Judge highlights ‘gargantuan’ challenges in finding suitable welfare placements

Fiona Simpson
Monday, January 29, 2024

A High Court judge has criticised “insurmountable challenges” in securing care placements for teenagers with complex mental health needs after a 14-year-old girl, who was deprived of her liberty, was forced to live in a hospital side room for at least six weeks before being placed in an unregistered setting.

The decision was made in London's High Court. Picture: Adobe Stock
The decision was made in London's High Court. Picture: Adobe Stock

The girl, known as X, was diagnosed with suffering episodes of severe depression with psychotic symptoms, anxiety disorder, ADHD and historical vocal tics aged 12 and was later observed as having traits associated with Autism Spectrum Disorder.

She was placed in a hospital side room in October last year after being handcuffed, taken to an accident and emergency department and admitted under the Mental Health Act 1983.

Following a five-day period of assessment, an application to deprive her of her liberty was granted through the Family Court’s Deprivation of Liberty Court.

X was forced to live in the hospital side room, under the supervision of three staff members, until at least December after more than 200 registered settings denied her local authority’s request for a placement.

On 8 December, Judge Kambiz Moradifar granted an application in the High Court for the girl to be further deprived of her liberty in a setting not registered with Ofsted on the grounds that an urgent registration application was made.

The government banned the use of unregistered settings for under 16s in 2022.

He praised “a significant concerted effort of the social work team and other professionals” to secure the placement.

His report on the case states: “The local authority has conducted an exhaustive search of over 200 registered placements and it has been unable to identify a single placement that is willing to accept or suited to accommodate X.”

The court heard that in her new placement, X would be deprived of her liberty “by locking the doors and windows, not allowing her to leave the placement alone, or to be in the community unaccompanied, to be supervised by three adults and to use physical restraint when her safety demands it”.

Mordifar said she is “not alone in her experiences of a system that is not equipped to meet her needs”, adding that she is one of many children who “do not easily fit the criteria of established services”.

“These children and the adults supporting them face a gargantuan and at times an insurmountable challenge to finding a safe placement that can cater for their needs.

“Invariably, these children are in their teens with professionals being presented with the last opportunity to assess, identify and address their profound needs so that they have a reasonable prospect of entering adulthood with a glimmer of hope and optimism.

“Sadly, the significant challenges in providing these children with appropriate placements and services, will contribute to making their future prospects ever more uncertain and raising the likelihood that they will require continuing professional support as adults,” the report adds.

It also highlights the impact of X’s extended placement in hospital on staff and other patients “through no fault of her own”.

It notes that this included X’s “encouragement of an 11-year-old girl to abscond from hospital and disruption to the treatment of another child receiving end of life care” while nurses suffered stress and anxiety and at times “feared for their safety”.

“None of this is X's fault. She and many children like her require access to suitable placements. The time to address this silent crisis is long overdue and requires urgent attention,” the report concludes.

A recent report by Ofsted found that more than nine in 10 local authorities struggle to find homes for children with complex needs, warns a report by Ofsted, highlighting a reluctance by homes to accept such referrals as a key factor behind the issue.

Meanwhile, speaking to the Today programme, Sir Andrew McFarlane, president of the Family Court said that austerity has contributed to a rise in the number of children in care.

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