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.