'The scales tip very heavily against us': Judge blasts system after suicidal Lancashire girl is left with nowhere suitable to stay in the UK
A judge said he fears for a girl’s life after again reluctantly agreeing the seriously mentally ill teenager can be kept in emergency accommodation - six months after initially approving a 28-day stay - because there’s nowhere suitable in the UK for her to go.
The Hon. Mr Justice MacDonald also cited the South African anti-apartheid revolutionary Nelson Mandela, who in 1995 said “there can be no keener revelation of a society’s soul than the way in which it treats its children” as he criticised the British system for failing the youngster.
The judge said: “It is possible to apply this illuminating metric to our society by reference to the extent to which [the girl’s] acute and complex emotional and behavioural needs have been met.
“The scales tip very heavily against us.”
The High Court's Family Division, sitting remotely because of the pandemic, was told despite 11 hearings, a bill to the taxpayer in excess of £26,000, and the involvement of Education Secretary Gavin Williamson and other officials, the youngster “still only has available to her a sub-optimal unregulated placement” that isn’t fit to look after her properly.
The girl, 16, who is in care and cannot legally be identified, is referred to only as ‘G’ in court documents. She is at serious risk of self-harm and has tried to kill herself many times, the court was told.
When Lancashire County Council first applied for a deprivation of liberty order last year, the court was told she was in “urgent need of a secure placement” after living with foster parents for most of her life - but that none were available “anywhere in the United Kingdom”.
The judge said the authority conducted a "diligent and comprehensive search", but was told a national system used by councils to find accommodation, the Department for Education-funded Secure Welfare Coordination Unit in Hampshire, had stopped giving the names and locations of available secure units due to capacity issues and the impact of Covid-19.
After being discharged from an adult psychiatric ward, G was instead sent to an “unregulated placement” that was “not prepared to apply to [education watchdog] Ofsted for registration” but was the “only option available” to keep her safe.
Mr Justice MacDonald said at the time: “She has nowhere else to go. As I make clear, however, I harbour grave reservations about this decision.”
And at the latest hearing earlier last month, the judge was told the girl’s mental health had worsened - as feared would happen by professionals - with several recent suicide attempts leading to hospital stays.
Diagnosed with Post Traumatic Stress Disorder with indications she will develop a personality disorder, she has also gone missing, barricaded herself in her room, and “begun to restrict her food intake”.
This newspaper has decided not to share details of the girl’s repeated self-harm and suicide efforts.
Mr Justice MacDonald said: “G’s acute and complex emotional and behavioural needs cannot begin to be addressed until she has the benefit of the stability and security that derives from a long-term regulated placement.
“It is plain that G is at present in intense and enduring emotional pain, the accounts of which should move anyone reading them.
“Notwithstanding this, and as I have noted, six months on and 11 court hearings on from the proceedings being issued in August 2020, the position remains that there is no regulated non-secure placement anywhere in the jurisdiction able to take G.
“The cost to the public purse of this ongoing lack of resources is substantial … the cost to G’s welfare of this ongoing lack of resources is infinitely more acute.”
Mr Justice MacDonald said he was being forced to choose between refusing the order, which would see G seriously hurt or kill herself, or to agree to a longer stay in accommodation that is “becoming more and more precarious”.
He ruled: “I once again and wearily must authorise the continued deprivation of G in an unregulated placement that is not fully equipped to meet her complex needs by reason of the fact that I have no other option but to do so.
“I make clear that I consider that I can say that the placement is in G’s best interests only because it is the sole option available to the court to prevent G causing herself serious and possibly fatal harm.
“Even then, it is clear that the placement is increasingly struggling to achieve even that limited goal.”
He added: “It is very hard, if not impossible, to do right by G, to keep her safe and to work to relieve her enduring and acute emotional pain, when the tools required to achieve that end are simply unavailable to this court.”
Mr Justice MacDonald sent copies of his judgement to the now former Children’s Commissioner for England Anne Longfield; Education Secretary Gavin Williamson; Children’s Minister Vicky Ford; Chief Social Worker Isabelle Trowler; and Ofsted.
The county councillor responsible for children, young people, and schools, Philippa Williamson, said: "The welfare of G is our absolute priority.
"We were making daily searches for a registered secure placement for her with associated mental health support.
"In the light of the continued inability of any secure placement willing to offer G a place and her age, the plan for her has changed and the local authority is now searching for a registered community-based, therapeutic placement.
"We are continuing our search for such placements but, again, sadly to no avail to date due to her high level of need.
"The current, unregulated placement is our only option at this time despite a full search of all current provisions nationally, but we are attempting to mitigate any risks by providing for high staffing levels and support for the staff looking after G, together with the deprivation of liberty order.
"We are in daily communication with the home and regular multi agency meetings, involving the child and adolescent mental health team, are taking place to ensure her needs are being met in the best way possible.
"She is also being seen regularly by her social worker. G has been appointed a children's guardian as part of the court process and she also has an independent reviewing officer due to her being a looked after child.
"The role of both of these professionals is to provide independent scrutiny and oversight.
"Senior Managers and leaders also have regular oversight and involvement in decision making.
"Any change to the care plan for G or any other development affecting her welfare is subject to the oversight of the court."
Mr Williamson could not be reached for a comment, but the Department for Education said it plans to ban under-16s from being housed in unregulated accommodation.
And it said: “This is a sad and complex case. Every young person in care deserves appropriate, safe accommodation that supports them in the best way possible and it’s important that all those involved in caring for these most vulnerable children work together in their best interests.
“We have invested more than £40 million in secure children’s homes to support councils in meeting that duty, with an extra £24 million in 2021-22, announced as part of the Spending Review, to start a new programme to maintain capacity and expand provision in secure children’s homes.
"This will provide high quality, safe homes for some of our most vulnerable children and will mean they can live closer to their families and support networks, in settings that meet their needs.”
Ms Longfield has now left her role, with her replacement Dame Rachel de Souza just days into the job, but head of policy and advocacy at the Children's Commissioner's Office, Emily Frith, said officials have been "closely following the development of this case" and "fully agree with the profound concerns raised by the judge".
She said: "We are continuing to take up these issues with Government officials and the NHS and to come up with longer term solutions to address both the shortage of places and the way that children are passed from one part of the system to another.
"We hope that an appropriate secure - or at least regulated - place is found for G as quickly as possible and are pushing for the system to be improved to prevent children like G falling through the gaps."
Yvette Stanley, Ofsted's national director for regulation and social care, added: "Too often, councils are stuck between a rock and a hard place, resorting to using inappropriate placements that do not meet children’s needs because there isn’t a viable alternative.
"The chronic shortage of specialist provision, especially in the secure estate and mental health services, means that the most vulnerable children aren’t always getting the care and support that they need.
"Ensuring there is enough good quality registered provision in the right places has to be a priority for the Government’s Care Review.”
The independent review of social care, announced in January, will set out to "radically reform the system, improving the lives of England's most vulnerable children so they can experience the benefits of a stable, loving home", the Government said.
Chairman of the review, Josh MacAlister, said it will "listen deeply and think boldly" and added: "Deep down I think many of those working in the children's social care system and certainly many of those who have experience of it know that radical change is needed."
Around one in eight children develop a mental health condition, a Government survey in 2018 found, while the lack of suitable accommodation for extremely troubled youngsters has been repeatedly highlighted in recent years.
Dr David Fearnley, chief medical officer at the Lancashire and South Cumbria NHS Foundation Trust, which cared for G for a short time while her current placement was arranged, said: "The trust recognises the growing need for additional support for the mental health of young people in both community and hospital settings across the UK.
"We continue to work at both a local and national level to support and advise on the development of services which can be accessed in a timely and appropriate way that meet those needs.”
G's case is set to be heard again in court on Thursday, April 22.
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