Case of mother who killed her children ‘should have seen services act earlier’

By The Press Association23rd November 2015News EnglandChildrens Services, Inquest, London, News England, Serious / Significant Case Review / Inquest, Tania Clarence

Health and social services staff should have intervened earlier in the case of a depressed mother who smothered her three disabled children, but the large number of workers involved were all waiting for consensus, a review found.

Tania Clarence, 43, has admitted the manslaughter by diminished responsibility of Olivia, four, and three-year-old twins Ben and Max at the family home (pictured) in New Malden, south-west London, in April 2014.

The children suffered from the muscle-weakening condition Spinal Muscular Atrophy Type 2.

A 70-page review into the complex case today found the deaths were unexpected and not able to be predicted.

But its authors believed the threshold for child protection intervention was reached one year before the tragedy amid increasing concerns from social services and allegations the mother had tampered with medical equipment in hospital. These were ultimately withdrawn.

Co-author Edina Carmi said child protection processes should have started in July 2013, meaning a senior manager would have been allocated “to make sure all assessments were able to be done thoroughly” and to get to the bottom of the allegations.

She said: “The wrong decision was to wait for there to be a consensus and agreement … it wasn’t a case of any one individual or one professional’s fault.”

Father Gary Clarence said his wife dedicated her life to the children’s care and always put their own wellbeing ahead of her own.

He said: “The overwhelming responsibilities of this care took its toll on Tania and led to feelings of despair and hopelessness, culminating in severe depression.”

Mr Clarence added that Tania’s depression was “certainly not helped by the constant pressure placed on the family by some aspects of the medical profession and social services”.

Health care staff could not agree with the couple’s stance of prioritising quality of life for the children over medical operations and interventions, he said.

The review, commissioned by the Kingston Local Safeguarding Children Board (KLSC), made 14 recommendations including that parents be offered support and information when a child is diagnosed with serious conditions.

It also said the couple’s “affluent, middle-class status” may have contributed to a “different safeguarding response”.

The report said it became clear early that Clarence was “overwhelmed” with a large number of appointments and by the end of 2010, professionals began to identify she was possibly depressed.

In July 2011 Clarence requested the children be designated Do Not Resuscitate if the need for ongoing treatment arose, and expressed the family’s view that “medically invasive treatment was cruel”.

She declined any offer of counselling.

The report said at that point “there was nothing in the mother’s behaviour that suggested she would need to be detained in a hospital in the interests of her own health or safety, or with a view to the protection of others”.

Richard Egan, the family’s solicitor, said the family repeatedly asked for an intermediary to help with the 80 or so health professionals to which it was allocated.

Mr Egan highlighted a conclusion in the report that the “complex case … should not have been allocated to a newly-qualified member of staff”, referring to a change of social worker.

The report said that, in July 2013, consideration was given to the involvement of the police but according to the social care records, St George’s Hospital “did not think that would be helpful”.

KLSC Board chair Deborah Lightfoot said: “While the review states that all of the deaths were not predictable nor preventable, it has found that there are learning points for practitioners involved.”

The review stated: “There is no certainty that any of the findings would have made any difference to the tragic outcomes in this case.”

Spinal Muscular Atrophy Support UK spokesman Martyn Sibley welcomed the recommendation of information and support being offered at diagnosis as routine.

He said: “We are aware that this happens very well in some areas but it is not consistent across the country.”

The family was involved with various arms of the health care system as it moved from Merton to Wandsworth and later Kingston.

The review examined the role of staff at Great Ormond Street Hospital, St George’s University Hospital, Royal Brompton and Harefield Hospitals, and Kingston Hospital along with NHS GP services.

Disability charity Scope said the case showed how crucial emotional and practical support was for the families of disabled children.

Chief executive Mark Atkinson said: “Our recent research showed that four in five families with disabled children feel anxious and stressed at not being able to access the support services they need locally.”

He added: “Almost half of parents caring for disabled children have been to see their GP because of stress and worry.”