“Any harm which . . . [the child] . . . is at risk of suffering.”
“. . . that the local authority would have to maintain an (undefined) ‘high level of support and intervention in the family for many years to come’ without . . . taking into account . . . the provision of support [that] is a recognised requirement for the parents with learning . . . [disabilities under the Care Act].”
“Children’s social [care] services duties under s17 of the Children Act can extend to providing parents with services for the child or services to the parent, and one need not be a child at risk [or even] . . . be a child in need; but the overlap between the two functions cries out for a protocol, for joint working, not a turf war between the two. Cases like this will perhaps”
“drive Directors to high levels of wisdom and co-operation so . . . there does not have to be further litigation to determine the proper approach.”
“Part of the criticism of the mother has been that whilst she is frustrated with carers and personal assistants, she isn’t able to recognise that support that she has is essential to [A]’s welfare and safety. She regularly and often dismisses carers and agencies without thinking of the effect that that has on [A] and [A]’s care, like dismissing a care assistant. Telling her to leave and calling her a ‘two faced bitch.’”
“Gross misconduct due to unsatisfactory performance resulting in neglect of employer and recurrent lateness leading to neglect.”
“In large part due to [R]’s difficult relationships growing up, along with multiple social traumas within and outside of her family environment, [R] developed social anxiety disorder from a young age. Her self-esteem was also significantly reduced, which is common in such situations, along with trying to cope with undiagnosed dyslexia and ADHD during her schooling and further education. Combined, these made coping well with and understanding social situations incredibly difficult for [R]. She experienced significant physical and psychological bullying at school causing additional distress. Further significant multiple traumas from her teenage years onwards have resulted in her developing post-traumatic stress disorder, which she has received minimal therapeutic support for to date. These difficulties have been compounded by undiagnosed ADHD, along with the development of multiple debilitating medical conditions, including ME and CFS.”
“That the report was insightful as to the extent of [R]’s difficulties and the cognitive impact with her conditions and her ability to care for her daughter. However, the interventions that have been suggested have been over the last five years tried and sadly failed. [R] will state that she has accepted support, or it’s not been offered. However, the reality is that the support has been offered, but [R] has not been able to consistently engage with this, therefore meaning that it has ended and it’s not been replaced. This in itself is causing a safety issue as the intervention is not consistent and [R] at times is left with little support for herself, let alone the support she requires for her daughter. It’s very important”
“to understand that this is not a case whereby [A] has moved to the care of the Local Authority with no consideration as to the alternatives, but more so that those alternatives have not been implemented on a consistent basis, leading to the need to have further more extreme intervention with [A] living away from the home. “The reasons that Mother isn’t able to consistently engage” said Miss Seekins: “is because she finds it very difficult to accept support and disagrees with the quality of support and there are disappointments as to her expectations.”
“Adult led rather than to consider what’s best for [A].”
“Was quite clear that whilst [R] can be part of [A]’s life and that they do have a meaningful time together, the extent of her health issues means that there are some real limitations as to what she can do and there is a worry about inconsistent and multiple carers for [A] and there has been a significant emphasis as to what support can be put in for [R] and what can be achieved for her, rather than how to meet [A]’s needs and less emphasis as to what the child requires. The consistency of care for [A] is really important” said Sarah Seekins: “because she needs a routine in place and she needs to know that when her mother is involved in her life, that it’s consistent. The same time every week and the same place every week, for example.”
“Mother’s health needs are not consistent and some days she feels better than others. Some days she might be able to manage more. So in another way the arrangements need to be flexible to meet that need, but a combination of personal assistants is not going to give [A] the consistency that she is now used to having.”
“At the end it was about [R] and it was not about [A]. She was hiding and it was becoming distressing, and it was quite rigid thinking. That R didn’t understand [A]’s loyalties or that [A] felt she wasn’t able to say no to her mum, despite the fact that she was explicitly telling others that she didn’t want to do it anymore.”
“Miss Seekins wasn’t able to see the difference between a nurturing act and one that was becoming an abusive act .”
“[R] remains focused on the failure of services to accommodate for her and her parenting role with a limited awareness of [A]’s lived experiences and the impact of her own limitations on [A]’s own development and on [A]’s ability to develop a safe attachment.”
“Did not think anything would be quite good enough for [R] because” she said: “she [R] finds it extremely frustrating to have people going into her home and that actually a live-in nanny is pretty much the job that [FC] had been doing, because she was there all the time, and that relationship still broke down fairly quickly. [R] finds it very difficult to maintain relationships if she thinks something that a carer has done is not right or isn’t to the right standard.”
“There was no reason or changes to justify [A] spending less than weekend contact with her mother as it was back in March 2023 under a somewhat shared care arrangement.”
“Her psychological presentation is complex because of a conjunction of psychological issues affecting her functioning.”
“[R] presents with neuro atypical traits which are common with adults with autistic spectrum disorder. Her difficulties are best understood from a neuro atypical perspective that underpins other aspects of her psychological presentation. In addition, she exhibits symptoms of post-traumatic stress disorder” (which is what Dr Crawford found), “and unresolved childhood trauma, as a consequence of exposure to abuse in adulthood and trauma in her developing years in the context of her relationships with her main care givers. Whilst she is caring and keen to empathise with others, her rigid black and white thinking style and deficits in her psychological mindness have restricted the negotiation of social relationships. In the context of requiring significant support for her and for her daughter to meet her parental need, her rigidity of thinking and the problems understanding how others and relationships with them have affected her capacity to bridge the gaps and access the support needed, have posed a significant challenge for her and are likely to have had a circular impact on her health, both physical and mental. She finds herself in a paradoxical situation where she needs to negotiate complex interactions to be able to access and engage with several agencies, but then lacks this efficient flexibility to adopt to others around her, including services.”
“That the combination of both her neuro atypical traits, including socio communication deficit, her black and white thinking, symptoms of ADHD and her controlling attachment strategy can be perceived by others as a sense of entitlement and actively dismissing the views and needs of others.”
“I have formed the clinical view that this is not the case. Instead, it is my psychological formulation that [R] has attempted to do her best in the context of limited social communication, interpersonal and emotional abilities, because the combination of her complex health needs, her neuro atypical traits, her deficits and psychological mindness. Her unresolved development trauma and her mental health difficulties, including symptoms of post-traumatic stress. In terms of therapeutic support, she would benefit from engaging in cognitive intervention, such as cognitive behavioural therapy for personality traits or cognitive analytical therapy to explore her understanding of dynamics and patterns in relationships, as well as to integrate her past traumas. The intervention could also support her in reducing the symptoms of Post Traumatic Stress Disorder (PTSD) and symptoms of anxiety and low mood, as well as exploring and addressing her childhood experiences of trauma. However” said Dr Martinez: “the intervention will have a limited impact on enhancing her ability to develop the flexibility of thinking required in order to adapt in a timely way to understand the queues and developmental needs of her daughter, because of her own physical limitations and the developmental nature of her neuro atypical traits.”
“Whilst she loves her daughter, she lacks the ability to adapt flexibly to all [A]’s needs. She can provide discrete episodes of care but adapting to the changing needs of [A], in a flexible way, is what is required to meet the child’s needs for continuity and safe attachment base.”
“This is going to be difficult, because [R]’s own limitations are likely to stand in the way of meeting all of [A]’s needs, including the provision of a consistent attuned base as a main carer. ”
“[R]may be amenable to therapeutic work to improve the likelihood of having some role in [A]’s care, though not as a main provider and in terms of timescales for any work, that’s likely going to be required for at least six months or longer.”
“[R] is not in a position to provide for [A]’s overall needs whilst undertaking therapy and the aim of the intervention, as I said in a nut shell, would be to improve her ability to mentalise for her child and others, as well as to develop reciprocal relationships with others in the role of supporting her, to be able to co-operate for her own care and to improve her relationship with [A].”
“Even if there was success in some areas and that she is amenable to change, that the developmental aspects of her difficulties are unlikely to change sufficiently, as I said, to cope with [A]’s ever changing needs. [A] is assessed as being intellectually able, although some aspects of her development are delayed. This points to environmental factors being potentially contributory to [A] not having achieved her potential levels.”
“[A]’s relationship with her mother appears to be a source of confusion and some distress. [A] has affection for her mother but does not perceive [R] as a consistent source of care provision, or as a safe base. She presents with an insecure attachment strategy in the context of this relationship. The priority for A is to continue to be provided” said Dr Martinez: “with a care giving relationship where she can build on a sense of stability and a safe attachment with her main carer and that she will benefit from therapy to build her sense of confidence and explore past experiences. Therapy should also focus on improving [A]’s safety in relationships and her ability to assert and understand herself.”
“Given that there has been a seven-month gap of [A] spending time with her mother, that this would need to be carefully considered as to how contact is reinstated and what work would both be needed for [A] and [R] around this.”
“I don’t think this is unwillingness, it is that she is unable. She can present as unwilling, but her rigidity is how she processes information and how she is self-referential but that this is not a choice. This is how she is.”
“[A] wanted it and that she wanted it so badly at times she was pulling at her boobs, even in public.”
“[FC] absolutely has the skills to minimise the emotional stigma of becoming a looked after child because she is an incredibly child focused carer and committed to [A] in the long term. [A] is described as thriving in [FC]’s care and she will ensure that [A] will receive the support she needs, including the support for her to be reintroduced to her mother. One of the reasons the Local Authority issued” said Miss Motivaras “was because of the instability on [A] of being between her mother and [FC] and the message this sent to [A], being one of confusion.”