Mother’s day of reckoning

    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.

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