Three young children suffered repeated, unprovoked and violent assaults for almost three years at the hands of their brother, after a council failed to properly consider the risks they faced and minimised the harm they suffered, the Local Government and Social Care Ombudsman has found.
The watchdog found that Somerset council failed to meet the respite care needs the family had been assessed as needing from 2015-18, declined the boy’s mother’s repeated requests for him to be taken into care and blamed her parenting style for the situation, amounting to “minimisation and normalisation of harm to three children”.
While the ombudsman said it was “exceptional” for him to recommend that an authority pay £1,000 in acknowledgement of “significant or prolonged” injustice to a family, in this case, he called on Somerset to pay the mother, Ms X £8,250 for injustices to her, her three youngest children and her son, Mr Z. It has accepted this and other recommendations.
Severe physical risk
During the period covered by the report, 2015-18, Ms X was mostly caring for her four children on her own, with her husband working overseas. Mr Z, now an adult, was a child at the time, with physical and learning disabilities that manifested in unpredictable violent outbursts and excessive appetite.
His weight increased significantly over the time covered by the complaint, from 28kg in 2013 to 106kg in 2018, and by 2016 he weighed significantly more than his mother and was far bigger than his slightly built younger siblings.
Somerset first assessed Mr Z in July 2015 and identified a “severe” physical risk to his younger siblings from his violent outbursts and noted a doctor’s report that said he may eventually need a residential placement.
The subsequent care plan, issued in September 2015, stated concerns that if Ms X didn’t have any breaks from Mr Z it would be eventually difficult for her to cope, and if nothing changed, Mr Z’s frustration would increase, endangering the rest of the family.
Although the care plan identified the need for respite care and the council referred Mr Z for one overnight break a week and one weekend a month, the referral stated that he “would probably not meet the criteria for these because of his violence”. The council did not provide the respite care it assessed Mr Z and that the family needed.
Care request declined
Over subsequent months, Ms X and third parties reported several incidents of violence by Mr Z against his siblings and at school.
In spring 2016, the council ordered some respite but only for three hours after school, once a week – far less than the assessed need of one overnight a week and one weekend a month.
In the same month Ms X asked the council to take Mr Z into care, while Mr Z’s social worker also made a request for a residential placement for him.
However, the council declined Ms X’s request, on the grounds that taking Mr Z into care would be a last resort, and while a placement panel did meet in May and June 2017, no residential placement was identified for him on either occasion. Instead, the panel recommended guidance for Ms X and suggested an external agency might be able to provide some support.
‘Very concerned about children’s safety’
In July 2016, a child and adolescent mental health services (CAMHS) nurse visited the family and witnessed Mr Z pinning his mother down on the sofa and striking his sister with an implement, which she noted would have been impossible to prevent.
The CAMHS nurse said the current three-hour-a-week respite was “not adequate to protect these children from further harm” and followed up with an email to the council saying she was “very concerned about the safety of the children”, and that she feared there may be a serious injury to them or to Ms X.
A complex needs panel sat the next day and was shown the CAMHS nurse’s evidence. The council agreed a residential placement in principle, subject to further assessment, but there was no evidence the council took any immediate action to address the harm witnessed by the nurse.
A further placement panel sat in September 2016 and rejected the request for a residential placement, saying there was no evidence as to what strategies were used at the family home and if they worked.
Relationships under strain
By the end of 2016, Ms X’s relationship with professionals was under strain, including because she felt the council was wrongly focused on her perceived inadequacy as a parent, not the help the family needed. A section 47 strategy meeting was held towards the end of the year regarding the risks posed to Mr Z by Ms X’s parenting but there was no evidence that the council considered the risk he posed to his siblings.
The CAMHS nurse emailed the council in February 2017 outlining the further physical violence she had witnessed from Mr Z to his younger siblings, adding that one of the brothers told her they avoided Mr Z:, saying: “I stay out of the way. I don’t know what will happen. He hits me when I pass him.”
In March 2017, the council carried out a fresh assessment of Mr Z’s social care needs. His subsequent care plan, completed in May 2017, took the view that Mr Z was being “ostracised” within the family.
The social worker put in another request for respite care, which was again declined in June 2017 and the appointed panel asked for another risk assessment.
Other than the two hours a week support from an agency, the watchdog saw no evidence of the council providing the respite care during 2017 that it had first assessed Mr Z as needing, despite multiple reports of violence incidents within the home and at school
In February 2018, Mr Z was excluded from school for two days after a violent assault on a teacher. The following month a social worker visiting the family home and observed Ms X to be exhausted, which Ms X said was typical of the last three years as Mr Z was often awake at night due to his condition.
At a special educational needs and disability (SEND) tribunal in April 2018, the council accepted that Mr Z needed a 52-week residential school placement. His education health and care plan was amended and he attended the school from May 2018.
Ombudsman Michael King said the council had a wealth of evidence but sought to blame Ms X’s parenting style, denying the family the respite they needed:
“Throughout the three years the council had a wealth of evidence both the mother, and the boy’s school, struggled to cope with the boy’s violent and unpredictable outbursts. Despite this, it sought to blame the mother’s parenting style rather than provide the respite the council itself assessed the family as needing.
“This left the family suffering both physical and psychological distress: the children have had to unlearn three years of coping behaviours, and the family was unable to enjoy quality time together.
“I am pleased the council has now agreed to my recommendations and hope the changes it has agreed to make will ensure disabled children and their families are safeguarded appropriately in future.”
As well as accepting the ombudsman’s recommendation to pay the family £8,250, the council also accepted his call to consider the use of section 47 child protection inquiries in exceptional circumstances in cases involving the support provided to disabled children and their families, and ensure placement panels record the information they consider and for the rationale of placement decisions.
A spokesperson for Somerset council said: “In this case we did not meet the standards we set for ourselves in the period up to 2018. We are a learning authority and have carefully considered, accepted and actioned all of the recommendations from the LGO, including giving an apology to the family.
“We work hard to get things right every time and continue to make improvements. As a result we welcome the positive feedback in our most recent SEND inspection in 2020 about the high quality of our current short break provision*. We continue to regularly review our support offer with families, so that disabled children and their families get what they need at the right time.”