Boy with complex needs placed in a holiday home – 2022vol1#44

See also Vol 2 of 2021: Judge said “disgraceful” that no CAMHS assessment or placement for teen whose situation GAL said was “as bad as it gets”

There were ongoing concerns about a teenage boy who was living in holiday accommodation following his release from a detention centre. The boy was the subject of a care order for the past two years and had spent time in secure care. The court had heard reviews of the boy’s case over a number of months.

Over several hearings, the court had heard that the boy had previously been residing in a residential unit where he was the only resident. There had been on-going significant issues which had included verbal and physical assaults to staff and the destruction and setting fire to property. As a result, the residential unit had terminated the placement. In addition, the and the boy had been remanded in a juvenile detention centre following charges under sections three and five of the Non-Fatal Offences Against the Person Act 1997.

While the boy was in detention, an application for bail had been heard and denied pending the report of a consultant forensic psychiatrist. A further application for bail was due to be heard in 10 days’ time.

The Child and Family Agency (CFA) had made applications to the special care committee to have the boy placed in a secure care unit, but the special care committee had refused on the grounds the boy had not met their criteria. As that time the child was in detention, and if the application for bail had been approved the boy would not have had a care placement.

The social work team leader gave evidence that the report of a consultant forensic psychiatrist would not be available for another 48 hours. He said there remained no placement for the boy. He said that the CFA had used all their best endeavours to secure a placement, but they had not succeeded. He said that there had been a meeting between the national providers of placements and the head of the CFA to secure a placement, but they had still not found a placement that would meet the boy’s needs. He said the special care committee had been due to sit on a specific date but that meeting had been adjourned. The CFA recognised that the boy could be released and have nowhere to go.

The GAL told the court that the boy could not be released because part of his bail conditions would be to have an address and as the boy did not have an address he could not be bailed, and this was an infringement on his right to fair procedures and justice. She said she had sent her reports and written to the special care committee and to the CFA.

The guardian ad litem (GAL) had made an application under section 47 of the Child Care Act 1991. The GAL had asked the court to direct the CFA to devise a care-plan for the boy which took into account his current circumstances, those that would occur after his bail hearing and to secure an appropriate placement for him. Counsel for the boy’s mother said she had instructions to make an application under section 22 of the 1991 Act (to discharge the care order).

At the time of the hearing, the boy was remanded to Oberstown. She said he was doing well in the juvenile detention centre and wanted to stay in there. He said he would do whatever it takes to stay in detention. She said the boy had said to her; “Is it because I am not cutting that special care will not accept me because I can cut myself if that is what I have to do.”

The judge said it remained unacceptable that a placement had not been found and adjourned the matter.

Subsequent hearing: boy remains in detention

At a subsequent hearing, the court heard the CFA had made two applications to the special care committee to have the boy placed in a secure care unit, but the special care committee had refused both applications on the grounds the boy had not met their criteria and they did not assess a child or young person for admission to special care if that child or young person was otherwise detained. It was recognised that if the boy were to be granted bail and not admitted to secure care, he would be homeless.

Subsequent hearing: boy placed in holiday home

At a further subsequent hearing, the court heard the boy had been granted bail and the CFA had secured accommodation in a holiday house with staff from social services. The CFA recognised this accommodation was not ideal.

On previous review hearings, the judge had directed the special care committee were to meet to review the application to special care of this boy. An application was made by the solicitors for the CFA and the GAL for the digital audio recording (DAR) of the previous review hearing. The solicitor for the CFA said it was necessary for a review of a transcript of the DAR to be absolutely correct as to the directions that were given. The GAL wished to examine the possibility of making an application for either a judicial review or a contempt of court application because the special care committee had not complied with the directions from the court of that review. The mother was not in court but was consenting to this application.

The judge granted the application and recognised it was a unique point of law. She said she would release a transcript of the DAR to the CFA and to the GAL but did not want a copy of the transcripts to be given to the parents at this stage. She said she would lift the in-camera rule for the purposes of a judicial review.

Subsequent hearing: Direction that representative of residential placement service attend court

At the time of this hearing, the boy had been released from Oberstown detention centre without a formal placement. The boy’s current placement was a holiday home supervised by social workers. This placement did not have the approval of Health Information and Quality Authority (HIQA). The application this day was for a continuance of the review of the boy’s care.

The social work team leader gave evidence that the boy remained in the holiday home and accepted that this was far from ideal. He said that he had been working with the national placement team both in the public and private sectors to try to secure a permanent and appropriate placement for the boy. He said that a provider had been approached by the social work department to ascertain if they would be able to offer a placement. This provider had stated they would consider the request and hoped they would be able to broker an agreement. This agreement would be a bespoke placement specific to the boy’s needs.

The social work team leader informed the court that there had been several incidents at the current placement and An Gardai Siochana had had to be called. However, he said the boy had recently confided to him about a sensitive personal matter. These matter had not been entered into any reports as the boy had specifically requested his father not be informed of them. The boy had informed his mother. Since this time, the boy had become far calmer. There had been no further incidents and the boy had made a remarkable change in his behaviour. The boy had asked the social work team leader to remove his PlayStation and requested that he be enrolled in some form of education. The boy had made changes to his self-care, had requested a healthier diet and wanted to become involved in a regular exercise routine.

Previously the mother had not engaged with any of the professionals and had in some circumstances been a negative influence. She had undermined the work that professionals had tried to undertake with the boy. However, that too had improved. The mother had now engaged with the social workers, the Child and Adolescent Mental Health Services (CAHMS) and had supported the boy in a positive manner.

The social worker said access was being reviewed after each access had taken place but at present the position of the boy was more positive that it had been for some time. The social work team leader said whilst these were very early days this was a remarkable turnaround and change. The social workers who were working with the boy were doing all they could to support the changes that the boy and his mother had made.

The social team leader was cross examined by counsel for the GAL. The social worker informed the court that this proposed bespoke placement was at present a proposal. He confirmed that funding would need to be approved, a property would have to be secured, staff would have to be appointed and the placement would have to be approved by HIQA. This entire process could take a minimum of six months.

The judge asked the social work team leader: “Why will it take six months? This boy has been in the care of the CFA with a full care order for over two years and still has not has a permanent placement.”

The judge continued that whilst she welcomed the progress the boy had made, the case was essentially back at square one. This boy had no placement and a unit had to be especially created. The social work team leader said he was aware it was not acceptable but that his department had exhausted all the public and private sectors to try to secure a placement for the boy.

The judge said: “During Covid 19 the government made a deal with the private hospitals to secure more beds for the public sector. The government had secured accommodation for those fleeing the crisis in Ukraine but a child in care with a care order that was two years old still did not have a placement.” She continued: “It was the state who made the application to bring this boy into the care of the state and the evidence for that was heard over three days. Regardless of the difficulties, it does not discharge the state’s duty to find a placement for this boy.”

The judge directed that a representative of the residential placement service attend in court at the next court hearing to give evidence as to why this boy still did not have a placement. She also gave leave for the GAL to write to HIQA for more information on the current placement in the holiday home. She adjourned the matter for two weeks.

Subsequent hearing: boy in holiday home, no allocated social worker

On the next hearing in three months’ time, a review of the teenager’s care took place. At this hearing, the judge directed that she wanted representatives from the Health and Information Quality Authority (HIQA), the person in charge of the placement and a director from the Child and Family Agency (CFA) who was responsible for long term placements to attend court to explain their positions. At this hearing, the mother was not in court but was legally represented. The father was not present and had no legal representation. The guardian ad litem (GAL) attended remotely and was represented by a barrister. Evidence was heard from the social work team leader and GAL.

Evidence from the social work team leader

The social work team leader said that as of the date of that day’s hearing the boy did not have an allocated social worker and he would be taking the role of key worker until another allocated social worker had been appointed. He said that when he was last in court the boy had been doing exceptionally well and although he was much better than he had been in the past, there had been some regression. He remained engaged with staff in the unit but as he had started to face some of his issues and reflect on the reasons why he was in care he had had significant self-harm episodes. He wanted to engage with counselling and all options were being explored to offer him supports including local services.

The team leader informed the court that the boy remained in the current placement which he [the team leader] knew was not sufficient. He said the search for a new placement still had the highest priority. It was discussed weekly, was the top of the priority list of the service and the national placement group were still trying to secure a placement. He raised the matter weekly with his senior managers.

He said as of the week before coming to court nothing had changed. There was still no long-term placement. He said previously it was hoped that an independent provider would be able to provide a long-term secure placement and although that was still being explored it was still a minimum of six months away but most likely would be longer. This temporary short-term placement in a holiday cottage had become long-term because no other placement was available. He said there were a core group of staff there, and the teenager was getting on well with them. It was positive there were no agency staff.

He said there had been a plan to make this current placement HIQA-compliant, but this had not happened. The provider of this placement did not normally provide this service, it was thought to be a short-term, emergency placement. This sort of placement was out of their normal remit and because of that they had not intended to become HIQA-compliant. The normal remit of this provider was outreach community work and access supervision.

The judge asked: “How much are they charging?”

The social work team leader: “€15,000 euro per week.”

The judge: “Why do they think they can charge that amount and not be HIQA-compliant.”

The social work team leader repeated his answer that this provider did not normally provide this service. However, he also stressed that the teenager was doing well there. He said that although there had been no threats or stands offs the provider might end the placement if HIQA compliance was forced on them.

Evidence of the GAL

The GAL said it was simply not tenable and not lawful that a provider of children’s residential care could not be HIQA compliant. Facilities that were not HIQA compliant were operated on an ad hoc basis. She said the provider could not operate if they did not want to comply with the regulations, the reasons for HIQA compliance was to ensure there were standards, such as standards for safeguarding, appropriate management, supervision of staff, safe policies, reporting mechanisms, agreed standards and procedures, appropriate staff ratios and training. This placement was a poorly decorated holiday cottage where the child was not protected by the safeguards of legislation.

She agreed that he was doing better and was playing less video games and had engaged with self-care. However, she said the problems of this teenager were deep-rooted and were not going to be resolved by brushing his teeth and combing his hair. He had had no education, had significant mental health issues and was morbidly obese. Although he was in significantly better form than where he had been, these issues were not being resolved or addressed. This teenage boy would be leaving the care system in approximately 15 months with no friends, no education, mental health problems and no resilience or coping strategies. The GAL said: “I am at a loss how to help, I do not know how to advocate for him when all mechanisms are thwarted.”

She said the court made directions that would have assisted, but they had not been complied with. The legislature had made safeguards which had been ignored and now the boy had no allocated social worker. The barrister for the GAL said that the GAL had wanted to write to HIQA and the Ombudsman for Children and would ask the court to lift the in-camera rule to facilitate this.

The solicitor for the mother said that she [the mother] was happy with this placement. The teenager was doing better there than in previous placements and she would be supportive of whatever was needed to help him stay there.

The judge said this was a shambles. This teenager was taken into the care of the state after a contested application. The threshold had been met. He had been placed in a residential unit, that resulted in criminal activity and proceedings. He had had some time in Oberstown and now was residing in a holiday cottage where the provider would not comply with HIQA.  Anyone charging an annual sum of €780,000 euro and was not HIQA compliant was beyond belief. This child would be leaving the care system in 2023 and would be incapable of independent living.

The judge directed that on the next hearing of this case she wanted to hear from someone from HIQA, from the person in charge of this placement and from a director of the CFA who deals with long term placement. She directed that the GAL had permission to write and inform the Ombudsman for Children of the position of this teenager and to HIQA of the placement’s non-compliance. She lifted the in-camera rule to facilitate this. She adjourned the matter for three months.