the parenting role at times when the children may need her most leading to them both feeling rejected and distressed."

There was then an assessment of the children who have both suffered significant disturbances in their attachment relationships and importantly both see themselves as responsible for their current predicaments. Y is described as presenting with obvious symptoms of trauma which are being gradually worked through at his current placement. X is described as having taken on a role reversal position where she is the adult trying her hardest to meet the needs of her mother. A very important feature of that for the short, medium and longer term is Dr H's point in respect of X:

"She has not been able to invest emotionally in her foster family, expressing a desperate longing to go back to her family…and worried about her mother. The family dynamics are complex and have been disturbed through historic sexual abuse, unintentional neglect and sibling rivalries. The parents have not been able to support the children in their relationships with each other."

Dr H went on to describe what she called a fundamental misalignment in the emotional needs of the children and the capabilities of the parents to meet them. In this respect, there is a risk of a repeat of previous cyclical patterns. That is to say, two children who are desperate to be at home are permitted to go home and when they exhibit, as they are likely to on the evidence, challenging behaviour, they are encouraged to think that that is their fault and when the mother expresses she is unable to cope with them, back they return to local authority care. And each time, as it seems to me, the cumulative effect on them of that level of abandonment is striking and worsening. It must be avoided if at all possible.

There are positives in the case. In addition to the deep and profound love that Dr H referred to, this is not a case attended by many of the concerns that feature in public law proceedings. That much is clear from what is an agreed threshold document. There are no issues of alcohol or substance misuse in the home. There are no issues of domestic abuse in this now long-term relationship. There is not a pattern of criminality or associating with risky individuals. The difficulties stem from and are reflected by the complex family dynamics based on previous trauma that I have already referred to.

That summary might speak to a possibility of the children being again cared for at home, if and to the extent changes can be made and if and to the extent appropriate packages of support might be put into place. In relation to the latter point, the local authority would say with some force that history shows the putting into place of packages of support by itself is not sufficient. That has been tried in the past and has not produced long-term sustained change. Notwithstanding, the cautious conclusions of the independent social worker, Ms P, was that it was contemplatable for the children to return or transition home with an extensive pattern and system of support in place. That ultimately has not been pursued by any party, not least given the apparent dearth of the availability of such support and the funding for it.

In her final statement the social worker made the point that if there was to be the funding and availability of the sort of support that the independent social worker was referring to, it would have been attempted already. I have also had regard to a sibling assessment prepared by the previous allocated social worker which concluded, among other things, again reflective of their levels of trauma and differing needs, that the children should be placed separately in the shorter term.

Ms M's final analysis was prepared in August in advance of an Issues Resolution Hearing shortly thereafter. She provided broad support for the local authority plans but urged consideration be given to therapy that Dr H had recommended.

The adjourned Issues Resolution Hearing took place on 1 October. Dr H had replied to questions about the funding and extent of the therapy that the mother in particular requires. In this regard, I make clear that Dr H's recommendations are not limited to the mother undertaking cognitive analytical therapy; that is one of a number of different examples of the sorts of therapy that she requires. There is also a need for wider family therapy, jointly and individually, for the various members within it to work through the trauma and the consequences of that trauma that they have lived through.

But the cognitive analytical therapy was an important first step. Dr H's best estimate at the time of writing her report and answering questions was that the mother was likely to need approximately 24 sessions, over approximately six months, although the mother's presentation may mean that might need to be extended. Dr H's estimate of cost was between £100 and £150 per session. Taking a midpoint and multiplying that by 24 sessions produces a cost of £3,000. Importantly, in my judgment, Dr H said that any therapist ought to be able and be expected to provide a sort of midway prognosis. That is to say, around session 12 whether things were broadly on track, whether it was likely that the work would take significantly longer or indeed whether unexpected and greater progress was being made.

In light of those observations and the figures involved, the obvious question arose at the Issues Resolution hearing of whether and to what extent the local authority would fund or would contribute to funding that therapy. It does after all arise from expert evidence that the local authority relies upon and stands behind. I was told at that hearing that the local authority would not provide any funding, effectively pulling the rug from under the mother's feet.

I was concerned about that stance, including having a broad idea of the costs of both children remaining where they are in the longer term from the perspectives both of a costs benefit analysis in terms of the use of public funds together with, and as importantly, a welfare analysis of what is best for the children. At that hearing, I directed the local authority to provide a statement from the (interim) Service Director; the wording of my order required the statement to set out: 1) the local authority's decision making process in reaching the decision that it would not fund the cognitive analytical therapy recommended by Dr H; and 2) how the local authority will be able to comply with its ongoing legal duty to consider the issue of reunification post any final orders in the absence of therapy an expert has advised is required prior to reunification being appropriate.

That statement was provided by Mr D, although I have to say I am not necessarily satisfied it does exactly what I required of it. In particular, for example, there is no description of any decision-making process. There are a couple of reasons why the local authority remains steadfast in its refusal to support with the funding. The statement contains no details of any comparative exercise of the costs to the local authority – and by extension to the public purse – of keeping the children where they are set against the likely or potential costs of the therapy.

The context for this, in my judgment, is important. I will not repeat what I said by way of the background but it includes these children having lived at home for most of their lives. It includes their primary carer herself being impacted by her and their trauma. It is case attended by an absence, as I have said, of a number of concerns that sometimes exist in these sorts of proceedings. I refer, as Dr H did, to G as a stable and steady presence in the lives both of the mother and the children.

Dr H's report contains both a clear exposition of the dynamics in play and what is and may be required to fix it. After Dr H's replies to questions with the figures in it set out, the mother's position statement for this final hearing was provided. At [12] Ms Gould wrote:

"The mother has sourced a private therapist who will provide for 16 sessions required for £80 per session so £1,280 in total."

So, pausing there and reworking the figures provided by Dr H, that would require £1,920 for 24 sessions but with a recommendation if possible at halfway through so after about £960 had been spent. However, at the end of [12], Ms Gould amplified the mother's position: "The mother despite her limited funds is content to fund 50% of that cost” which meant the local authority was asked to commit to around £480 (half of £960) and up to £960 in total.

During a brief adjournment on day one, Mr Yeung who represents the local authority at this hearing as he did at the Issues Resolution hearing, and if I may say so has been incredibly helpful throughout in making sure that observations made by the court are accurately passed back and instructions taken in a timeous way when documents, such as the mother's position statement, are provided, made clear that the local authority's view was unchanged. It will not spend £480, it will not spend £960, it will not commit a penny to the therapy that the expert has said is the starting point for the mother to get into a position where these children might safely be reunified home.

Those figures, which I accept are variable, are only of course one half of the coin. The other half of the coin is the (public) cost of funding of the placements for Y and X respectively. There have been varying figures provided in respect of Y's placement but Mr Yeung told me shortly before the lunch break today and given where he got the information from, I will take that at face value, the cost is £7,400 per week. The cost of X remaining in foster care is £810 per week.

I accept there is far more nuance than describing this as a situation where all could be made well with an outlay of £480, £960, or even £3,000. I accept that there is therapy required beyond the initial analytical therapy. The point that emerges from the expert and professional evidence, however, is that that therapy is both required, reasonable and may well lead to these children being reunified to their mother's care with the wholesale stopping of the costs otherwise attendant on them remaining in foster care. And so, accordingly, and notwithstanding the nuances in the case, I nonetheless feel able to say that the notion there was any conceivable cost benefit analysis properly applied that might sensibly lead to a refusal to either provide or even contribute to that funding is hopeless on the facts of this case.

It is important, in my judgment, that the public knows how public funds are being applied. More importantly and more specifically to each case, it is important to know for children when they come to look back at what happened, what decisions were made around them and why, together with the opportunities that might have been made available, how and on what basis those decisions were made.

I go further and accept that it is not realistic to expect Y in particular to be returning home immediately after the end of a period of cognitive analytical therapy. It is, however, beyond argument that Y returning home represents a realistic medium-term goal. To offer some estimate of figures, the costs of Y remaining where he is for, say, six years is over £2.3 million. The costs of X remaining in foster care for four years, let us say from her 14th birthday, is over £166,000. I say again the costs of therapy on the mother's recent research for 12 weeks when a prognosis might be provided is somewhere around £960. It is one half of that that is requested from the local authority.

I accept the submission, unreservedly, that Mr Yeung made on day one that the local authority would be concerned about an open-ended commitment to funds and I make clear that is not what is being required. If, for example, the midway report, the prognosis after 12 sessions suggested this looks far more complicated and difficult and we simply cannot say if this process might work, then for the sake of a few hundred pounds it had been tried and it would be realistic and reasonable for the local authority to say (and commit to) no more.

It is equally tenable on the evidence for that report to have indicated this is working approximately as we anticipated it or there may be a couple of months more than was originally anticipated required. It still involves the cost of avoiding an outlay well into the millions of sums totalling no more than hundreds and possibly a few thousand pounds. It is a situation where the phrase ‘a drop in the ocean’ is scarcely sufficient and I simply do not understand the local authority's stance.

At the Issues Resolution Hearing and to my recollection at the beginning of this hearing, the guardian's frustration and sadness on behalf of these children at the local authority's approach led to references to the possibility of an application for judicial review. An observation that tellingly brings to mind the ostensibly unreasonable nature of the decision-making at the heart of that aspect of this case.

Those observations deal of course only with the financial consequences of the decision. At the end of the day and returning to the legal principles that I apply, I have to ask myself two questions. The first is whether the threshold conditions are met that enable the court to go on and consider whether to make an order, any order or a public law order. There is an agreed threshold document in this case. The evidence in support of the matters set out within amply justifies the findings sought and I make them accordingly. That does not mean that the court has to go on and make any particular order. The answer to that second question is determined by applying principles, some of which come from caselaw and some of which appear in section 1 of the Children Act.

The welfare of X and Y is my paramount consideration. That means, among other things, that if there is a reasonable and realistic prospect of them avoiding remaining as looked after children with all the stigma, inconsistency, changes of placements and being away from the family that they both desperately want to be in can be achieved, then it should be. That is why it is written into the law that the local authority with the benefit of a care order has a duty to keep under active consideration and review the possibility of a reunification home. That is why I directed the statement in relation to funding that I did at the previous hearing.

I am concerned that the reasons set out, which include the availability of the therapy on the NHS (albeit not for a considerable period of time), the possibility that other forms of therapy might be available without setting out at all what those alternative forms are and otherwise the lack of certainty that the therapy might work demonstrates, if I may say so respectfully, how superficial and inadequate the decision-making process has been. For the local authority to say, as it does in its written presentation, not only that it will keep under review the possibility of reunification but that it is committed to keeping reunification under review whilst simultaneously saying but before that can happen the mother needs to undergo cognitive analytical therapy that we are not willing to provide a penny towards collectively combined to create the risk that those are empty words.

In applying the principle that the children's welfare is paramount, I consider the checklist of factors in section 1 (3) of the Act. The wishes and feelings, particularly of X, have been consistent, clear and if I may say so, articulately expressed. Her wishes and feelings are expressed in the context of the love and concern that she feels for her mother. A double-edged sword, in other words. The concern, the need to look after her mother, being one reason why a return home at this stage would not be safe or appropriate.

I record that I have had X's wishes and feelings not, as is commonly the case, simply through the guardian's work, through what X felt able to say to the local authority professionals but in both a meeting that was held in this court with me and through two letters that X has written directly to me and to which I will respond.

Y's wishes and feelings are evidenced in a more nuanced way as I read the totality of the evidence. He himself has recently written a letter although there is some doubt within the local authority about whether that was, as it were, unprompted and decided upon entirely by Y but he too makes clear that he wishes to return home. With a remarkable degree of insight and maturity, not least given his age coupled with his challenging needs, he told the guardian when speaking to her in the summer that whilst he wanted to go home, he realised that now was not the time and that work needed to be done before that could happen. He is of course in all respects right about that.

Otherwise, I bear in mind the physical, emotional and educational needs of the children, the effect on each of them of changes in circumstances, other characteristics of them, the ability of relevant people to meet those needs and deal with those characteristics and the harm that the children either are suffering or are at risk of suffering. They need physical and emotional safety and security. It is reasonable to assume that those needs for physical safety at least will be fully met in foster care.

It is plain on the evidence and Dr H expressly made the point that X's emotional needs are not being met in foster care and so, by itself, the application of that factor involves a difficult balance. X has not invested in foster care and is likely, at least in the short term, to be devastated when she is told what my decision is. How much more devastating for her when it cannot at the same time be honestly said to her that a plan is in place in the short to medium term of working towards reunification to her mother. Were that to be the case, and having met her, I express cautious but reasonable confidence that she is far more likely to be able to buy into foster care in the shorter term. That is not available to her because of the decisions around funding.

In terms of the effect of any change, a return home now for either child, but particularly Y, is fraught with difficulty and risk and I credit the mother in the stance that she now adopts with sufficient insight to have recognised that. I have already made the point but will do so again in the context of the welfare analysis, that the repeat of previous patterns of behaviour where when they become challenging at home, they are scapegoated and then rejected and sent into care will have, in my view, untold long-term emotional and psychological risks for them.

So too, albeit to a lesser extent, are the likely consequences of them remaining in care in the medium to longer term. They are not children from a home that means remaining in long-term care is inevitable. This is a case dogged by practical difficulties which it is relatively straightforward to solve, but there is not the will or the funding or the resources there to do so.

When the local authority says in its care plan and other written presentation it cannot fund the therapy that the mother requires I must make clear in this judgment that that is inaccurate. It is not a factual dispute, it is simply wrong for the local authority to assert it cannot fund the therapy. What it means is it will not, despite the financial context I have set out and the longer-term (and, I accept, unknown) wider societal costs of these two young people entering adulthood with the status of care leavers.

The research is clear about the reduced life opportunities attendant upon people in that situation and the consequences for them are as yet unknown.

I have already dealt with the harm they are suffering and are at risk of suffering both in terms of the consequences of them returning home as well as the consequences of them in the short term being told my decisions and in the medium term coming to understand that they will remain in care. The capability of this mother and her husband to look after the children is well documented. They are not parents from whom young children need to be removed quickly because they are not able to offer them any level of care at all. Most, if not all, of the basics are regularly done. The problems in this case are more specific, more dynamic, more nuanced and come from and emerge from the trauma that the family has been through.

Accordingly, when I undertake the realistic options analysis between a return home and the making of care orders, no party today puts forward the prospect of a return home. That, however, ought to be considered a realistic option in the shorter to medium term. I cannot say that it is at the moment unless and until views around the funding of the necessary therapy change.

For those reasons and with a very heavy heart, I will make a care order in respect of each child. With the developing thinking around the importance of contact orders under section 26 that has emerged, and I am grateful that the local authority suggests/submits to an order, expressed as a minimum monthly contact, together with care plans that involve keeping contact under regular review which I regard as absolutely vital, I will approve the care plans accordingly.