CA-2025-001313 & CA-2025-001318 - [2025] EWCA Civ 1044

In 2024, the mother became pregnant. She attended for antenatal care from July 2024, stating that she did not know the identity of the child’s father. The local authority was concerned about her mental health needs not being managed and supported, her use of skunk cannabis during the pregnancy, and her consistently hostile and confrontational attitude towards professionals trying to help her. After a pre-birth assessment, X was made the subject of a child protection plan in October 2024.

X was born in January 2025 and remained in hospital with her mother for several days. Care proceedings were issued. At the first hearing on 23 January 2025, the judge granted an interim care order and approved the local authority’s plan for a residential assessment, which began the following day.

When issuing its proceedings, the local authority advanced this basis for threshold:

“1.

M misused cannabis during her pregnancy with X, placing her at risk of suffering significant harm;

a.

M had urine testing as part of her antenatal care and tested positive for cannabis on the 05.07.2024 and on the 16.12.2024.

2.

M has a diagnosis of Chronic, Complex PTSD with psychotic features, placing X at risk of suffering significant harm in her mother’s care;

a.

M presents as highly triggered and quick to anger, without any coping mechanisms in place, placing X at risk of suffering significant harm.

b.

M declined intervention with the perinatal mental health team during her pregnancy with X placing her at risk at suffering significant harm.

3.

M has an extensive history with social services involvement since 2008. On 18.12.2018 her first child sadly passed away at 5 months old. On 14.05.2020, M was arrested on suspicion of the murder of the child. On 01.09.2022 inquest into the death identified M as the main carer and determined possible shaken baby syndrome but severity of trauma did not meet the criteria. The inquest concluded with an open verdict with cause of death given as a Head injury.”

The mother applied for a psychiatric assessment, and the children’s guardian applied for the instruction of an expert paediatric neurosurgeon (Mr Jayamohan) to review the evidence surrounding Z’s death and to advise the court about its causation. At a case management hearing on 10 February 2025, the judge granted the mother’s application and adjourned the guardian’s application, which was opposed by the mother, for skeleton arguments to be filed. Other directions were given ahead of an issues resolution hearing set for 4 July 2025, including hair strand testing of the mother, a final parenting assessment, and the obtaining of a transcript of the coroner’s conclusions.

At a hearing on 18 March 2025, the judge acceded to the guardian’s request to adjourn the application in relation to Mr Jayamohan until the court had decided whether a fact-finding enquiry would be held and, if so, the scope of such enquiry. A hearing was listed on 12 May 2025 for the court to determine that question. Before that hearing, the local authority itself issued an application for a paediatric overview of Z’s case to be conducted by Dr Rose or Dr Cartlidge.

On 11 April 2025, the local authority filed a revised threshold document in these terms:

“The Death of Z

1.

On or around [date] December 2018, X’s maternal half-brother, Z (a boy, born [date] 7.2018), at the age of 5 months, sustained the following injuries:

a.

Extensive, bilateral, intraneural and perineural haemorrhage involving the cervical spine nerve roots and ganglia.

b.

Generalised cerebral and cerebellar swelling (with effacement of the basal cisterns and of cerebrospinal fluid of the foramen magnum).

c.

Retinal haemorrhages in the right eye and bilateral optic nerve haemorrhages.

d.

Encephalopathy causing primary respiratory arrest and collapse.

e.

Ischaemia in the brain and spinal cord as a result.

2.

The cause of Z’s injuries (and each of them) was abusive head trauma.

a.

The trauma consisted of shaking and/or impact.

b.

The level of force required to cause the injuries was in excess of rough handling.

c.

Collapse will have occurred shortly after the episode of shaking and/or impact.

3.

Z’s injuries (and each of them) were caused by M, in whose care he was at the time.

4.

Z died at 20.51 on [date] December 2018. There was no evidence of any underlying natural disease that caused or contributed to his death.

5.

Z died as a result of the injuries set out at paragraph 1. Accordingly, his death was caused by M.

6.

X is at risk of suffering similar significant physical harm.

The Mother’s Mental Health

7.

M has a diagnosis of chronic complex post-traumatic stress disorder with psychotic features.

8.

M declined intervention with the perinatal mental health team during her pregnancy and was not receiving support or treatment for her condition.

9.

As a result of her condition, M is easily triggered and quick to arouse. This places X at risk of suffering significant physical and emotional harm.

Cannabis

10.

M has been an habitual user of cannabis for many years.

11.

M was using cannabis around the time of Z’s death.

12.

M misused cannabis during her pregnancy with X, testing positive for cannabis ante-natally on 5th July 2024 and 16th December 2024.

13.

X has been exposed to the risk of developmental harm in utero. She is at risk of emotional harm and neglect as a result of the impact of cannabis use on M’s capacity to parent and her emotional unavailability at times due to cannabis use.”

In argument on behalf of the local authority, Mr Twomey KC accepted that paragraphs 7 onwards are free-standing threshold allegations that do not depend on the findings sought in the previous paragraphs.

Dr Cleo Van Velsen, consultant psychiatrist, produced reports on the mother dated 15 April and 8 May 2025. I take this summary of her first report from the guardian’s skeleton argument:

“In her report Dr Van Velsen noted that the mother had experienced chronic difficulties when she was younger from her own mother's drug use, her parents’ hostile relationship and poor home conditions. She also noted the mother's past history of significant substance misuse. She noted a pattern of a lack of transparency. Dr Van Velsen observed that in relation to the mother's personality there is a long and consistent description of the mother being emotionally labile, hostile, angry and non-collaborative. Although she expressed the view that the mother does not appear to have significant symptoms of borderline personality disorder, there were some underlying borderline personality difficulties. Although Dr Van Velsen expressed the view that there was some evidence that over time the mother had matured, which process can play a significant part in the improvement of personality difficulties, in her opinion there remained ongoing vulnerabilities in her situation and she was heavily reliant on her family for support.”

The final parenting assessment report produced by the residential placement is dated 30 April 2025. It noted that X was thriving, that the mother was capable of meeting her practical needs and that there was a strong emotional bond between them. However, family and professional support would be required for at least 12 months and the author was concerned about whether the mother would engage fully and openly as she struggles to work with professionals whose views do not align with hers.

Earlier in April, the residential unit had proposed the mother and X would move to the mother’s own flat with a strong support package, but concern about the mother’s cooperation led to the unit and the local authority instead proposing an 8-week mother and baby foster placement to support a move to the mother’s flat. Since X’s birth, the mother has expressed frustration about not being allowed to return to her flat with her. By the time of the hearing before the judge, she was allowed to spend unsupervised time in the community with X.

It was against this background that the judge made his decision. He heard submissions on 12 May 2025 and handed down a written judgment at a hearing on 28 May 2025.