District Court grants Care Order under Child Care Act 1991 s.18 for child's safety and welfare.

[2012] IEDC 24

AN CHUIRT DUICHE THE DISTRICT COURT

HEALTH SERVICE EXECUTIVE

APPLICANT

-AND-

RC

RESPONDENT

CHILD CARE ACT 1991 — SECTION 18

IN THE MATTER OF CHILD 1

21 November 2012

This decision was delivered ex tempore on 21 November 2012 and the written decision was circulated to the parties on 18 December

2012.

1. This is an application for a Care Order under section 18 of the Child Care Act, 1991 (hereafter referred to as ‘the 1991 Act’) in

respect of Child 1, heard on 19–21 November 2012. Child 1 is currently in the care of the Health Service Executive (“HSE”). Child 1

was admitted to the care of the HSE pursuant to an application for an Interim Care Order on 7 October 2011. The Interim Care Order

has been extended by the Court on 30 occasions since that date.

2. The HSE was legally represented in these proceedings.

3. Child 1’s interest in these proceedings was represented by his Guardian Ad Litem (“GAL”) who was legally represented. The GAL

indicated to the Court her support for a Care Order in respect of Child 1 and recommended that the Care Order be for the full duration

until Child 1 is 18 years of age.

4. The respondent mother was represented in these proceedings by her barrister and solicitor.

5. I am satisfied that the mother has been properly served with notice of the proceedings and that in Child 1’s interests, the matter

should proceed.

6. I am satisfied that the [District given] has jurisdiction to deal with this case.

7. I have heard the evidence of the Psychologist. She confirmed and swore the contents of her report and gave evidence of the

developmental assessment she carried out on Child 1 in 2010. She noted that Child 1 is a bright child with severe speech and

language delay and gave evidence of the difficulties in engaging the mother with the assessment. She gave evidence of her follow up

review of Child 1 in 2011 and noted his language skills had improved and her involvement ceased. She informally observed him a month

ago and was satisfied with his development.

8. I have heard the evidence of the crèche worker. She confirmed and swore the contents of her letters for Court. She gave

evidence that the mother had brought Child 1 to the crèche for 3 visits in November 2009 and that the mother did not interact with

Child 1 or staff on these occasions. She gave evidence that Child 1 returned between July 2010 and August 2011 when his

grandmother appeared to be his primary carer and she built up good relations with staff. She gave evidence of the crèche worker’s

initial concerns about Child 1’s communication skills which improved over time with input from the Speech and Language Therapist.

Child 1 has recently seemed like a happier child.

9. I have heard the evidence of the Speech and Language Therapist. She confirmed and swore the contents of her reports. She gave

evidence of Child 1 being referred in April 2010 and presenting with a significant speech and language delay. Her interventions with

Child 1’s grandmother and preschool resulted in Child 1 improving to being only moderately delayed in April 2012 and to being within

normal limits when he was reviewed in September 2012.

10. I have heard the evidence of the allocated Social Worker. She confirmed and swore the contents of her reports at Tabs 1, 2, and

3 of the Booklet of Evidence. She gave evidence of the initial concerns of the Social Work Department of the mother’s capacity to

parent Child 1 and the concerns for the mother’s mental health. She gave evidence of the initial assessment of the case which

resulted in social work intervention. She gave evidence of linking in with the Public Health Nurse, the psychiatrist, the crèche, and the

Speech and Language Therapist who all felt that Child 1’s needs were being met by his grandmother rather than his mother. She gave

evidence that Child 1’s grandmother was not unduly interfering with his day to day care from the mother and that her intervention

was necessary for Child 1. She gave evidence of the difficulties in discussing the concerns about her parenting with the mother and

Child 1’s speech and language problems. She gave evidence of the parenting capacity assessment she carried out on the mother

which indicated that she had a very limited ability or capacity to parent Child 1 and had limited insight into her own difficulties and

that the mother did not engage with the social work services to improve her parenting capacity. She gave evidence that the mother

had been diagnosed with schizophrenia but the mother did not accept this diagnosis and did not engage with mental health services.

She gave evidence that the mother’s presentation deteriorated in September 2011 resulting in the application for Child 1 to be

brought into care in October 2011 and placed in foster care with his maternal grandmother who has now been approved as a long-

term carer for Child 1. She gave evidence of the difficulty in engaging the mother with social work and support services since Child 1’s

reception into care and of the mother’s very threatening and abusive behaviour at times. She gave evidence of the efforts made to

arrange access between the mother and Child 1 and that access did not take place for 11 months until last week when she agreed to

supervised access, and this access was somewhat successful. She gave evidence of linking Child 1 with a Children’s Hospital with

regard to his febrile convulsions, which his grandmother and school are managing well. She gave evidence of a huge improvement with

Child 1 since his reception into care. She summarised the grounds for seeking a care order as the mother’s mental health problems

make her incredibly vulnerable, not open to support and make her unable to care for Child 1 and Child 1 was neglected in her care.

She gave evidence that the HSE will continue to assist the mother to access supports but this will require her to engage with the

HSE. She gave evidence of the efforts made to contact Child 1’s father who is believed to be living somewhere in Country 1.

11. I have heard the evidence of the Social Work Team Leader. She gave evidence of her recent meeting with Chid 1 to discuss

access and their informal conversation regarding what would be required of the mother to resume care of Child 1. She reported that

the mother did not demonstrate any insight into parenting for Child 1 at this meeting. She gave evidence that the mother will be

invited to meet to discuss access and all other matters again.

12. I have heard the evidence of the Psychiatrist. She confirmed and swore the contents of her reports at Tab 10 of the Booklet of

Evidence. She gave evidence of the mother’s involuntary admission into Hospital in April 2010 when she diagnosed the mother as

suffering with schizophrenia and the mother’s subsequent discharge in May 2010. The Psychiatrist described the mother’s major

difficulties with motivation, organisation, and self-care skills and described the mother as being at high risk of homelessness. She gave

evidence that she has had only intermittent contact with the mother since her discharge. She gave evidence that she believes the

mother stopped taking her medication soon after discharge and that she has a high risk of further psychotic episodes where she could

be a risk to herself or others. She gave evidence that the mother is not prepared to engage in any supportive work. She gave

evidence that she is open to re-engaging with the mother and assisting her to get a second opinion and described how taking

medication, having regular contact with mental health professionals, and life skills training could assist the mother if she were willing

to do these things.

13. I have heard the evidence of the Community Mental Health Nurse. She confirmed and swore her report at Tab 21 of the Booklet of

Evidence. She gave evidence of her role to monitor the mental health and compliance with treatment of the mother and how the

service was discontinued after 6-7 home visits at the mother’s request and how she had offered occupational therapy to the mother,

which she had refused.

14. I have heard the evidence of the mother, who gave evidence that she was the sole carer for Child 1 until her hospitalisation in

April 2010. She gave evidence that Child 1 had no difficulties as a baby and that she had no difficulties caring for him. She gave

evidence that she was offered speech and language and psychological services for Child 1 if she wanted them but she did not want

Child 1 to see anyone at that time. She gave evidence of her trip to Country 1 with Child 1 and the difficulties she encountered there

which caused her to be ‘under the weather’ when she got back and so she asked her mother to look after Child 1 for a couple of

weeks. She gave evidence of taking herbal medicine and fasting to treat this and attributed her episode of hallucinations to fasting.

She denied that she now suffers from schizophrenia. She gave evidence that she does not take drugs and described herself as a

moderate drinker. She denied being disorganised or unmotivated and gave evidence of her involvement in her local community. She

gave evidence that her mother had taken over the care of Child 1 and bullied her into things, such as getting Child 1 vaccinated and

forcing her into hospital and that her mother had taken over the care of Child 1. She gave evidence that she was not happy about

speech and language therapy and social work involvement and just wanted to be left alone. She gave evidence that she did attend

meetings with social workers and did not remember the social worker calling while she was in bed. She gave evidence that she found

it too difficult to care for Child 1 with her parents and was going to get a friend to help her for a couple of months and that she made

it clear to the social worker that things would be better if her parents were not involved. She gave evidence that she was not in

agreement with a care order for Child 1 or his placement with her mother. She gave evidence that her health collapsed completely

after being assaulted on two occasions: once by her father and once by a stranger. The mother gave evidence that she has recently

been severely sick due to an electrical problem in her house but that she is now better. She gave evidence that she has a different

attitude towards parenting but she would not place Child 1 in danger in any way. She gave evidence that her access with Child 1 the

week before was great.

15. I have heard the evidence of the GAL who confirmed and swore to the contents of her report for Court. She advised the Court of

her support for a Care Order for Child 1 to age 18. She gave evidence of her concerns as the mother’s presentation and mental health

needs, Child 1’s immediate safety, Child 1’s lack of relationship with his mother and described the mother as being a very vulnerable

adult who does not appear to be able to keep herself safe. She gave evidence that Child 1’s health is generally good and that his

grandmother is monitoring and managing his febrile convulsions well. She gave evidence that Child 1 is attending pre-school where he

is thriving and she described her satisfaction for how all services have come together in this case and will follow Child 1 on to school.

She described Child 1 as a very bright and as a child who sees himself staying with his grandmother and with his grandfather playing a

large part in his life. She described his placement as excellent — the mother is never far away through pictures and conversation. She

gave her opinion that Child 1’s grandmother would love the mother to be well enough to be reunited with Child 1. She gave evidence

of the mother as being an extremely vulnerable adult who is not engaging with her mental health team and does not have a good

relationship with the social work department. The GAL gave evidence of the efforts she has made to engage with the mother and

bring her through this process and that she thinks the mother may have been very unwell during the summer. The GAL gave evidence

of the efforts over the past year for Child 1 to have access to the mother, which only recently resulted in an access visit as the

mother was very volatile before this. She described some lovely moments of interaction during this access but described the last 20

minutes as not being good quality access. She recommended at present that access should take place one time per month for half an

hour and should be supervised in a contained environment while there is uncertainty about the mother’s mental health status and this

can be reviewed. She approved the care plan and recommended that Child 1 continue to have access to speech and language

therapy, psychological services, life story work, and support from his social worker and fostering link worker. She formed the opinion

that a care order is required to safeguard Child 1’s immediate need for safety and to meet his emotional needs and that she did not

think that the mother could engage with therapy herself and does not presently have parenting capacity.

Decision

16. I have considered the views of Child 1, indirectly conveyed to the Court through the report and the evidence of the GAL, and the

mother and considered the best interests of the Child 1 in making my decision in this case.

17. Having heard the evidence set out above and read the Care Plan filed, I am satisfied that in respect of the infant Child 1, the

threshold criteria under section 18(1)(a), (b), and (c) of the 1991 Act are met and that Child 1’s health, development, and welfare

would suffer if a Care Order was not granted.

18. The duration of the Care Order shall be until Child 1’s 18th birthday on [date given], because the mother does not at this time

have the ability or insight to adequately respond to or provide for:

(i) Child 1’s health needs;

(ii) Child 1’s emotional and behavioural development;

(iii) Child 1’s basic care needs;

(iv) Child 1’s safety;

(v) Emotional warmth for Child 1; and

(vi) Consistent stimulation, guidance, boundaries, and stability for Child 1.

19. I am satisfied that the findings of fact proposed by the HSE have been proven and that it is proportionate to make this order

having considered the evidence and the supports that have been offered to the mother, her refusal to engage with services, and her

hostility to the social work department.

20. I direct that access between Child 1 and his mother be at the discretion of the HSE subject to section 37 of the 1991 Act and

with due attention to the recommendations of the GAL, outlined in her evidence and contained in her Report. I direct the matter be

listed for mention regarding access on 21 February.

21. I have read and approve the Care Plan submitted and approve the relative foster-placement of Child 1 with his maternal

grandmother.

22. GAL to continue to be appointed until 21st February 2013.

23. Under section 47 of the 1991 Act, I direct that the case is to be re-entered before the Court and the GAL reappointed four weeks

before the date of re-entry in the event that:

(i) a Social Worker/Fostering Link Worker becomes unallocated to Child 1 for a period of 4 weeks;

(ii) a planned or unplanned change of current foster placement of the child;

(iii) After Care Review for Child 1 on his 17th birthday [date given] to assess his After Care Service needs;

(iv) The Annual Child in Care Review is not carried out in respect of Child 1 for any reason.

24. I recommend that the mother be kept informed of Child 1’s educational, medical, and general progress.

25. This matter be re-entered on 21 February 2013 to review access.