Grandmother holds the key

A mother and father are suspected of
repeated   physical assaults on their
baby daughter and she is placed in care. Fiona Bennett led a risk
assessment team that had to decide on the baby’s future care, and whether to
enlist the support of the child’s grandmother. Graham Hopkins reports.

Babies can’t do anything for or to
themselves. Others have to do that – usually parents. Usually, this brings out
the best in people but occasionally the worst. In those instances when babies
have been physically abused or damaged, suspicion falls upon the parents.

Babies, despite their size and
vulnerability, are rather resilient. It is almost impossible, for example, for
a baby to break an arm, leg or rib in all but the most exceptional
circumstances. To cause such damage takes some effort. So multiple fractures in
a baby can point to very little other than abuse. These can be caused by
pushing from side to side, twisting, pulling or squeezing. In short, very
deliberate acts designed to cause pain. While acutely painful for a baby,
fractures may display little outward sign.

Such was the fate that befell Lizzie
Collins, a six-week-old baby girl. A hospital check revealed numerous current
and previous fractures. The daughter of Sandy and Mary was taken into care by
the social services department of a north of England authority. The family had
moved there from their native Scotland because of Sandy’s posting with the
armed forces.

However, feeling isolated and with
their marriage breaking up, Mary decided to return to her home town in central
Scotland – causing Sandy to pursue custody. This meant that the Scottish
authority would continue the child protection work – although with two
different national legal systems this served only to further complicate matters.

“This was a very complex case,” says
Fiona Bennett, project leader with Barnardo’s family assessment and support
service, who managed the case when the local social work department contracted
her project to carry out part of the complex risk assessment on the family.

“Both parents had consistently
denied any involvement, and to make matters more worrying, Mary was pregnant
again – and we had to consider the potential safety of that child from birth
also, given that Lizzie’s injuries were inflicted at a very young age.”
“Initially, we were very concerned about the high risks involved,” she says,
“and felt it very unlikely that either baby could return home as neither parent
had accepted responsibility.”

Child abuse, by its very nature,
usually takes place behind closed doors, in secret and without witnesses,
making investigation difficult. A joint police investigation brought criminal
charges – along with a case for care orders – but both parents were found “not
guilty” on the grounds of insufficient evidence. The task then was to decide
what should happen to Lizzie.

Sandy Collins’s employers were
co-operative, allowing him leave to take part in the assessment. However, his
involvement began to fade as he became more and more difficult to engage. Mary
became more involved, although she found this process distressing and
depressing. Indeed, this proved somewhat reassuring to Bennett and her

As a result of his disengagement,
suspicion increased that Sandy may well have been the perpetrator. But once
again, at the end of the risk assessment, it was not clear which parent had
caused the injuries to Lizzie. “We were looking at ways to move this forward,”
says Bennett. “Things were still not clear. Both were consistently denying
responsibility.” However, with Sandy withdrawing, Mary became the only parental
option. It was felt this might become viable with some extended family support.

The chances of keeping Lizzie with
her family increased with the positive involvement of her maternal grandmother,
who, despite the natural difficulty in doing so, was willing to keep an open
mind about who had inflicted harm on Lizzie.

It was decided to move Lizzie from
her foster carers to her maternal grandmother. Reassuringly, she made a good
job of looking after Lizzie. Six weeks later it was agreed that Mary, although
it was still very possible that it could have been her that inflicted the
injuries, could move in with her mother, Lizzie and her new baby.

Both children are on a supervision
order and the situation is being monitored. And while there may be what Bennett
refers to as “conflict issues” if Sandy Collins once again wishes to become
involved, things are settling down well and relationships are developing

“With the safeguards and plans we
had in place,” concludes Bennett, “Mary’s parenting skills have developed quite
well, and she’s showing good abilities and strengths that are helping the
girls’ development.”

Case notes

Practitioner: Fiona Bennett

Field: Project leader, family
assessment and support service, Barnardo’s. Location: Central Scotland

Client: Lizzie Collins, the daughter
of Mary and Alexander “Sandy” Collins, was born last year.

case history: Following confirmation
from the hospital doctors that six-week-old Lizzie Collins had suffered a number
of fractures an interim care order was granted and she was accommodated with
foster carers by the local authority in her then home town in the north of
England. Both parents denied causing the injuries. The family situation was
complex. During this time Mary moved back to Scotland causing problems given
the different legal systems of the two countries. A joint police investigation
into Lizzie’s injuries proved inconclusive.

The Scottish local authority’s
social work service in association with Barnardo’s and a local family centre
then conducted a comprehensive risk assessment on what should happen to Lizzie.
The fact that Mary was pregnant again was also a matter of concern for the

Dilemma: Lizzie had been seriously
physically assaulted but no conclusive proof was found as to who did it.

Risk factor: Could Lizzie be
returned home to either of her parents given that the fractures were most
likely to have been caused by one or both of them?

Outcome: Lizzie has been placed with
her maternal grandmother, with whom Mary Collins now also lives.  

The names given for the child and
her family have been changed.

Arguments for risk

– Mary had not been convicted of
causing Lizzie’s fractures, although suspicion inevitably hung over her.
Nonetheless, wherever possible, efforts should be made to keep families
together. By seeking a compromise solution in keeping Lizzie with her family it
was essential to explore the possibilities of other family members playing an
important role.

– The positive relationship struck
up with Mary’s mother and professionals involved in the case indicated that a
placement was possible, especially as professionals were convinced of her
mother’s sincerity about keeping an open mind whether Mary had caused Lizzie
harm. This would ensure that she would be vigilant should Mary also move in.

– Mary – although maintaining her
innocence – was very depressed and distressed that Lizzie had been taken away
from her, but was nonetheless willing and able to co-operate with Bennett and
other colleagues. This indicated an understanding of the responsibility she
needed to demonstrate before being re-united with Lizzie.

Arguments against risk

– Although no conviction was
possible, there remained a grave suspicion that one, if not both, of the
parents caused Lizzie’s fractures. There remained a very strong possibility
that Mary may harm Lizzie.

– Should Mary indeed be the
perpetrator, not only was Lizzie at further risk of harm and damage, but there
could arguably be a greater risk to her new baby who would be the same age as
when Lizzie first suffered her fractures.

– While placement with Mary’s mother
was considered safe (she was capable of looking after Lizzie well) there might
also be the suspicion that she was simply saying and acting out what she thought
was needed to get her daughter and grand-daughter together again.

– Although separated, there was
always the danger of further conflict – either physical or psychological –
should Sandy return and wish to become involved in the family once again.

Independent comment

Cases of severely injured infants
are among the most difficult to deal with. Lizzie cannot have sustained
injuries like these accidentally. When two parents deny responsibility, and
there are no other likely suspects criminal convictions are difficult.

However, protecting Lizzie relies
not on convictions but a multi-agency risk assessment that ensures the context
of Lizzie’s short life is as understood as possible. Issues for exploration
would include any post-natal depression, domestic violence and its impact on
Mary, any misuse of drugs or alcohol, and mental health problems. The risk
assessment would explore what coping strategies each parent used when things
got tough, and most importantly, what safety mechanisms they identify as necessary
in order to guarantee Lizzie’s safety. This is intrusive, but the risk to
Lizzie is grave and so justifies the intrusion.

Currently, Mary’s mother is the key
protective factor for Lizzie. It is crucial that Mary and her mother are very
clear about agency expectations. Legal parental responsibility of Lizzie and
the new baby appears to remain solely with Mary so the plan needs to spell out
individual and state responsibilities. It also needs close supervision and
regular reviewing. If Mary and Sandy decided to reunite in the future, Lizzie
and her sibling could not be returned to their care unless a thorough risk
assessment indicated that history would not repeat itself. Without any
assumption of responsibility, this seems unlikely.

Sheena Doyle is programme manager with The
Children’s Society.

More from Community Care

Comments are closed.