A clean break with the past

The names of the child and family have been changed

CASE NOTES

Practitioner: Gill Fox, social worker.

Field: Children and families.

Location: Stockport, Cheshire.

Client: Baby Keeley Saunders was placed with
her maternal grandparents along with her three half-siblings, who
are on a  residence order.

Case History:  Keeley’s mum, Sarah Saunders,
29, has a history of drug and alcohol misuse and has been in prison
three times. It was during her most recent spell inside that it
emerged that Sarah was pregnant with Keeley, her fourth child. Her
chaotic lifestyle had resulted in her first three children being
placed on the child protection register and then with Sarah’s
parents. Sarah also had a history of being dependent on her
partners who had physically abused her. Keeley’s  father had left
Sarah long before their daughter was born. Having lost her partner,
Sarah was also concerned that Keeley would be taken away. Foster
care was considered initially as it was felt that Sarah’s parents
could not cope with three children and a baby.

Dilemma: If Keeley were placed with
grandparents while an assessment was carried out on Sarah, she
would not be able to stay if things failed with Sarah – and would
be placed in care.

Risk factor: Sarah’s history, if repeated,
would put Keeley at risk.

Outcome: Keeley moved in with Sarah last June
and mother and baby are doing well. Weekly monitoring visits have
reduced to monthly and there are no longer concerns.

Working in partnership with parents and carers, non-oppressive
practice and empowerment are everyday theoretical values and ways
social workers do their jobs. But how often are these values
enforced in the face of difficult cases?

If a mother has a record that includes her first three children
being taken into care, imprisonment and a chaotic lifestyle
dependent on drugs, alcohol and abusive partners, what hope is
there for the fourth child on the way?

In the case of baby Keeley and her mother, Sarah Saunders,
social worker Gill Fox believed there was a chance that things
could be different.

“Research tells us that the best indicator of the future is the
past,” says Fox. “But this case made me question my own values
because, if we based it on past assessments, we’d say: ‘No way. Why
am I continuing with this – she’s lost three children?’ But the big
issue for us was partnership – not only with mum, but with the
grandparents as well.”

Indeed, the grandparents were crucial to any potential success.
Fox says: “They had been honest with us about the other three
children and had prioritised their needs before Sarah’s, which
sometimes put them in a difficult situation. Their history of
honesty with us was key: because if they didn’t tell us what was
really going on, we wouldn’t know.”

Sarah agreed to have supervised contact with Keeley at the
grandparents’ house. Throughout the assessment period Sarah would
arrive at 7am and stay until 9pm. Contact was a big issue, says
Fox. “If the baby was placed in foster care, Sarah would never have
these levels of contact, which would have meant mother and baby
attachment would not have been as strong. Nor would Keeley’s
siblings or grandparents have been able to have any relationship
with her.”

Another worry centred on Sarah’s past drug use. “We never had
any evidence that she had taken drugs in prison while she was
pregnant. Sarah said she hadn’t,” says Fox.

Medical records did not suggest that Keeley had any withdrawal
symptoms after she was born. “So Sarah could be telling the truth,”
Fox says. “However, we know that people who take drugs don’t always
do so.

Equally, if she was using there was little chance she would be
able to stick to her caring routine each day.”

The only way to be certain was to have Sarah tested. Fox says:
“Whereas urine samples indicate usage over a week, a hair sample
can provide evidence over three months. Her first test was clear –
and our only question was whether she could maintain this. The
answer was a resounding “yes”. Two further tests would prove her to
have been drug-free for nine months.

A psychological assessment mirrored concerns identified in
Sarah’s core assessment: for example, her low self-esteem and
reliance on a dominant and abusive partner. But being devoted to
her maternal role left little time to meet new partners.

“We felt her daily routine was a defence mechanism,” says Fox.
“There was a risk that if we ended supervised contact she’d be off.
So, we needed to test the water. We started a couple of hours a day
of unsupervised contact and built it up until there was no
supervision at all. But she continued with the same pattern of
arriving early in the morning and leaving late.”  She continues:
“We got Sarah involved in a local women’s centre and a domestic
violence group, through which she made a new friend. She also
started to attend a parent and tots group.”

The psychologist felt that Sarah needed a 26-week programme, but
the children’s guardian and Fox felt this would be excessive and
expensive. Fox says: “We went to the women’s centre, which provides
a 12-week ‘freedom programme’ with psychotherapy and counselling. I
also felt that the women’s centre was more relaxed, less clinical,
and the course could be taken at her pace and would not be
time-limited.

“I felt she was more likely to commit to this and thus make it
succeed than if we had made her do something.”
The local authority applied for a supervision order rather than
care order because, as Fox says, “we had no reason to doubt that
Sarah would continue to work with us – which she has”. She adds:
“Sarah felt that we had given her a voice. I look back on the case
now and I think I did take some risks but they have paid off: this
little girl is now back with her mum.”

Arguments for risk

• The relationship built up between Fox and Sarah made for a
  positive partnership. Fox says: “She was included in all
  decision-making and she felt I was giving her a fair shot. I told
  her ‘I’m going to give you every chance. If Keeley can be with you
  that is where she should be’.”
• The relationship with the grandparents was crucial. They were
  honest about what was going on in the family and their information
  could be trusted. Fox agreed a contract with Sarah and visited
  weekly. Monthly meetings, which included the health visitor, and
  statutory reviews were held. “But the linchpin to it all was the
  partnership working with Sarah and her parents.”
• Initially, the partnership avoided the need for court orders.
  Fox says: “The mother was working with us, so we didn’t apply for
  one. Nor was Keeley on the child protection register, so we didn’t
  have any official power.”

Arguments against risk

• The past is indeed a strong indicator of the future. At least
  Fox realised that she was taking risks in choosing to assess this
  case differently.
• In Sarah’s case there is alcohol, drugs, crime and violent
  relationships. Psychological assessments all concluded that she
  couldn’t live alone, and would need to become dependent on a
  partner. It may be a matter of time before Sarah becomes bored or
  overwhelmed with her maternal duties and slips back into her known
  lifestyle.
• Much is made, rightly, of the importance of trust and
  relationship building. And yet Sarah tried to conceal her
  pregnancy. Although it could be argued that she would obviously do
  so given the circumstances around her first three children, it is
  an open act of dishonesty.
• Disagreeing with the final psychological assessment was another
  big risk and, although Fox found an ally in the children’s
  guardian, it is a professional decision that might have
  backfired.

Independent Comment

Those working to  safeguard children do so under media scrutiny,
waiting to pounce upon their smallest slip, writes Patrick
Ayre.

How much more comfortable it is then to choose an approach with
which no one could find fault, even though in our heart of hearts
we believe we could and should do more.

Gill Fox and her managers are clearly made of sterner stuff. To
propose a rehabilitation plan in the face of the Sarah’s record
seems at first glance to risk being laughed out of court.

However, if we take the time for a second glance, we may
conclude that our question should not really be “Why  bother even
trying?” but rather “Why not?”. Despite the grim historical
background, the immediate risks were low and the only obvious
serious  potential downside to Fox’s plan is the delay in placing
Keeley.

Nonetheless, the viability of this experiment depended crucially
on several  factors which are not always present. It was essential
that the grandparents could be trusted completely and also that
Sarah genuinely believed she was being given a chance. 

Equally important for Keeley’s long-term well-being was Fox’s
understanding that the key challenges in this case might not be
found during the short months of the rehabilitation period but
during the long years thereafter.

Without access to local services able to address effectively the
psychological issues identified in Sarah’s assessments, returning
Keeley to her care might well have been a risk too far.

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