Case No. EWFC-156

The social work evidence24I have considered evidence from two local authority social workers who have been allocated to this case, Esther Danquah, who was the allocated social worker until April 2022 and prepared the original final care plan, and Fatmata Koroma, who took over after Ms Danquah left the local authority and is the current allocated social worker. Factually, the evidence of both social workers was largely unchallenged. As I have explained, the background is not significantly in dispute, at least as to the overall themes if not the detail of individual events. 25Having heard the evidence of both social workers, I was left significantly concerned about the local authority’s presentation of this case. My concerns centred on three areas.26First, neither social worker, in my judgment, had paid any real attention to the authorities and guidance in respect of parents with cognitive difficulties. That guidance has been in place for some years and all local authorities should be aware of it. The written and oral evidence of both social workers, together with the background material provided by the local authority, made it clear that throughout its involvement with the family the local authority has worked on the basis that support will not be available in the long-term. The expectation in both the child protection plans and during the pre-proceedings process was that support would be tapered down and the mother would be expected in due course to manage largely independently. In her written statement, Ms Danquah said, in the context of the support that the mother would need, that the local authority “deem it is not fair on P that Children’s Services would be involved in her life until she is an adult”; apparently missing the obvious point that Children’s Services would be far more heavily involved in P’s life if she spends the rest of her childhood in foster care.27In Ms Koroma’s witness statement she said that she thought the mother could make the changes needed with support but went on to say, “however, it is my view that she would require ongoing support to sustain these changes”; the implication being that such support could not be made available. In her oral evidence Ms Koroma referred more than once to an expectation that if P were to remain in her mother’s care there would come a time, probably after the end of a twelve month supervision order, when the local authority is no longer involved.28It is questionable whether an assumption that services will be withdrawn over time is ever appropriate as a blanket approach for any family. It is certainly not appropriate, in my judgment, for a family where the health condition shared by mother and child, and the mother’s cognitive deficits, mean that both are likely to need considerable support in the long-term from both health and social care.29Secondly, the written and oral evidence of both social workers, in my judgment, demonstrated a linear, “pass/fail” approach to the options for P that ran contrary to the authorities. One clear and quite startling example of this approach is the fact that neither Ms Danquah nor Ms Koroma had given any thought to the possibility of the father caring for P after the receipt of a negative independent social worker assessment. When asked about the advantages and disadvantages of this option, Ms Koroma simply said that the parenting assessment had been “negative”. When pressed further on that, she admitted that she had not read all of it. Ms Danquah said that she had based her planning on the fact that the assessment was negative and that “the local authority was holding to that.” When questioned, she too admitted that she had not re-read that document before the hearing and could not remember any of its content.30This linear approach fed into the written evidence of both social workers and, most importantly, into the final evidence and care plan prepared by Ms Danquah. Under the heading “Realistic options analysis”, the only option identified as realistic is a placement in long-term foster care. The advantages of that option are listed but there is no acknowledgement that this option carries any disadvantages. The mother appears in the table of options only to be dismissed with the words “This is not a realistic option”, and there is no identification, in that section at least, of the benefits to P of remaining in her mother’s care. The father does not appear in the table of options at all. In my view, the local authority’s evidence in this respect is seriously deficient.31Thirdly, the local authority’s care planning for P was characterised by a “one size fits all” approach that emerged several times and at different points in the evidence. It was very apparent in both social workers’ evidence about the care plan. Despite the fact that this is a nine year old girl with a significant medical condition, the local authority have given little or no thought to the type of placement required, how prospective carers would be trained and supported to meet her needs, or how a move to foster care would impact on P. Ms Danquah’s final statement was completely silent on these issues. Ms Koroma was asked what would happen if the foster carers struggled to manage P’s condition, given that, as I explain below, no training can take place before a move to their care. She had clearly never thought about this possibility and ultimately suggested that if there were problems they could call an ambulance. It was clear that this was the first time these issues had really been considered by the local authority.32A further and very concerning example of a “one size fits all” approach was in the local authority’s thinking about contact. I have referred already to the change in the final care plan which took place during this hearing and without explanation. It was not practical to recall Ms Koroma on this point so I asked Ms Seitler, on behalf of the local authority, to explain its thinking. I was told that the rationale for the substantial reduction was that this is a long-term placement. I was reminded of Ms Koroma’s evidence when asked to explain the thinking behind the original plan for weekly supervised contact for two hours on each occasion. Her answer was: “I have arranged contacts with parents before.” It did not seem that at any point in this case the local authority have given any meaningful thought to what P’s own particular needs and circumstances would require.33In her closing submissions on behalf of the father, Ms McGrath told me that her client felt that the local authority had not been considering P as an individual and that the care plans provided were generic. She said it had seemed to him that the local authority was grabbing at straws for a placement willing to accept P rather than the starting point being what she requires. I agree with that perception. It is striking that when giving evidence about a possible foster placement in Dagenham, the local authority’s initial preferred option, Ms Koroma was anxious to emphasise that the carer was Muslim, despite the fact that the mother’s family at least is not particular religiously observant. But after the Guardian had visited and expressed concerns about that placement, the local authority proposed a white family in Romford about whom almost nothing is known other than that they have two children in placement already.34I appreciate, as the Guardian has pointed out, that there is currently a real shortage of foster placements and that an extensive search was undertaken by the local authority before it was able to find any placement prepared to accept P. I do not for a moment criticise the Family Finding Team for the efforts they have made, which appear to have been exhaustive. Where I do find fault with the local authority is in its failure to engage honestly with the difficulties inherent in a plan for long-term foster care for this particular child and to put the risks and disadvantages of this option properly before the court. The local authority has, in my judgment, presented the option of foster care as a panacea without any real consideration of the likely reality.35I was left, after hearing the social work evidence, with the impression that there have been significant gaps in the local authority’s thinking and planning for P. Overall, what was missing was anything approaching the sort of holistic balancing exercise or weighing up the pros and cons that is required when a decision of this significance falls to be taken. That does not mean, of course, that I must dismiss the local authority’s case but it means I must take extra care to conduct the balancing exercise myself and that the views and recommendations of the local authority can carry only limited weight.The evidence of the family support worker, Jade McKenzie36Ms McKenzie is the current family support worker allocated to the family. She has been providing four hours of support per week. A few weeks before this hearing, the time increased to six hours spread over three sessions and for a further family support worker to be allocated. I have considered Ms McKenzie’s evidence alongside the written notes in the bundle. It is clear from the notes and her evidence that she has built a good relationship with the mother and has been providing substantial support. I accept that the support provided goes beyond the four hours per week that she was initially asked to provide and also includes considerable ad hoc involvement with the mother through texts and phone calls. 37It is clear that Ms McKenzie’s involvement, and that of the previous family support worker, Ms McDonald, has been key to ensuring that P’s medical needs have been met. Ms McKenzie is on a WhatsApp group with the mother, the allocated social worker and the Great Ormond Street nurse, which is used to prompt the mother about things like blood spots and medical appointments and which the mother uses from time to time to ask advice. Overall, the evidence suggests that the mother has worked well with both recent family support workers. Ms McKenzie told me that the mother would generally follow advice, although she said it definitely takes a few attempts and a few different ways of explaining and giving reasons before she does so.The expert evidence38Evidence as to the mother’s mental health and cognitive functioning is contained in two psychiatric reports prepared by Dr McClintock and a psychological assessment carried out by Dr Parsons. Those reports were all prepared in the pre-proceedings process, so some time ago. Neither was required to give oral evidence. 39Dr McClintock expressed the view that the mother was suffering from clinical depression with features of low mood and anxiety. She described a history of self-harm in her teenage years and again more recently. Dr McClintock suggested that the mother might have an emotionally unstable personality disorder but that that diagnosis was complicated by what he suspected were difficulties with her cognitive functioning. He recommended a cognitive assessment.40Dr Parsons, who carried out a cognitive assessment as part of his psychological report, considered the mother to be functioning in the borderline range of adult intellectual ability, specifically he thought she had significant difficulties understanding information given verbally. He made a number of recommendations about how information should be provided to her and suggested that any parenting assessment should use the PAMS model. Dr Parsons was of the view that the mother did not meet the criteria for a personality disorder but that she did have emotionally unstable personality traits. He thought that she had an insecure adult attachment style which might cause her to experience conflict between her need for support and a fear of intimacy and the expectation of being hurt. He noted that she had a history of oppositional behaviour and a need to challenge boundaries. He thought she might benefit from some therapeutic input but that there would be a need to allow for her verbal deficits. As a result, he suggested therapy using the “toolbox” method, that is giving the individual specific skills to deal with specific problems.The evidence of the independent social worker, Liselle Harold41Ms Harold’s two assessments of the mother were both carried out using the PAMS method. The first was conducted in September 2020, during the pre-proceedings period, and the second in these proceedings in November 2021. Ms Harold gave oral evidence before me.42As I have already summarised, Ms Harold’s recommendation in her first report was that the mother could continue to care for P although she thought that she would require a great deal of family support and would be unlikely to be able to manage if she was the sole carer in a household. She would be reliant on the support of the maternal grandmother, although that was problematic in light of their difficult relationship.43By the time Ms Harold prepared her second report a further two years had elapsed and she was able to review progress made and not made. She concluded that there had been some progress. The mother had engaged with talking therapy. Her communications with professionals had improved and Ms Harold thought that she had developed some insight into her emotions. She had also improved in managing P’s health condition. However, Ms Harold concluded that the mother continued to require a high level of support in a number of parenting domains. She observed that she still lacked insight into her own level of need and her difficulties accepting advice and guidance. She was clearly ambivalent about the role of professionals in her life. She told Ms Harold that she felt part of a team and this had given her a sense of empowerment but at other times she seemed keen that professionals should no longer be involved and would speak about all concerns being in the past. She was particularly resistant to suggestions made by professionals that she should undertake more activities with P outside the home.44Ms Harold expressed a particular concern about the mother’s own vulnerability, which manifested itself in two ways. The first was in the mother’s care for her own health. The mother accepted that she was not compliant herself with her treatment regime, meaning that at times she would become tired and found it hard to care for P, and also that it was difficult for her to model the compliance which P needed to follow. The other concern was in the mother’s online friendships and relationships. She told Ms Harold that she had met a man online and was planning to take P to the USA to meet him as soon as the proceedings concluded. Ms Harold expressed particular concern that the mother had been sending money to people she had met online.45Ms Harold concluded with the following observation:“The previous report identified that Ms N-Z’s learning needs, mental health needs and her difficulties remaining focused will always impact on her providing consistent parenting. It was therefore recognised that Ms N-Z will always require high support and engagement and it was hoped that this could potentially be provided from family. This support does not appear to be forthcoming. I am of the view that Ms N-Z’s needs are so great she is not able to care for P as a sole carer.”46Whilst recognising that the ultimate balancing exercise is mine to undertake, I accept and rely on the majority of Ms Harold’s evidence which I considered overall to be balanced and fair. I make three observations. The first is that Ms Harold clearly anticipated in her first report that the primary source of support for the mother would be the family network and there is little indication in her report that she anticipated the possibility that the local authority would play any significant long-term role. She refers a number of times in her report to the point when services will cease. As I have explained, I consider that to be an incorrect assumption.47The second is that the evidence as a whole suggests that since Ms Harold completed her second report, in November 2021, the progress made by the mother has continued. In this context I rely, in particular, on the updating reports from Great Ormond Street, which confirmed that blood spots had been consistently sent in, a report from P’s school that the mother is working well with them and is fully engaged, and the evidence of the family support worker summarised earlier in this judgment. In Ms Harold’s report and in her oral evidence, she said that she thought the mother would need someone in the home with her undertaking a co-parenting role for P in order to provide good enough care. That observation needs to be considered in the light of the continued progress that has been made with a much lower level of support in the eight months since the report was prepared.48The third observation is that although the impact on P of a move to foster care was not strictly within her remit, Ms Harold acknowledged that this would be a huge and traumatic change for P and emphasised that the feature that distinguished this option from a move to the father’s home country was the fact that P would have the ability to maintain continued contact with her mother and to sustain the relationships she has now. She was clear in her oral evidence that she thought P’s bond with her mother was a significant factor.49Ms Harold also carried out a remote parenting assessment of the father. The father has challenged her conclusions, which are that P should not move to his home country to live with him. Ms Harold accepted in her oral evidence, as she did in the report itself, that there were limitations to her assessment given its nature. Despite that, I am satisfied that the report covers all relevant issues and puts them before the court in a balanced manner. Ms Harold’s conclusion that the father was not in a position to provide a home for P is primarily based not on the father’s parenting capacity or lack of it, but on the fact that Ms Harold thought that a move to the father’s home country was not a feasible plan for P given her additional needs. In fact, she observed in her oral evidence, that she thought the father had a lot of strengths in terms of his parenting capacity.50At a pre-trial review in advance of this hearing, the father made a Part 25 application for a further independent social work assessment. He struggled, however, to articulate what had been left out of Ms Harold’s report or where her approach was deficient. I refused the application at that stage, partly because it was not obvious to me that there were any gaps in Ms Harold’s report. I remain of that view having heard Ms Harold give evidence and having heard her evidence challenged under cross-examination. I consider this to have been a fair and a comprehensive report.The evidence of the mother51The mother had the support of her intermediary while giving evidence and was given frequent breaks. I have borne in mind when considering the mother’s evidence the evidence of Dr Parsons and Ms Harold. I am very aware that the mother’s verbal skills are particularly low and that her sometimes assertive style can mask a lack of understanding. I have been anxious to satisfy myself that the mother has understood the questions asked and been able to give her best evidence in response.52The mother has accepted that she has not previously managed her own or P’s condition well. There were some inconsistencies in her evidence about the history. At times she had a tendency to be defensive and to deny but at other times she accepted faults in her care of P and I thought that she did recognise where P’s needs have been neglected in the past. Overall, the mother showed more insight than I had expected from my reading of the papers.53The mother is obviously P’s primary attachment figure and that came through in her evidence with her very close knowledge of P. She was very attuned to P’s personality, her likes and dislikes and, indeed, her health condition and her health needs. Of course, the mother’s knowledge cuts both ways in that, given her level of understanding of what P’s condition requires, she might have been expected to manage it better than she has done in the past.54The mother was evasive in her evidence on one issue relating to her own sexual history. Given that the father was present in this hearing, I can well understand why she was reluctant to give me that information and I am satisfied that this is not an issue which should carry significant weight in my analysis.55The key issue in this case is the mother’s attitude to ongoing local authority involvement. There is evidence in the bundle that she has resented professional involvement and at times has been resistant, for example, to social worker visits. When the Guardian visited her on 9 May, it was apparent that the mother did not accept that she needs continued professional support. The mother told me, when asked about offers of support that she has rejected in the past, “I am the type of mum that I like to do everything myself and I was very naïve at that time.” When she was asked how she felt about the family support workers coming to the house, she said she thought she did need them “at the moment with Social Services in my life just so they can report back to the social worker that I am doing a good job.” She said she would accept their help if they felt she needed it “until they are 100 per cent sure I can do it with help from family members.” I thought the mother was very ambivalent about the prospect of the local authority remaining involved in the longer term. I observe at this point that it is not surprising that the mother has not anticipated long-term local authority involvement, given that the local authority has been of a similar view.The father’s evidence56The father is in a difficult position putting forward a positive case at this hearing because the reality is that he has not seen P in person since she was a very small child and, because of the language and geographical barriers, he has not yet had any real chance to build up a secure relationship with her. I do not doubt the father’s commitment. He has engaged throughout these proceedings and before, since the local authority first made contact with him in 2020. He has undertaken his own research into P’s condition. He has done as much as he can but his knowledge, unlike the mother’s, is theoretical rather than practical. He is open to learning about P’s medical needs and I am satisfied that he would have capacity to manage her condition if provided with training.57At times the father appeared to minimise the difficulties that P might face in making a transition from the UK to the father’s home country. That, in my judgment, is not something for which he can be criticised. It is natural for any parent to want to overcome obstacles of that nature and it is very hard for a parent who does not have a close day to day relationship with a child to know how they will respond to significant change. 58A practical problem facing the father is that he has been refused a visa to travel to the UK to visit P. It is very unfortunate that this is the case. It is easy to see if the father had had the opportunity to spend time with P over the period of local authority involvement that her relationship with him could have developed and he might have been able to provide a considerable amount of support. During the course of this hearing, the local authority was asked if it would support the father by writing a letter he could use in a future visa application. On the final day of the hearing the parties were told the local authority was not prepared to do that for reasons which were not clear to me. In my view, it would be entirely appropriate for the local authority to write a letter confirming the purposes of the intended visit, which might provide the immigration authorities with some reassurance. As was pointed out on behalf of the father, if a care order is made and the local authority shares parental responsibility for P, there will be an obligation on them to support her relationships with family members, including her father.The evidence of the paternal family59Viability assessments have been carried out of P’s paternal grandparents and paternal aunt, both of which were negative. The family members indicated that they wished to challenge those assessments although no further application has been made. At the pre-trial review I determined that it would not be proportionate or necessary to join the family members as parties given that they were only putting themselves forward as a back-up to the father and many of the same considerations, particularly geography and language, applied as much to them as to him. Therefore, they were not required to give formal evidence but they were invited to and did attend parts of the hearing that related to them. The family heard, in particular, the evidence of the social worker who carried out the viability assessment and the evidence of the father. I have also given them the opportunity at various points in the hearing to address me directly and convey their views. In this way I have gathered the views of the paternal grandmother, the paternal aunt and the father’s wife.60My conclusions in relation to the paternal family are that there exists a substantial and very capable family network in the father’s home country which has the capacity to provide strong and robust support for the father as a carer. As with the case put on behalf of the father, the drawbacks to a plan for P to move to the father’s home country and to live with her paternal family have nothing to do with the family themselves.Evidence as to prospective foster placements61The local authority has produced two written statements from its Family Finding Team, one dated 23 May this year and one dated 22 June. The search for a suitable placement has not been straightforward. There were no in-house carers available from the local authority who would be able to meet P’s needs. The local authority contacted nearly fifty external agencies and identified initially four potential placements, two of which were in East London. 62At the start of the hearing the local authority’s preferred option was one of these placements, a single carer in Dagenham. The statement from the family finder described this carer as “experienced in giving one to one care, managing young people with autism, ADHD and ODD.” The Guardian was able to visit this prospective carer during the course of the hearing. She is, in fact, a new foster carer, caring for an autistic child who is already in the placement. It emerged from the Guardian’s evidence, contrary to the social worker’s understanding, that this carer would not, in fact, be able to take P to school in the mornings. The morning school run is a crucial and sometimes tricky part of P’s day, because she has to take one of her amino acid shakes in the morning but frequently struggles to finish it, and does so on the journey to school or once she has arrived. The Guardian expressed the view, having visited this placement, that it would have been very high-risk, and that she did not think the carer would have been able to manage both children’s needs.63In its second statement, produced towards the end of the hearing, the local authority indicated that it had conducted a further search, this time contacting fifty-eight independent agencies. Through this search the local authority has identified a white British family in Romford who currently have two children living with them in long-term placements. There is as yet no further information available about that placement, save that during the course of closing submissions it was confirmed that P could stay in the same school.64The information I have about potential foster placements for P is limited and uncertain. If an order is made today, the likelihood is that P will be placed with the family in Romford. The advantage of that placement is that it appears that she will be able to continue to attend her current school. I do not know the prospective carers’ views about the frequency of ongoing contact between P and her mother or whether weekly contact would be feasible taking into account the carers’ other commitments which, with two other foster children in placement, are likely to be considerable.65A significant problem faced by any foster carer with whom P is placed is that initially at least they will have to manage her medical needs without prior training. The reason for that is that Great Ormond Street has said, not unreasonably, that they cannot commit the resources to training anyone other than a parent until they are certain that P is going to live with them. Training takes about six weeks. That means that in the early weeks and months of the placement, any carers will have to get by without a detailed understanding of how to monitor P’s tyrosine and phenylalanine levels and how to manage her diet. Even if I assume that the prospective carers will have the capacity and time to learn, they will be starting from a point where they have no knowledge at all about this condition and will have to build that up very quickly. The learning period will, of course, coincide with the time when P most needs stability and reassurance if she is to have any chance of adjusting to the placement without unmanageable distress and trauma.66It is important to recognise also that P, like many children with significant health conditions, is often resistant to her treatment regime. That means that any carers will have to build up her trust very quickly if they are going to put in place a routine of ensuring her needs are met. If that does not happen, P is likely to become oppositional and the stress on the placement will be significant.The evidence of the Guardian67It was clear from Ms Gulabivala’s written report and oral evidence that she has found this a difficult case. She says explicitly in her report that throughout the proceedings she had hoped that P would be able to remain living with her mother. That was, indeed, my sense of her view having been involved with this case, as she has been, since it was issued.68The Guardian sets out in her report the reasons why she has come to the conclusion, I think with reluctance, that the best option for P would be a move to foster care. Ultimately, her view is that the mother would be unlikely to maintain a good enough standard of care for P on a consistent basis in the long-term. 69In her oral evidence, she emphasised P’s vulnerabilities associated with her health condition and her developmental delay. She thought that the next few years would be particularly important if P is not to fall further behind academically. She continues to be worried about P’s low weight, although Great Ormond Street has said that there is not a cause for clinical concern, and she was concerned that the mother did not accept that she needs support going forwards. She said that she could not have confidence that the mother would work well with professionals in the future and maintain the current stability that has been achieved.70On the other hand, the Guardian fully recognised, both in her report and her oral evidence, the disadvantages to P of a move into foster care. Her evidence as to the availability of prospective foster placements was not available when she prepared her final analysis. The fact-finding statement produced by the local authority was prompted by this gap in the evidence. I did not get the sense that Ms Gulabivala was confident that a suitable placement has yet been found for P. She was also particularly concerned about the impact on P of a sudden move to foster care. She did not agree with the local authority’s plans to reduce contact, either around the time of the move or later. In the long-term she considered that it was crucial that P should maintain a meaningful relationship with her mother and was worried that if contact reduced to what is essentially identity level contact this would diminish P’s relationship with her mother well below the level of her needs.71Ms Gulabivala’s views and recommendations were explored thoroughly in oral evidence. She was very clear about the relative advantages and disadvantages of each option. Her evidence has been of real assistance to me in formulating my own views about this case.