Case No.: 12484638
Neutral Citation Number: [2015] EWCOP 92
IN THE COURT OF PROTECTION 
IN THE MATTER OF THE MENTAL CAPACITY ACT 2005 

IN THE MATTER OF NB 

2nd October 2015 

Before: 

District Judge C.H.J. Hilder

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BETWEEN

LONDON BOROUGH OF TOWER HAMLETS
Applicant 
-and-

VW
First Respondent 
-and-

NB
(by her Litigation Friend, the Official Solicitor)
Second Respondent 

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H. Harrop-Griffiths for the Applicant Local Authority

J. Anderson (instructed by TV Edwards Solicitors) for the First Respondent

S. Reeder (instructed by Steel & Shamash Solicitors) for the Second Respondent by
her Litigation Friend, the Official Solicitor

HEARING DATES: 21st and 22nd September 2015

The proceedings were heard in private.

This judgment is being handed down and delivered to the parties by e-mail on Friday
2nd October 2015. It consists of 15 pages and has been signed and dated by the judge.

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JUDGMENT

INTRODUCTION 

1.	These proceedings are concerned with NB, who was born in 1993, and is therefore now 22 years old. The proceedings began as an application by the London Borough of Tower Hamlets for authority to remove NB from her family home. At the hearing on 21st and 22nd September 2015 the main issue to be decided was where NB should live for the immediate future, the options being either:

	 a. to remain living at P House (where she has lived since 29th April 2015), at least while the protracted search for a long-term placement is pursued; 	OR 

	b. to put in place (either for the long-term or as interim measure) a ‘shared care’ arrangement, whereby NB returns to live with her mother for 4 nights a week, and spends the other 3 nights a week at P House 	(or such other placement as may be identified in due course.)

2.	At the conclusion of the hearing late in the afternoon of 22nd September I was invited to give my conclusion on this main issue. I informed the parties, with NB herself present in court, that I considered it in her best interests to remain living at P House while a permanent placement is sought. 

3.	 Although offered an immediate ‘ex tempore’ explanation of the reasons behind the conclusion, Mr. Anderson on behalf of VW (who is NB’s mother and the First Respondent in these proceedings) asked instead for written judgment. 

MATTERS CONSIDERED 

4.	I have read the following documents: 

	a. Filed on behalf of the Applicant: 

	Position statements dated 24th February, 3rd July & 14th 	September 2015 
	Statement by Janet Eweka dated 28th March 2014 
	Statements by Nina Ezekiel dated 12th May, 12th August, 26th 	September 
	2014, 27th January, 20th March, 22nd April, 16th June and 	4th September 	2015 
	Statement by Bright Okeyere dated 27th January 2015 

	b. Filed on behalf of the First Respondent VW: 

	Position statements dated 26th February, 2nd July & 18th 	September 2015 
	Statements by VW dated 28th April 2014, 9th February, 27th March, 30th 
	June 

	c. Filed on behalf of the Second Respondent NB: 

	Position statements dated 24th February, 6th July, 1st & 17th September 2015 
	Statements by Janice Kaufman dated 24th February & 18th September 2015 
	Statement of the Official Solicitor dated 22nd April 2014 

	d. Expert assessments and reports 
	Dr Kabir, dated 6th January and 2nd April 2014 
	Dr. Hall, dated 8th May, 29th July & 1st September 2015 
		Dr Kabir & Dr Hall dated 14th August 2014 
	Niah Gaynair dated 13th June 2014 
	Dr Rippon dated 29th July 2014 
	Dr Fitch dated 18th August 2014 
	Dr. Sahni dated 21st August 2014 and 27th August 2014 
	Dr Ezeokwuka dated 26th August 2014 
	Laura Copsey OT dated 22nd April 2015 
	Keith McKinstrie ISW dated 19th December 2014 & 13th April 2014 

	Various e-mails, placement reports and follow-up assessments (in section E 
	of the hearing bundle) 

	e. Care Plans 
	Contained in section D of the hearing bundle, ranging in date from 14th April 
	2014 to 29th June 2015 

	f. Miscellaneous 
	Documents contained at sections F and G of the hearing bundle, including 
	incident reports and contact notes 

	Documents produced at the hearing, including: 
	NB’s Support Plan dated 18th September 2015 
	a CQC report on O Gardens 
	VW’s housing appeal application dated 14th August 2015 
	OT rehousing needs assessment report dated 28th August 2015 

5.	Most of these documents were collated into a bundle of 3 files for the hearing. 
	Where there are numbers in brackets in this written judgment, they are 
	references to pages in those files. 

BACKGROUND 

Before issue of these proceedings 

6.	NB was born in Canada. From the age of 6 she was placed into the care of the Local Authority and from September 2007 she attended a residential school in Herefordshire. Family contact was maintained by telephone calls and visits. When she reached 18 in 2011, NB returned to live at the family home in London. 

7.	NB has autistic spectrum disorder and a moderate learning disability. Her understanding of and her ability to manage living situations are affected, and she displays challenging behaviour. She is functionally able to complete virtually all personal care tasks, with some prompting and practical support but she tends to adopt set routines, any interruption of which causes her anxiety. Her speech is affected by echolalia and stammering but she is able to write and to make her wishes known. If anxious, or feeling that her wishes have been thwarted, NB may become angry and can grab or strike out at whoever is around her. 

8.	NB’s return to living with her family is said to have been managed less well than it should have been and in due course difficulties arose. NB displayed agitation, anxiety and distress; and the family struggled to manage her needs and behaviour. 

		a. In November 2013 it was reported that there had been a physical 
		altercation between NB and her sister R. 

		b. In December 2013, security guards were involved with removing 		NB from a shopping centre when she became distressed on a family 		shopping trip. 

		c. Then in March 2014, VW brought a suitcase of NB’s possessions to 		the Local Authority offices saying she wanted a break. When NB was 		delivered home from her day care centre she was not let in, and so was 		delivered instead to the Local Authority offices. After speaking to her 		mother on the phone, NB tried to run away, in the process hurting her 		head on a glass window. Both police and medical services were called. 		NB finally returned home some time after midnight. (C143)

From involvement of the Court

9.	By COP9 application dated 28th March 2014 (B39) the London Borough of Tower Hamlets applied to the court for authority to remove NB from the family home. 

10.	At the first hearing on 29th April 2014, after discussion the parties in fact agreed to work together to support NB’s continued residence at the family home, and further agreed that such co-operation would include the preparation of an amended support plan and consideration of any request for additional support. Various directions were given (B89). 

11.	The realisation of the parties’ agreements was interrupted by events and a change of arrangements: 

	a. VW went to Jamaica between 30th May and 21st June, on a trip which 	had 	been arranged before the Court hearing but not disclosed to the Local 	Authority, the Official Solicitor or her own representatives. NB was provided 	with respite care at HITP whilst her mother was away but that placement 	unfortunately was characterised by incidents of verbal and physical 	abuse of staff. 

	b. Shortly after NB had returned home, on 31st July 2014 there was an 	altercation when NB is said to have bitten her mother and tried to push her 	downstairs. NB was returned to the HITP again (E772), and the Local 	Authority sought urgent direction from the court. 

12.	There was a hearing on 28 August 2014. The order made (B108) included 

	a. final declarations that NB lacks capacity to litigate and to make 	decisions 	about where she should live, how she should be cared for and the contact she 	should have [with family members]; 

	b. an interim declaration that NB lacks capacity to consent to particular types 	of medication; 

	c. provisions to bring about NB’s move to a supported living placement at LG; 

	d. directions for joint instruction of an independent social worker. 

13.	NB moved to LG immediately after the hearing. She did not settle smoothly. In September she made allegations of assault by staff (C204, C212) (which were subsequently withdrawn); and there was some difficulty around contact with VW, involving violence by NB. In October and November 2014 there were incidents when NB was aggressive to the staff, and the police were called. More positively, the Christmas and New Year contact with VW was reported to have gone well. 

14.	On 26th February 2015 what was supposed to be a final hearing on the question of where NB should live began before me. The options for the Court to consider were said to be remaining at LG, returning to the family home, or moving to a new placement to be offered by the Hoffman Foundation. It was NB’s very strong wish that she attend this hearing. She stayed throughout and explained to the court herself her wishes and feelings with determination and dignity. 

15.	Over the course of oral evidence from Arun Manuel (deputy manager of LG), Nina Ezekiel (social worker) and Keith McKinstrie (Independent Social Worker) it became apparent that there was in reality no clear identification by the Local Authority of an appropriate placement for NB to move to on a permanent basis. The allotted hearing time concluded not with a final order but with further directions intended to secure such information. It was provided that NB was to remain living at LG meanwhile, with specified unsupervised contact arrangements. 

16.	By the time the matter came back to Court on 23rd April 2015, NB had been given notice that her placement at LG was to be terminated. Faced with very limited options, the parties agreed “the least worst option:” that, as an interim measure and with careful transitional arrangements, NB should have a ‘shared care’ residential arrangement between her mother’s home and (an untested) residential care home at P House. The Court indicated at the hearing its endorsement of such agreement and the legal representatives agreed to draw up and submit a draft order for approval. Such order was drafted and submitted but never issued because by the time it was referred for approval, matters had again moved on. 

17.	Within a few days of the hearing, VW notified the other parties that her circumstances and her intentions had changed and NB could not in fact move to live, even on a shared care basis, with her. VW’s subsequent statement (dated 30th June 2015 – C529) gives her reasons as follows: 

	a. the planning for the return home had been inadequate and left too much 	of 	NB’s timetable uncertain; 

	b. there had been too little detail given on the support which would be 	provided to VW; 

	c. without the facilities and aids (in particular an autistic-friendly shower and 	a planner board) which had been provided at the previous placement but not to 	VW, the move home would be unsustainable; 

	d. On 29th April, VW’s son H had moved back to live at the family home, sleeping in the room which NB regarded as ‘hers’, “too scared to go back” to his previous semi-independent placement; 

	e. “I do not believe that my home at …is suitable for NB, partly because of 	a lack of space.”

18.	So, instead of any shared care arrangements being implemented, on 29th April 2015 NB moved to P House full time. On 15th May an order was made by consent to reflect and authorise this arrangement, and giving further directions for identification of medium and long-term residential options to meet the recommendations of the ISW, Mr. McKinstrie.

19.	The matter came back to court on 7th July for a review hearing. At the request of all parties, NB was told by me that she could not return to her mother’s house; that everybody now agreed she needed special care, and would be looking for a new home for her. An order (B131) was made which provided for assessment of a proposed permanent placement at O Gardens, with directions for transition planning, and for a round table meeting between the parties to consider the conclusions of such assessment. Directions were given for the parties to submit a consent order for consideration if they were able to reach agreement; and in respect of the final hearing if they were not.

20.	On 21st July the Local Authority received notice from P House that NB’s place was being terminated after incidents of challenging behaviour, including property damage (C538). After considerable efforts were made by the Local Authority to address the concerns of the staff and management of P House, the notice was withdrawn. NB has been able to remain living at P House to date.

21.	At the outset of this hearing, 

	a. the Applicant’s position was that NB should continue to live at P House 	until an appropriate long-term placement could be identified, which was 	thought likely to be in July 2016 with the opening of a new in-borough 	facility; 

	b. VW sought an immediate progression to a ‘shared care’ arrangement, 	whereby NB spent 4 nights at week at the family home, and 3 nights a week at 	P House, on a permanent or at least a trial basis; 

	c. The Official Solicitor’s written position was that the assessment process 	directed in July had failed to be completed properly (and, this having been 	apparent at the round table meeting, the OS had delivered his position 	statement some 3 weeks ahead of the final hearing “in an attempt to galvanise 	the parties to focus on suitable available long term residence and care 	options”) but that O Gardens still offered some immediate prospect of 	appropriate long-term placement. As a result of discussions between the 	parties and the late production of a CQC report, the O Gardens option was 	discounted. The Official Solicitor’s orally-stated position when the hearing 	began was therefore that the Court has no suitable options before it to 	consider.

22.	Given this lamentable situation, and the anxiety which all agree that NB is caused by these proceedings, I required the parties to identify and set down in writing such issues as were capable of resolution at the hearing. The agreed list of issues reads as follows: 

	“1. whether there is shared care as a long-term solution; 

	2. If not, whether pending a log-term placement there is shared care or NB 
	remains at P House in the interim; 

	3. In any event, whether the proceedings continue or not; 

	4. If proceedings continue, the directions to be made.” 

23.	In addressing those issues, I heard oral evidence from Mr Najoo (the Manager of P House), Nina Ezekiel (NB’s social worker) and VW. I have of course also had the benefit of reading those documents identified above, hearing evidence in February (including from the Independent Social Worker Mr. McKinstrie) and of hearing from NB herself. 

THE EVIDENCE 

24.	Keith McKinstrie (ISW) : In his first report of December 2014 Mr. McKinstrie noted in respect of NB living with her family that: 

	“the period NB and VW lived together was characterised by VW and NB 	refusing to engage with health and social care professionals other than in 	response to a crisis, arguments between NB and VW that could on occasion be 	violent, VW seeking respite care for NB and NB refusing to allow support 	workers to care for her as she considered this should be done by VW. 
	It is my opinion, should NB return to the care of VW, their relationship is 	likely to revert to the same dynamics and patterns as previously, which were 	physically and emotionally harmful for both…” (E807) 

25.	In respect of shared care, Mr. McKinstrie noted that: 

	“NB has a need for predictability and routine in her life. In my view a shared 	care arrangement will not provide this. The care and support she receives from 	VW and from carers in her placement will almost inevitably be different and 	inconsistent. “(E810) 

	“A shared care arrangement would only have a chance of working in NB’s 	best interests if all those caring and supporting NB agree how her needs 	should be met and are willing and able to abide by a protocol that prescribes 	their practice. 
	Previous experience implies VW would find it difficult to work cooperatively 	with health and social care professionals if she disagreed with what was 	proposed by either the local authority or the placement provider as to how her 	daughter should be cared for and supported. 
	Similarly a placement provider would be unwilling to compromise their 	practice if they considered what was proposed by VW was either not in NB’s 	best interests or counter to their organisational principles or ethos.” (E811) 

26.	In his second report of April 2015, after the L G placement had collapsed, Mr McKinstrie 

	a. “consider[ed] the suitability of [living at the family home] to be largely 	determined by the availability, or lack of availability, of any alternative 	potential placements for NB.” (E862) 

	b. “…in the absence of a viable alternative long-term placement … now 	consider[ed] it to be in NB’s best interests to return to live with VW rather 	than a series of unplanned, short-term placements, should these be available.” 	(E869) 

	c. maintained the opinion that ”living with VW would not provide NB with 	the consistency and routine she requires in order to feel sufficiently safe and 	secure. This may lead to NB’s behaviour becoming increasingly challenging 	to those around her and a further unplanned removal from home.” (E869) 

	d. remained of the view that “there are a considerable number of 	disadvantages that outweigh any possible advantages of NB having her care 	and support shared between VW and a residential placement and this should 	not be considered.” (E869) 

27.	Mr. McKinstrie was present at the hearing in April 2015 and, so the court was 
	informed, had “useful” input into the arrangements agreed between the parties 	on that occasion. 

28.	Mr Nujoo (Manager of P House): In oral evidence Mr Nujoo explained that he thought NB was currently more settled at P House. He confirmed that NB does use the communal areas, and he explained the quite complex regime in respect of NB’s use of ‘as required’ medication. He confirmed that NB’s placement at P House could be kept open for a shared care arrangement but he questioned how well outreach staff would be able to cope with transition journeys because they would not know NB well, explaining that NB had “said ‘no’” to two agency staff whom he had tried to recruit. It was his view that “leaving home is different to leaving class…it’s a different level of anxiety” for NB. When asked by Mr Reeder, he agreed that a shared care arrangement “creates more risk” of encountering behavioural challenges such as might lead to breakdown of the placement at P House. 

29.	Ms. Ezekiel (social worker): In oral evidence Ms. Ezekiel expressed her concern that NB “would find it very hard to get over the loss of her room” in the family home. She agreed with Mr. Anderson that the proposed shared care arrangement offered a “structured respite” which was “more promising” than historical arrangements but expressed concern that NB’s time at P House would be at weekends, the very time which had previously been considered “family time,” which she may experience as distressing rejection. Ms. Ezekiel felt that much depended on handover arrangements, and the experience of contact sessions suggested to her that leaving home would cause NB “a lot of distress.” 

30.	Ms. Ezekiel considered that NB’s current wishes were “to be in a place where she can be cared for.” She acknowledged that VW “has tried hard,” and that “if sustainable, Mum should be tried” but ultimately she felt that a return to the family home would not be sustainable. She felt that the relationship between VW and NB was “already at breaking point and NB’s needs can’t tolerate that.” She referred to comments made “as recently as Tuesday 15th” by VW about balancing the demands of NB and her other children – not meant to hurt NB, but having that effect. She felt that VW’s household was “resourceful but people are busy. It would all fall on mum. It’s not sustainable.”

31.	Ms Ezekiel was quite positive about P House. She considers that the staff there are “trying to get it right now” and NB is reasonably settled and stable: In May, shared care was the ‘least worst’ arrangement but it isn’t now – [NB] is reasonably settled and still has good relations with her family.” She considered that, in contrast, shared care would limit NB’s opportunity to grow into adulthood. 

32.	VW: VW confirmed that she was proposing that NB stay at the family home for Monday, Tuesday, Wednesday and Thursday night of each week, and return to P House for the weekends, with transition journeys arranged through Ms. Ezekiel. She proposed in oral evidence that NB would have her room back, that her younger son T would have the box room, she and her husband their usual room and her older son H “would sleep downstairs.” She explained that H is very nearly 18, had a baby of his own and “they’ll be giving him a flat at some point.” She did not agree that there would be any pressure on NB’s use of the bathroom because the other members of the household would be up and out before NB wished to use it. 

33.	VW raised her concerns that NB was not eating properly at P House and as consequence putting on weight. She explained in startling terms the effect she feared this might have on NB. (It was apparent in court that her evidence caused NB some distress at this point.) 

34.	When asked about H’s return to her home, VW spoke passionately about her determination to meet the needs of all her children; how she has “beaten my care orders” because her children all want to be with her. She referred to having to take NB to a blood test recently and how this demonstrated that “you can’t tell me about care bearing in mind what they can’t do for her.” VW understood the concern about sustainability of NB returned to live at least partly at home but considered that placement anywhere else would be unsustainable: “I’m holding those placements together. She phones me every day. I am the key person.” 

THE LAW 

35.	I have regard to the principles of the Mental Capacity Act 2005 as set out in section 1, and in particular the requirement at section 1(5) that my decision must be made in the best interests of NB. 

36.	In determining what is in NB’s best interests, I have regard to section 4 of the Mental Capacity Act 2005 and in particular the requirements at s4(6) to consider NB’s past and present wishes and feelings, her beliefs and the values that would be likely to influence her decision if she had capacity; and at section 4(7) to take into account the views of anyone engaged in caring for NB or interested in her welfare, which I consider clearly includes the views of VW. 

37.	I have been referred to 

	a. the decision of Peter Jackson J in A and B [2014] EWCOP 48, and in 	particular his reminder that the Act requires “a sensible decision” in the best 	interests of the protected person, not the pursuit of perfection; and 

	b. the case of K v A Local Authority [2012] EWCA Civ 79, in respect of 	which it is common ground between the parties that the court must determine 	the best interest decision as required by Mental Capacity Act first; and then 	cross-check that decision against Article 8 requirements. 

THE BALANCING EXERCISE

38.	The relationship between NB and VW: Before considering the specific question of where NB should live, it is important to recognise the importance of the relationship between NB and her mother. I have no doubt at all of the strength and sincerity of VW’s wish to have NB live with her, or her belief that this would be in NB’s best interests. It is very clear to me that VW loves NB, wants to do her best for her, and is willing (in Mr Reeder’s words) to “step up to the mark” for her. 

39.	However, it is also clear to me that the relationship between VW and NB is informed by their historical separations. They have lived apart longer than they have lived together, and VW expresses a conviction that such separation will be overcome (in respect of all her children) with a sense of grievance. In return it is common ground between the parties that NB is particularly demanding of her mother’s sole attention. In reality, the demands of caring for NB are great. The practical experience of living together since NB returned to the family home on reaching majority is that there have already been two occasions (in March 2014 and in April 2015) when VW felt unable actually to provide the care which NB requires. Faced with competing demands, VW was not able to give NB’s needs priority. I agree with Mr. McKinstrie and Ms. Ezekiel, that there must be a significant risk that VW would again reach a point of feeling unable to cope, with further emotionally damaging consequences for NB. 
 
40.	The wishes and feelings of NB: NB has mostly expressed a clear wish to live with VW. That is what I understood her to be saying when she spoke to me in court. Latterly, there is a suggestion that her wishes may be more nuanced. Her most recent written wish was to “leave P House and go to a different care home or live with family” (C610). Ms. Ezekiel considers that she really now wants to live somewhere other than P House where she will be cared for. It seems to me likely that NB’s recent expressions owe something to the mixed messages she has received from the progress of these proceedings to date. 

41.	Shared Care: In the statements and reports filed there have been various analyses of the advantages and disadvantages of NB returning home on a full time or a shared care basis, but not of precisely the proposal VW puts before the Court today. 

42.	I consider the benefits of VW’s proposal of shared care to be as follows: 

	a. Goes some way to meeting NB’s wishes: NB has not expressed a wish for 	shared care but the proposal would mean that NB spends significant periods of 	time with VW. Family relationships, which are very important to NB, could 	be maintained. 

	b. Familiarity: NB is now familiar with both the family home and P 	House, so combining the two in her weekly routine would not require her to 	adjust to any new surroundings. She could continue with her known activities, 	such as Poetry in Wood. Three nights a week at P House amounts to a planned 	and stable arrangement which could be explained to NB in advance and which 	could potentially become part of her routine. 

	c. Continuity: NB would benefit from continuity of care by CLDS 	professionals with whom she is familiar. 

	d. Respite: NB and VW could use the P House placement for periods of 	respite support, so relieving some of the strain of VW providing sole 	care.
	 
43.	I consider the disadvantages of VW’s proposal of shared care to be as follows: 

	a. New domestic arrangements: the domestic arrangements at the family home  have changed since NB last lived there. Her brother H now lives in the household, and NB’s relationship with him is an unknown quantity. He has been using the room which NB regards as ‘hers.’ I accept Ms. Ezekiel’s evidence that, if this were to continue, NB would find it very distressing. The alternative proposal 	is that H sleeps on a blow-up bed downstairs. I agree with the assertion of the 	Official Solicitor that this arrangement would be likely very quickly to leave 	the whole family living in cramped conditions, without the communal living 	space which NB is accustomed to and needs, with consequent strain and risk 	to NB’s ability to cope. 

	b. frequent transitions: the shared care proposal would require NB to leave her 	family setting every week. It is generally agreed that NB finds partings 	difficult. Mr Mckinstrie noted (E810) that NB would be likely to find shared 	care arrangements potentially confusing and disruptive, and find it difficult to 	leave the family. NB has refused respite before. It seems to me much more 	probable that she will resist separation from her mother and become distressed 	(as Ms. Ezekiel and Mr McKinstrie suggest) rather than accept it as an aspect 	of routine with a promise of return (as VW suggests). 

	c. inconsistent care: NB’s special needs are such that she requires stability, 	consistency and routine. I accept the evidence of Mr. McKinstrie that a shared 	care arrangement, almost inevitably, means inconsistency -two different care 	regimes, each unlikely to change to match the other. Moreover, within the 	family home setting, VW has to date found it difficult to prioritise NB’s needs 	and balance them with the needs of her other family members, leading to an 	experience of inconsistent support for NB. 

	d. sustainability: any shared care proposal depends to a high degree on the 	various parts of the arrangement being able to work together constructively. 	This particular proposal also depends heavily on VW being able to meet NB’s 	needs during the ‘home’ period. Experience demonstrates that such demands 	have not been sustainable before. It is acknowledged that VW has done 	considerable work with psychological services in the duration of these 	proceedings, but her own evidence was that she had not found this helpful and 	she has effectively stopped going because she did not see any use to it. I can 	find no basis for confidence that the difficulties which were experienced last 	year would somehow not occur again. Consequently there is, I consider, a 	very high risk that the proposed shared care arrangement would not be 	sustainable, with emotional damage to NB as a consequence. 

	e. Not supportive of developing independence: Ms. Ezekiel considers that 	NB’s fixed preference for her mother’s exclusive attention would mean that 	the proposed shared care arrangement reduces NB’s prospects of developing a 	more independent lifestyle. However hard VW may try, experience suggests 	that Ms Ezekiel is right because NB would be less likely to commit herself to 	a more independent approach. 

44.	P House pending identification of permanent placement: The alternative option to the shared care proposal is that NB remains at P House until a permanent placement can be found for her. 

45.	I consider that the benefits of continued residence at P House would be as follows: 

	a. Familiarity: NB has now lived at P House for some 5 months. There have 	been difficulties but the staff are now showing commitment to her and have 	demonstrated willingness to adopt strategies which tackle challenging 	behaviour and have reduced incidents. NB is now familiar with the layout and 	approach of the placement. She can continue familiar activities, such as Poetry 	in Wood. 

	b. Proximity to family: It is said that P House is 36 minutes from the family 	home by public transport. This proximity makes possible the continuation of 	contact arrangements. 

	c. Other service users: the other two service users are young and verbal, and 	share some socialising opportunities and some interests with NB.

46.	I consider that the disadvantages of continued residence at P House are as follows: 

	a. Lack of permanence: it is not suggested by any party that P House is a 	suitable placement for the long term. It does not meet all of the “McKinstrie 	specifications” (as identified in the order made on 15th May 2015 (B124). In 	particular, there is only one bathroom. Moreover, if NB stays beyond the 	current proceedings, she will lose the support of her current CDLS team 	because the placement is out-of-borough. 

	b. Difficulties experienced: there have been several incidents of challenging 	behaviour from NB. The staff group is new and still stabilising. In response to 	difficulties, staff have called police (which exacerbates NB’s anxiety) and 	have previously given notice that the placement will be terminated. 

	c. Peer group: the other service users at P House are male, and do not 	share all of NB’s interests or her cultural heritage. 

	d. NB’s wishes: NB does not wish to stay at P House. 

	e. Health concerns: VW has expressed concerns that NB is not being given a 	healthy diet at P House, has put on weight and is at risk of developing diabetes 	(C646). 

CONCLUSIONS 

47.	Weighing all of the advantages and disadvantages of each option in the balance, I consider that the risks inherent in the shared care proposal significantly outweigh the benefits; and the disadvantages of remaining at P House whilst a permanent placement is found are less grave. 

48.	It follows that I do not consider the shared care proposal to meet the best interests of NB, either on an interim or a permanent basis. Although it is less than perfect, I consider that remaining at P House for the time being is in the best interests of NB. 

49.	VW may of course ask why, if there was nearly a shared care arrangement by consent in April, can there not be shared care now? The answer is in the changed circumstances. Unfortunately, NB’s life does not stand still whilst court proceedings are underway. 
	a. In April this year, there was an urgent need to move from the known 	quantity of LG without any other placement having been tried. In those 	circumstances, shared care seemed to offer relative stability and security. In a 	situation of very limited options, it seemed to provide “the least worse” 	option. 

	b. Now the position is different. VW’s domestic situation is more complicated 	– as she herself recognised when explaining why she subsequently resiled 	from the shared care agreement before it could be put into effect. It was her 	own considered conclusion (C530) that the shared care would in fact have 	broken down. On the other hand, the available alternative is less uncertain. 	NB has now tried, and is showing positive signs of settling at P House, so 	there is a known quantity against which a return home can be compared. 

So I am satisfied that, although a shared care arrangement was considered appropriate a few months ago, the court can properly take a different view today.

50.	Insofar as arrangements necessary to give effect to this decision may amount to a violation of Article 8 rights, I am satisfied that such violation is necessary and proportionate. 

51.	I acknowledge that these conclusions will come as a disappointment to NB and to VW. I would like to emphasis that the decision is based on NB’s best interest, not on a view of anyone’s “fault.” VW gave evidence with determination, and without wavering. She did her best to “step up to the mark.” I urge her now to do her best again to help NB accept the court’s decision, as she indicated she would. VW still has an important role to play in NB’s future. 

NEXT STEPS 

52.	After giving my decision, the parties agreed to discuss the further directions they sought and submit a draft order for consideration. The draft has as yet not 
	been received by the Court. Unless it is filed by 4pm on 7th October, I 	propose to list the matter for a brief attended directions hearing. 

District Judge C.H.J. Hilder 

2nd October 2015