Sean Sadler, 32, from Northfield, Birmingham was convicted of the murder of Lilly Hanrahan after her death in November 2017.
At the time of her death, Sadler, the partner of a relative named as her special guardian, was looking after Lilly.
The special guardianship order was granted in July 2016 due to Lilly’s mother’s history of drug abuse, including while she was pregnant.
Birmingham Council social workers had called for Lilly to be placed in foster care, however, her maternal grandmother and special guardian both stepped forward as long-term carers for her.
The review, carried out by Birmingham Safeguarding Children Board, notes that in April 2017, the special guardian rekindled her relationship with the perpetrator, the father of her first child, “who is now known to have a history of mental health problems and violence, which includes domestic abuse”.
“At the time he was attending a domestic abuse perpetrators group work programme and disclosed that he had started a relationship with a woman with children. This important information was not shared by the probation service, with partner agencies,” the review states.
It adds that during October and November 2017, the special guardian expressed concerns to nursery and healthcare professionals about the number of bruises sustained by the child. A medical review at hospital was undertaken a month before Lilly’s death, but at that time no safeguarding concerns were identified.
In November 2017, Lilly was admitted to hospital and died three days later after Sadler claimed he had found her unresponsive on the sofa at her home.
In March this year he was sentenced to life imprisonment for her murder.
In her report, lead reviewer Hillary Corrick Ranger notes several concerns around Lilly’s placement stating that had her special guardian “applied to be an adopter or foster carer for Lilly, it is likely that her application would have been refused. Her vulnerabilities would have been explored in more depth and her position as a single mother of three young children, with no support from any of the fathers, would have precluded her at an early stage”.
She adds that “the probation service failed to follow their own procedures when they became aware that a convicted perpetrator had developed a relationship with a woman with children. Had they done so, children’s social care would have been alerted and safeguarding processes put in place”.
The report states that all agencies involved in the case have completed a learning plan following Lilly’s death and training guides and sessions have been created for practitioners, including GPs, on bruising in children.
“Since the sad death of this child the local judiciary and the local authority have taken steps to ensure that children who achieve permanence through special guardianship receive the appropriate levels of support and supervision following the order.
“In many instances a care order with a view to the making of a special guardianship order is the judicial preferred way. Many children thrive into adulthood through special guardianship and it is important that the judiciary do not dismiss the idea of special guardianship in the first instance as a result of this sad event,” Corrick Ranger says.
Penny Thompson, independent chair of Birmingham Safeguarding Children Partnership, said the review “provides a detailed and thoughtful analysis of events which merits reading in full”.
“I’d like to highlight two issues: firstly, the importance of adult-orientated services sharing information with those supporting children and families, and secondly the value of professionals having open and curious minds.
“This second issue specifically includes following safeguarding guidance when caregivers present with repeated bruising on their young children,” she said.
