Transcript: Permanence panel: part one

This mock Adoption and Permanence Panel considers the case of nine month old Douglas who is being considered for adoption. All characters are fictional although the facts of the case are drawn from real cases.

Podcast Episode: Permanence panel: part one

Category: Child protection 

What follows is a transcription of the audio recording. Due to differences between spoken and written English, the transcript may contain quirks of grammar and syntax.

C - Chair
D - Dave
M - Margaret
A - Anne
J - Jean
H - Helen

C OK, good morning, everyone. Thanks for attending this meeting of the Permanence Panel. First item on the agenda this morning is Douglas Jones, a nine-month-old child, and we have Jean, Douglas’s social worker, attending. I think it might be useful first just to do a quick roundtable of introductions. I think, Jean, you’ve been before, but there might be one or two people who weren’t on the previous panel. Dave, could you start by introducing yourself?

D Dave from the childcare team.

M Margaret, legal advisor to the Panel.

A Anne, deputy chair.

J I’m Jean, social worker to Douglas.

H And I’m Helen, Medical Advisor.

C And then we have our panel secretary as well. OK. So according to the reports that we’ve received - and thank you, Jean, for a very comprehensive FORM E and the associated reports. Douglas, nine-month-old child . Mum is Lauren, who, according to my calculations is 19, but there’s no mention of a father, Jean. Can you put us in the picture as to the situation around dad?

J We’ve spent some considerable time with Lauren discussing Douglas’ father. Unfortunately, Lauren feels that she’s not in a position to disclose who Douglas’ dad is. We have managed to get to a point where she is saying that she knows, but unfortunately, as I say…one of the reasons she’s saying behind that is that Douglas’s father is somebody who would not be appropriate to be around her son. He’s a drug addict, she says, and has considerable problems himself with offending behavior. We will continue in terms of Douglas’s best interests through his life to glean that information, and we have a better relationship, I feel with Mum now.

C Margaret, you think that social workers taken reasonable steps at this stage to try to ascertain who father might be?

M It’s kind of difficult with mum’s not passing on any information about dad, and I take it that you’ve heard no other local information or any suggestion that anybody else..?

J No. We had approached both the maternal grandmother and maternal grandfather to see whether or not Lauren had disclosed to any of her extended family. However, they say they’re in the same position, and that Lauren will not disclose to them, either. And as far as knowing some of Lauren’s associates, yes, some of those are males, and some of those are – because she does frequent the drug fraternities – some of those are young men who are heroin addicts and have offending problems. However, we still can’t identify this person unless Lauren will come forward.

C OK, that’s fine. Thanks very much. And there are no siblings in relation to Douglas?

J No

D No

C OK. And Douglas is currently placed with Mr. and Mrs. Smith who are approved foster carers, and I understand that Yvonne is going to be joining us later to speak to the panel.

A Yes, she will.

C That’s great. Right. In terms of the referral to the panel today there was a LAC review in November 2011, and there was a recommendation that permanence be sought for Douglas through adoption. Jean, can you say a little bit about the other key recommendation from the panel, that of post-permanence contact, what the LAC review had said in that respect?

J Absolutely. The panel at…the LAC review…sorry…at that time there was full discussion around post-adoption contact for Douglas and his mother and the two maternal grandparents. The two maternal grandparents have requested that they don’t have any direct contact. They’ve never had any contact with Douglas, and they feel that he should be allowed to move on. As far as mum is concerned it is felt that the most appropriate form of contact would be letterbox contact once a year. That was the decision of that LAC review at that time or recommendation.

C OK. We’ll come back to the issue of post-permanence contact a bit later. Just wanted to get that on the table at this stage. And there was a children’s hearing in December of last year which I think did give some indication of its views in respect of permanence planning.

J That’s right. We had a children’s hearing on the 15th of December. The Children’s Panel are fully supporting the local authorities view that permanence in Douglas’s best interest, and accordingly, they reduced Mum’s contact to once a week and that was to support memory building for Douglas and also, obviously, for mum.

C OK, thank you. We normally just have a quick word with panel members at this stage about the factual nature of the reports. Occasionally, there are factual anomalies or things we just want to clarify. I have one of them, but I’m wondering if other panel members have any other things that they want to ask about the reports? …. The only thing that I wasn’t sure of, Jean, and it may well be in the reports, was how Douglas was secured in foster care when he left hospital, I think as a 10-day-old child. On what basis was that foster placement made?

J What happened was just prior to Douglas’s birth Lauren actually began engaging with the social work department. Up until then she hadn’t done at all. I made several visits to Lauren in hospital after Douglas’ birth, and through the process of our discussions, and concerns that Lauren had for herself…she was at the time homeless, and she felt that it would be more appropriate that she could provide evidence of her parenting skills but with Douglas being looked after in foster care. On that premise mum signed consent to a Section 25 placement, and that was the way that that proceeded.

A Can I just clarify?

J Yes, Anne.

A He was on the register at that point, was…?

J Yes, there pre-birth case conferencing, which, unfortunately, Lauren hadn’t actually engaged with any of the meetings pre-birth. However, Douglas’ name was placed on the register at birth, and we had also sought some preliminary legal advice. Mum’s continued use of substances was deemed to place Douglas at serious and significant risk of harm as well and her lifestyle choices at the time of the birth. So all that information together with Lauren’s views and wishes led to, like I said, her consent to his being accommodated.

C Just…maybe just to follow up to the stage then, Jean, the child is now on supervision through the children’s hearing system, so referral was made to the reporter. What were the grounds for that referral?

J The grounds for the referral were that Douglas was likely to suffer due to a lack of care, a lack of parental care. The information that we’d had through mum’s pregnancy and her lack of engagement with social services, and her admittance to continued heroin use, concerns for Douglas at birth in relation to the impact of that use on his health led to a referral at Douglas’ birth to the children’s reporter.

C Right. I presume the grounds then were considered by the sheriff, who…

J Mum actually agreed with the grounds at the initial hearing, and we moved forward with that.

C OK, good. Right. If we can move on now just to the discussion of the current circumstances of key people involved in the case, we know that Douglas is in foster care, and we’ll hear more about his experiences in foster care in a wee while. Could you just explain briefly, Jean, what mum’s current circumstances are? Where is she in her life at the moment?

J Well, as we’re aware, Douglas is now nine months old, and through the period of Douglas’ life to date, mum received a custodial sentence for four months for which she served two. This was around…Douglas would have been four months old at the time. During that period there was a wee bit of stability for her, I suppose you could say. She was receiving services while she was serving her custodial sentence and came out with a very positive outlook. She did engage with Drug and Alcohol Services for about four weeks after then, but unfortunately that’s now fallen by the wayside again.

Lauren is engaging with the childcare social worker, myself, and also the support workers from Action for Children who are supervising contacts. However, she is not engaging with the supports for herself, and therefore progress for her has declined significantly.

We’re aware at this stage that she has accrued again charges, and we’re also aware that as we speak there is a warrant out for her arrest which puts her in a very difficult position, and it is likely by her own admission that she will serve another custodial sentence in the near future. Therefore her position is chaotic.

D So, Jean, can I clarify, because you said there that she’s engaging with the social work involved in support worker in Action for Children. In what way if that’s not for herself?

J Actually, I think things have moved on for Lauren in her thinking, and in terms of engagement it’s around Douglas’ welfare and his needs, I guess through the process of adoption and Douglas moving on. What Lauren is saying is that she’s not willing to consent to an adoption, however, what she’s doing practically is engaging with services. She’s been supplying an awful lot of information, for example, for Douglas’ life story work which is…she’s to be commended on that. It’s a very, very difficult process for her. She’s obviously very emotional around this situation, however she wants Douglas to move on – if that is what’s going to happen for him – with as much information she can give regarding her family circumstances and history.

A But there’s no evidence to point that she’s able to change her lifestyle at this point?

J Unfortunately not, no. Lauren’s history goes back to her later childhood years, and it’s built on that. Lauren is very, very open about how, for example, she became involved in the use of heroin, and that was when she served her first custodial sentence of a year when she was just 16 years old, and that was where she was introduced to heroin.

And this has been an ongoing problem for her and all the other associated issues around that such as the criminal activity to support the heroin use. And at this point in time, as I’ve just described I guess, there are no changes. In actual fact things are set to become quite difficult for her, in terms of more offending behavior.

C OK. That’s fine. I’d just like to move on to the part that extended family might play in Douglas’ life. Do they have an active role, any members of the extended family?

J No, they don’t. We only have two members of extended family on mum’s side, and as we’ve discussed earlier, we don’t know who dad is, so therefore we’ve not been able to explore any supports from that side of the family. Mum’s mum, the maternal grandmother, has problems with substance misuse herself and offending behavior, and in a sense Lauren and her mum are very close and collusive, and again, that has led, I guess more so for Lauren in keeping her engaged in some of those activities.

The maternal grandmother would not be deemed appropriate to…not just only to have care of Douglas, but also in terms of contact. In actual fact Lauren has asked that there is no contact between her mother and Douglas.

C I’ll come back bit later on, Jean, to issues of whether there are any famil y possibilitities or Douglas. I’d just like to move on. The only current contact, then, would be between Douglas and his Mum. I think Anne wanted to ask a little bit about those contact arrangements.

A The current contact at the moment is once a week? Because, in the Children’s Panel it was going to be twice a week, and then…

J It was reduced to once a week on the 15th of December.

A That’s fine. Can you tell us a bit about the quality of the contact between Douglas and his Mum? How does she respond? How does he respond?

J Lauren turns up for contact on time. She will admit, herself, that she gets herself into a position where her presentation is good. She focuses on that in the week. She focuses on her contact.

A It’s supervised?

J Oh, it’s fully supervised, yes, and needs to be. Mum presents at the Social Work offices first, just a half hour prior to contact. She’ll come in and have a short discussion with ourselves and the social worker who’s our duty worker, or myself, will check Lauren to show that she’s free from the impact of substance use, which she invariably is. She’s always presented relatively well for contact.

Contact in itself takes place in Family Centre in the area and, as I said, is fully supervised. The quality of contact, in itself… Lauren manages for the hour. Contact is for up to one hour, once a week. She manages that fairly well. She keeps her emotions outside of that contact.

In terms of the attachment between Douglas and Lauren, there’s been a lot of issues in and around that. She served a custodial sentence when he was just around about four months old, and that impacted greatly on Douglas’ recognition of his Mum.

Contact, now, what happens to Douglas is that he’s very reliant on the support worker that is supervising the contact. His interaction and his attachment is to that worker, who has been around right from the beginning, so he relies very much on that worker for support in the contact.

A How does Lauren respond to that? Does she resent it, or is she able to interact as well?

J No, Lauren very much is able to acknowledge. She really noticed the change in Douglas when she came back into the area, having been released from prison. It was actually very distressing for her to see how Douglas had moved away from her, and she recognized that immediately in terms of his emotional attachment to her. She enjoys the contact, because she sees Douglas. There’s a lot of work that’s been done in contact. Practical things. Photographs for herself that she’s able to take away with her, there’s also been some work done to support life-story work, so there’s dialogue as well, between the supervisor and with Lauren, and that keeps the contact lifted

Douglas will allow her to change his nappy and give him a feed. However, there is absolutely no distress at all from Douglas on leaving Mum. There isn’t that significance that we would normally see in a mother-infant bond.

A Does she show any indication of having any understanding of what his needs are?

J Yeah. One of the things about Lauren is that her actual capacity to manage the care needs… When Douglas first moved to foster care, contact was actually set at a very high level to support a parenting assessment, Anne. What happened there was that Douglas was seeing his Mum five days a week and those contacts were for two and a half hours each session. What Mum provided there, in terms of evidence, was that she very clearly had the capacity, not just to meet his care needs, that is the practical nappy changing and clothes changing and feeding and making up bottles.

All of this was a part of that assessment process, but she was also able to respond and stimulate at an age-appropriate level. What happened was that Lauren’s continued offending impacted. The lifestyle choices impacted on her capacity to be there for Douglas.

A So it was the inconsistencies that caused the problems you found.

Jean: That’s right. What happened, leading up to the period that she went to prison, was that we saw a deterioration in the month leading up to that. For example, Lauren started to miss contacts, which was extremely unusual. She was always well-presented, she was always there on time. In actual fact, before the time that we would require to see her. Seeing a deterioration in Lauren as we did, not just in her physical presentation, but also it was suspected that she was under the influence of substances on a number of occasions, which have been noted in the chronology.

We didn’t ever have to stop contact at that point. She was presented well enough to see Douglas, however, there was that concern. She’s later on admitted that there was a high level of heroin use, and she was keeping herself at a level where she was managing.

The contacts that she missed in the month prior to going to prison became so inconsistent. She was missing, I think it was three… The chronology makes it clear. Three out of the five in the week before. The week prior to that, she only made one of the contacts, so Douglas was already beginning to establish a pattern of not seeing Mum as the primary carer.

A That leads on to, what impact does contact have on Douglas?

J Absolutely. The issue there has been…

A How does he respond? What impact after contact is finished…?

J There is no impact for Douglas. In a sense, as I said, he’s established a good and secure relationship with the supporting supervisor from Action for Children, and that person is his safe base. That is so obvious within the contacts. He’s happy to go back to his foster placement with that worker. There is no distress in leaving Mum. Although there’s some interaction, as I said, what Douglas is doing is equally or, in the most part, interacting with that supervising worker.

A How is Lauren responding to contact? Does she see that as a way for rehabilitation, or does she the contact as a means to just see him?

Jean: It has been made very clear to Lauren through the processes. Really, from the LAC review, where permanence was recommended on the 22nd of November, Lauren has become more and more aware, if you like, but also acknowledges that there isn’t going to be a return to her care. The Children’s Hearing that we had on the 15th of December reinforced that, in terms of reducing the level of contact for Lauren and Douglas.

A She has a clear understanding?

J She has a clear understanding, yes.

A OK, thank you.

C Thank you, Ann. Anybody else want to ask anything about contact? Margaret?

M Yes. I had a couple of questions, John. Jean, you talked a bit, obviously, there was a period of time when Mum was in prison. Was it not possible to support any form of contact while she was there?

J We did, actually, approach Lauren and asked her her views on that, initially. Lauren was placed in a prison that is a three-hour drive from the place of residence for Douglas, so there was some concern on the social worker’s part, that too much of a frequency of contact to the prison wouldn’t be helpful. However, it was very much considered, but unfortunately Lauren herself felt that it was not an environment for a baby to come to, and she really didn’t want to engage with that, but put that as the reason.

She felt that some of those memories, for her, would have been about having her child come to her while she was serving a prison sentence.

M OK. My second question was about the Children’s Hearing and the reduction of contact. I really just wanted you to explore a bit more the rationale around that, relating to Douglas’ needs, I suppose.

J When we went to the Children’s Panel on the 15th of December, there was full discussion in relation to the impact, as we’ve just discussed in this meeting, today. The inconsistency that then led up to a period where Mum wasn’t around for Douglas did have such a huge impact on his developing bonds and developing attachment.

Given that the view was that we should be moving towards permanence for Douglas, the Children’s Panel felt that it would be in Douglas’ best interest to continue contact, but at a much reduced level, and agreed with the recommendation from the Social Work Department that this would support memories and the life-story work that would support Douglas through his life.

M Thank you.

D Maybe, Jean, it’s implicit in some of what you’ve already said, but just to pull it together, summarize the impact of the contact arrangements on the attachment between Lauren and Douglas.

J To be quite blunt, there is no apparent attachment on Douglas’ part, with his Mum. Douglas doesn’t show any of the signs that we would be expecting to see from an infant of nine months old. A safe base and a primary attachment figure would offer a nine month old infant… Would be somebody who would really, really struggle, for example, on leaving that primary safe base. Douglas does not show that at all.

As I said, interaction within the contact is more with that supervising worker than it is actually with Mum. The impact for Douglas has been that he sees Mum, I guess, as somebody that comes occasionally into his life.

What we do know, from observations of Douglas within the foster placement, is something very different. The foster placement, which I know we’re going to discuss later, but just as an example in terms of his ability to attach, because that might be the question, is that actually Douglas has a very secure, a very strong and positive attachment to his current foster carer.

He sees that foster carer as his primary carer, and he has grown and developed as would be expected for any infant of his age. If Douglas had issue, in terms of attachment, we would see a consistent delay in his development. However, that has not been apparent.

Those are the two poles, I guess. Again, that was forwarded to the Children’s Hearing, with support from the foster carer’s attendance.

D That’s very helpful. It puts in the context of mum and also his overall development and ability to form attachments. Thanks, Jean.

C We’ve had a reasonable run-over now, I think, Panel members, about the general history with respect of Lauren and Douglas. What I’ve picked up is that, from the point of reception into care and up until this point in time, the concerns have been about the mother’s reliability, consistency as a parental figure. There’s some evidence that she has the skills, but exercising those skills consistently and reliably have been the issue. It seems as though there’s little or no attachment between Mum and Douglas at this moment in time.

I just wanted to get your sense of the capacity for Lauren to change her lifestyle and her commitments, and so on and so forth, in a time scale that was somewhat related to Douglas’ needs, in order to think whether she has any in your opinion, Jean, any part to play as a direct carer in Douglas’ life.

J What Mum has provided in terms of evidence of motivation and capacity to change, is actually very little. The issue for Lauren has been her engagement with her own supports. A bit of that is identifying where those supports have come from. She’s had support from Social Work and Health and the Drug and Alcohol Services. They were put there specifically to enable Lauren to manage her heroin addiction. She was on the methadone program at the time of Douglas’ birth, however withdrew from those supports when Douglas was around about three months old.

When I say “withdraw,” she began using heroin again, and not meeting with any of her appointments, so unfortunately, the methadone program had to be withdrawn from Lauren, because there was real concern that her methadone program and prescription, on top of additional use of heroin, was going to have a considerable impact on her own health, and there were concerns around overdose.

Since that time, Lauren served a prison sentence for a month. While she was in prison, she was placed back on the methadone program again, and made some progress. Of course, we saw that on her release from prison.

Unfortunately, once released from prison, within about four weeks again she stopped attending her appointments with Drug and Alcohol Services, and again her methadone program has been withdrawn.

In addition to that, she’s had support from the Criminal Justice Services in relation to her offending behavior. This is on-going for Lauren. Again, there’s inconsistency in her meeting with her Criminal Justice social worker, and there are concerns again, as I said, that she’s accrued more charges. Lauren herself is aware that there’s a warrant out for her arrest at the moment.

Lauren has also received support from the Housing Department, who are able to put additional resources around young people who have issues with homelessness, so Lauren has had a support worker as well as a housing officer who has been supporting her in sustaining temporary homeless accommodation.

Unfortunately, Lauren has not been staying within her temporary housing tenancy, and also there’s been issues in relation to concerns raised by neighbors. In addition to that, she’s not been meeting with the Housing Support officer, which puts any thought of her being able to sustain and manage a full tenancy at a very high level of risk.

D Can I maybe ask, just how did she engage with Health Services during the pregnancy?

J There were a lot of issues in relation to engagement with all services that were placed prior to Douglas’ birth. Up until Lauren’s seventh month of pregnancy, she inconsistently engaged with Drug and Alcohol Services. She missed numerous appointments with Midwifery Services, and had to be re-titrated back onto the methadone program, actually on-ward at the local hospital. That was because she had had her methadone withdrawn due to non-attendance with Drug and Alcohol Services.

In relation to Health support, that would include the midwife who is responsible for mothers who have significant issues with drug and/or alcohol problems and, again, there was inconsistency in engaging with those.

What Lauren’s pattern of engagement in terms of support for herself is telling us, is that she’s not currently in a position where there’s the motivation or capacity to change. The concern there is that that motivation and capacity, if it does become apparent, is not going to be within a time scale that is appropriate to meeting Douglas’ lifelong needs.

A Does she give a reason why she’s not been able to engage with people, other than her drug and alcohol misuse?

J We’ve only really just got to a point with Lauren where she’s opening up about her own experiences through childhood and up until the present day. What we’re hearing from Lauren is that she had a very chaotic childhood herself. Her Mum had issue, herself, with substance misuse. Lauren was kept from school, by Mum, in a kind of emotional caring role. That parenting role was reversed and Lauren took on an awful lot of responsibility.

Although she presents as a very bright young woman, she missed out significantly, herself, on not just being parented, but also on the education, as well, that she would have needed at that time, and the stability and security that attendance at school would have offered her.

A She’s never suggested any alternative supports that she might respond better to?

J There have been changes in supports for Lauren through the Drug and Alcohol Services. They did, at one point, at Lauren’s request, place a Family Support worker. That was to give Lauren additional support in managing budgets, which she found very difficult. Managing her money, making appointments with housing. This Family Support worker would actually go along with Lauren to these appointments and also, practically, help her to work through budget plans and this kind of thing. Unfortunately, Lauren missed all the appointments with that Family Support worker.

We have, I believe, as the child’s case social worker, I believe that the services that have been offered to Lauren have been exhausted in terms of her need.

A She wasn’t able to sustain that?

J No, she’s not been able to sustain any interaction or any engagement with those services, from the point at which it became apparent that she was pregnant with Douglas.

C I think it might be useful, now, just to get a sense from Panel members whether they feel that those supports have been reasonable in the circumstances, and whether there is any more that could or should be done at this stage.

D I think there’s a great deal being offered and I can’t see what else could have been provided.

C Would Panel members generally agree with Jean’s view that the prospects for Lauren to change her lifestyle to the point where she could be considered as a potential carer for Douglas in a time scale that makes sense for him, is not there? [general agreement]

A No. One point I would just like to clarify. I understand that Douglas went into foster care, really from hospital, and Lauren has never had the opportunity to care for him. Has there ever been any sort of suggestion that some sort of parental assessment of her needs under supervision, either within the foster home, or perhaps in another establishment… Has that ever been discussed or considered?

J The assessment was undertaken immediately post-birth, with five contacts weekly. From Monday to Friday, Douglas went out from the foster placement, to a Family Centre. The Family Centre provides us with an environment and a facility whereby things like bottles can be made up.

Lauren had clothing that she’d had prepared for Douglas’ birth, actually in her temporary tenancy, so she was washing all his clothing and bringing that to contact, doing changes there. She was managing his feeds and doing all the practical work.

That was assessed under observation, and it was assessed within that environment that she did have the capacity to meet his basic care needs.

There was a growing attachment, so the issue here wasn’t so much in relation to that, it was in relation to the lifestyle, Lauren’s chosen lifestyle, in terms of the offending and the continued use of drugs, that impacted most on her capacity to actually be consistent for her son, to be there for him and to develop an attachment with him.

A That was the reason why rehabilitation into her full-time care was not considered.

J We were never able to consider rehabilitation.

C Thank you, Anne.

Transcript Copyright:
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License