Lack of secure care placements for vulnerable children leaving courts with ‘no real choices’

Courts are left with “no real choices” as to how to deal with vulnerable children in need of secure care placements because of an ongoing crisis in which there appears to be “no end in sight”, a High Court judge has said.

Mr Justice Poole made the remarks as he approved continued restrictions placed on a 13-year-old girl with complex needs who is currently in a hospital, despite her not needing any treatment, because there is no suitable accommodation available for her.

The girl, who cannot be identified and was referred to in the judgment as J, has autistic spectrum disorder and attention deficit hyperactivity disorder, and a history of challenging behaviour including assaults on others and self-harm.

She is unable to leave the hospital other than to attend school, remains supervised at all times by carers, is not allowed a mobile phone or social media and cannot access the hospital grounds after 8pm each day.

The restrictions on her also mean she will be returned to the hospital and may be physically restrained if she attempts to leave outside of authorised times.

In a ruling on Wednesday, which was made public on Thursday, the judge said the case “calls into question the court’s role”, as do many other cases involving the care of children with complex needs.

The lack of provision of secure care placements has been lamented by a number of judges in recent rulings, including a Supreme Court judgment last year in which Lord Stephens, one of the court’s justices, referred to the “scandalous lack of provision”.

Mr Justice Poole said in his ruling: “Very often the court is told that there is only one place where the child can be accommodated.

“The court’s role is therefore very limited. There are no real choices for the court to make. The court cannot direct that placements shall be made available.

“The court is not a regulator and cannot inspect potential placements or oversee care regimes.

“On the other hand, even when there are no other placement options, the court does not merely provide a rubber stamp for the restrictions sought, and there are decisions to be made about the extent of the restrictions that are necessary and proportionate and, in a child’s best interests.

“However, the courts, like the parties, continue to be confined by the consequences of what Lord Stephens called a ‘scandalous lack of provision’ for which it appears that there is no end in sight.”

The judge said Manchester City Council (pictured), which has responsibility for the girl’s care, has identified a “bespoke placement” in private rented accommodation at a cost to the local authority of £9,600 a week.

However, her move there has been delayed as staff caring for her will need to undergo “restraint training”, and the local authority’s aim is for her to be in the new placement by the end of October.

The judge said J’s “own, clear views” on the restrictions are that she would like to go for walks as and when she can, does not eat hospital food and would like to be able to go to the shops near the hospital at mealtimes to get her own food.

She would also like her curfew to be extended to 10pm and to attend an activity centre where she could use a gym.

He said he had also heard from the trust which runs the hospital that, although physical restraint is permitted, it has not been used for some time.

The judge said he would have been “unlikely” to continue to authorise the restrictions on her freedom in the hospital if it wasn’t for the alternative accommodation being available within a reasonable time.

He said: “As it is, I struggle to find that the continuation of the present arrangements even for a relatively short time is in J’s best interests.

“A hospital is not a suitable home for this 13-year-old girl who has no need for treatment.

“It is surely harmful to her to spend any more time in hospital than is absolutely necessary.

“However, due to the national lack of resources to accommodate and care for children with complex needs, that appears to be the only place where she can live until, as is hoped and expected, the local authority is able to arrange and have ready the proposed bespoke placement.

“The redeeming feature of this case is that under the plan put forward, J will be able to continue at her school before the move.

“Remaining at the hospital during the transition period to the new placement will afford her some stability at least.

“Hence, after anxious consideration I shall authorise the continuation of the restrictions that deprive J of her liberty whilst she remains at the hospital as being necessary, proportionate and in J’s best interests.”

The judge said he will review the case later in October and directed that his ruling be sent to Education Secretary Kit Malthouse and the Children’s Commissioner for England.

A “deprivation of liberty court” was recently set up to deal with such cases and analysis from the first two months of the court’s operation showed there were 237 applications for deprivation of liberty orders.

In last year’s Supreme Court ruling, Lord Stephens referred to the “enduring well-known scandal of the disgraceful and utterly shaming lack of proper provision for children who require approved secure accommodation”.

He added: “These unfortunate children, who have been traumatised in so many ways, are frequently a major risk to themselves and to others.

“Those risks are of the gravest kind and include risks to life, risks of grievous injuries, or risks of very serious damage to property.

“This scandalous lack of provision leads to applications to the court under its inherent jurisdiction to authorise the deprivation of a child’s liberty in a children’s home which has not been registered, there being no other available or suitable accommodation.”

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