Case notes

Practitioners: Jackie Hooper, assistant team manager, and Nikki Osborne, leaving care adviser.

Field: Young people leaving care.

Location: Reading, Berkshire.

Client: Hannah Gregory, 22.

Case history: Hannah came into care when she was 14 after allegations of sexual abuse by her father. Because of her high risk and violent behaviour in care she was moved to various children's homes, accumulating a number of cautions and convictions. On reaching 16 Hannah was transferred to the leaving care team, who support young people up to the age of 21. Around this time, having been convicted of malicious wounding after a stabbing in a pub, she received a combination order (now a community punishment and rehabilitation order), comprising supervision and community service. But, after another assault charge, Hannah was imprisoned. The leaving care team continued to work with her on building a relationship but this was complicated further when in custody Hannah found she was pregnant.

Dilemma: While taking a back seat to direct child protection concerns for the unborn baby, the team still has to consider Hannah's transition to independence.

Risk factor: Hannah may return to her lifestyle of violence and drugs, placing her baby's safety in danger.

Outcome: Hannah is now living independently with her daughter, both of whom are stable and thriving.

Self-help and motivational books, talk show guests and inspirational figures often rely strongly on those life-changing moments - usually when they successfully turned adversity into opportunity. Indeed most, if not all, of us can pinpoint times when things changed - for better or worse.

Hannah Gregory is no different in that respect. Her adversity, though, was different from most: abused as a child, she developed into a teenager who was going off the rails and involved with violence and drugs.

Placed in care at 14, her behaviour- particularly violence and drug use - became more challenging as time went on. This culminated a few years later in a community sentence following a stabbing, by which time she had become the responsibility of the leaving care team.

"Throughout this time we worked with her building up a relationship," says leaving care adviser, Nikki Osborne. "We sorted out some accommodation for her and she was settled for a while. However, she started to re-engage with undesirable friends, and before long she was back in the crown court for street robbery for which she received a custodial sentence."

Being imprisoned, however, seemed only to be the start of Hannah's difficulties. Shortly into her sentence she found that she was pregnant. Coupled with this were worries over her drug use.

Osborne says: "When she found out she was pregnant, I think reality kicked home for her with the concerns being expressed about the unborn child. So, with help from the prison service, she got off the drugs and started to turn herself around. Nonetheless, given her background, we had to be concerned about the unborn child, which was due to be born while Hannah was still in custody."

The leaving care team called a strategy meeting, including child protection and family support workers. "Based on her history - past behaviour, criminal conviction and drug use - there was significant evidence for us to discuss whether this was a case where the baby should be removed at birth," says assistant team manager Jackie Hooper.

"It was difficult," says Osborne. "You are only allocated so much time for each visit, so we were only getting a snapshot of Hannah. However, as most of the team came from residential services we did have the benefit of an ongoing history with her."

It was agreed that, on release from prison, Hannah should be placed in a mother and baby unit on the south coast which could offer therapeutic input relating to drug misuse. "We could then see how well she could manage both pressures of life outside prison and those of being a new mum," says Osborne. At birth an interim care order placed the baby with foster carers as Hannah had two more weeks to serve before release.

Moving Hannah out of the area proved decisive. Hooper says: "The six-months assessment of her parenting skills gave Hannah a break from the area and time to bond with her baby. It also gave her time to think about whether she wanted to go back to a life of crime and drugs or look for a new way forward." Hannah chose to work with all professionals involved "but was a bit cagey at first", says Osborne, "because she was worried we were going to take her baby away".

Hannah's life-giving proved to be her life-changing moment. "It was a hugely significant event that led to where she's at now," says Osborne. With Hannah committing herself to parenting, she hit all the milestones of achievement that were set for her and so the care order was lifted - within a year of being placed.

Hannah has now moved back to the area. Hooper continues: "The move from mother and baby unit into independent living was also a significant event - not just in finding stable accommodation but managing her moving back to the area." Osborne visited her at least twice a week to help smooth the transition: "We work closely with housing and managed to place her in an area with no drug issues, and we made sure she had all she needed, such as furniture and so on," she says.

Hannah has taken easily to living independently and enjoys being a mother. "Although beyond our remit now, she keeps in contact and uses us a support network. But that's good," says Hooper.

Arguments for risk

• Although there were clear signs that Hannah wanted to change - her determination to kick her drug habit, for example - in order to stay with her baby, the professionals involved were wise to be cautious. Working closely with the colleagues from the prison service, probation and even the Howard League for Penal Reform, the workers wanted to ensure that if Hannah’s life outside the care system was to include her daughter, she needed to prove that she had changed for the better.
• Placing her in a mother and baby unit for a six months-assessment ensured three things: first, she would be able to demonstrate her parenting ability; second, she would be away from the distractions of her old life, and third she could address her drug misuse in a focused way.
• The staff always had the interim care order: "We didn’t use it as a power thing but Hannah knew that, if she chose the wrong path, her baby would be taken away," says Osborne.

Arguments against risk

• Although the circumstances for her being taken into care were clearly traumatic, Hannah demonstrated over the next six years that, through drugs use and violence, she was a danger to others. Her behaviour, which included the willingness to use a knife, appeared to show little maturity and certainly did not indicate willingness, let alone an ability, to parent a child.
• Despite the supportive attitude of the workers after her conviction and community service, Hannah all too easily lapsed and went back to her old ways and friends, resulting in a theft and custodial sentence.
• It is now known how important a baby's first days are in developing a bond with its mother. Indeed, Osborne says: "Knowing her as I do now, Hannah should have had the chance to bond with her baby but we were very much on a knife's edge because of the risks we knew at the time to the child."

Independent comment

Had they chosen to use certain traditional risk assessment techniques, which involve ticking boxes and adding up the number of negative factors, Jackie Hooper and Nikki Osborne might well have been forced to conclude that allowing Hannah to care for her baby was a risk which they just could not afford to take, writes Patrick Ayre.

Fortunately, they realised that risk is rather more complex than that. In a child protection context, it has two essential dimensions. The first consists of the underlying factors which may predispose someone to abuse or neglect a child in their care. These would include their personality, psychological profile, personal history, skills and attitudes. The second consists of the immediate factors which are affecting the situation at the time, including the stresses, strains and supports which are coming to bear. The level of risk cannot be calculated by simply adding together these factors but is determined by the way in which underlying tendencies and immediate pressures interact with each other.

In this case, it was possible to alter radically the level of risk by removing Hannah and her baby to a safe and supportive environment. This created a space within which she and those working with her could tackle some of the more deep-seated challenges. They were fortunate to have access to a mother and baby assessment which offered a "win-win" solution to their dilemma.

Patrick Ayre is senior lecturer at the University of Luton and an independent child welfare consultant.