Another day, another High Court case about an extremely vulnerable child with no suitable accommodation. Honestly, i could write four of these posts a week.
Nottinghamshire County Council v LH (A child) (no 2) 2020
On 23 September 2021 I refused to exercise the inherent jurisdiction to authorise the continued deprivation of the liberty of LT, a 12 year old child who was being confined in an acute psychiatric admission unit for adolescents. She does not have a psychiatric condition requiring hospitalisation. She is a looked after child but the local authority had not been able to find anywhere else in the whole country to accommodate her. Evidence before the court demonstrated that it was harmful to LT for her to remain on the unit. The only reason the local authority sought to keep her on the unit was that it had been unable to find any alternative placement. I had previously been prepared to authorise the deprivation of LT’s liberty on the unit whilst urgent efforts were made to find alternative accommodation but by 23 September 2021 LT had been on the unit for over a week. She had just come out of isolation (as a Covid-19 precautionary measure) and it was anticipated that this would, if anything, increase the distress to her. Still no alternative accommodation had been identified. I refer to my judgment Nottinghamshire County Council v LH, PT and LT  EWHC 2584 (Fam).
Really sadly, within the psychiatric unit, LT is by far the youngest patient and because of her huge needs she is being taunted by other patients as a result of the attention she gets from staff.
The Local Authority found a resource for her, which was an empty registered children’s home. They did not have staff with psychiatric training to staff it, so have had to hire and train staff specifically to care for LT.
The local authority’s plan now is to apply for a Secure Accommodation Order. However, according to evidence put before the court from Mr Edwards, Director of Youth Families and Social Work at the local authority, there are currently approximately 50 children nationally on a waiting list for secure accommodation and those with behaviours such as LT’s often remain towards the back of the queue. Hence, he advises, it is “highly unlikely that this will be a viable solution for LT.” Accordingly, as what Mr Edwards refers to as “the least bad immediate alternative available”, the local authority proposes to transfer LT to the W Children’s Home from Monday 27 September 2021. This is a registered children’s home which is currently empty after previous residents have departed. It can accommodate up to four children but for so long as LT is there, she will be the only resident. The staff on site are unqualified and have no experience of managing children who self-harm but the local authority plans to rely on agency nurses, using the same agency as currently provides nurses to work alongside the NHS staff to care for LT on the psychiatric unit. On handover, the Trust will provide advice and materials about managing LT to assist those caring for LT at the new placement.
They have done remarkably well to put this together, but it is a shameful state of affairs that in our country we don’t have something proper in place for all of the children like LT, and bespoke placements are having to be put together out of thin air. I don’t know what the solution is, but a starting point would be building units staffed by medically trained professionals aimed at managing and alleviating the problems of young people like LT – at present, they don’t fit well into adult psychiatric units or into children’s homes – we need specialised resources dedicated to helping these most troubled children.
Mr Edwards says that the decisions he has now had to make in respect of LT are some of the most difficult he has had to make in his professional career of over thirty years. I fully acknowledge the extreme difficulties faced by all those involved in these decisions, and in caring for LT. This case demonstrates the consequences of the national shortage of secure and other suitable accommodation available for vulnerable children. It has caused avoidable harm to this child, anguish to her mother, stress for numerous professionals and carers, disruption to other vulnerable children and young persons, and avoidable expense to the NHS and the local authority. I direct that a copy of this judgment is provided to some of those who might be able to address the root cause of the problems this case demonstrates: the Children’s Commissioner for England; the Secretary of State for Education; the Minister for Children; the Chair of the Care Review; the Parliamentary Under Secretary of State in the Ministry of Justice, Lord Wolfson QC; the Chief Social Worker; and Ofsted. It will join a number of similar cases brought to their attention.
Sadly, the way the news cycle and political attention work, I’m afraid that it will take a real tragedy to open eyes to the desperate need for an urgent solution to these cases. Everyone involved in these cases is working tirelessly and under huge pressure to make sure that the tragedy does not involve the case they are working on, but it is no way to run a system.