North Yorkshire County Council v C
| Jurisdiction | England & Wales |
| Judge | Mr Justice MacDonald |
| Judgment Date | 30 July 2021 |
| Neutral Citation | [2021] EWHC 2171 (Fam) |
| Court | Family Division |
| Docket Number | Case No: FD21P00312 |
[2021] EWHC 2171 (Fam)
IN THE HIGH COURT OF JUSTICE
FAMILY DIVISION
Royal Courts of Justice
Strand, London, WC2A 2LL
THE HONOURABLE Mr Justice MacDonald
Case No: FD21P00312
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Miss Jacqueline Thomas QC (instructed by North Yorkshire County Council) for the Applicant
The First Respondent appeared in person
The Second Respondent did not appear and was not represented
Ms Laura Twist (instructed by NHS England) for the Third Respondent
Nageena Khalique QC and Mr Martin Todd (instructed by Jones Myers Solicitors) for the Fourth Respondent
Mr Karl Rowley QC (instructed by Leeds City Council) for the Fifth Respondent
Hearing dates: 29 July 2021
Approved Judgment
I direct that no official shorthand note shall be taken of this Judgment and that copies of this version as handed down may be treated as authentic. Covid-19 Protocol: This judgment was handed down remotely by circulation to the parties' representatives by email. The date and time for hand-down is deemed to be at 10.30am on 30 July 2021.
This judgment was delivered in private. The Judge has given permission for this anonymised version of the judgment (and any of the facts and matters contained in it) to be published on condition always that the names and the addresses of the parties and the children must not be published. For the avoidance of doubt, the strict prohibition on publishing the names and addresses of the parties and the children will continue to apply where that information has been obtained by using the contents of this judgment to discover information already in the public domain. All persons, including representatives of the media, must ensure that these conditions are strictly complied with. Failure to do so will be a contempt of court.
INTRODUCTION
In this matter I am concerned with M, born in 2005 and now aged 15. M is represented by Ms Nageena Khalique QC and Mr Martin Todd of counsel. M has attended this hearing and listened quietly to the submissions that have been made. The mother of M is the First Respondent, C. The mother appears before the court in person. The father of M is the Second Respondent, F. He did not appear.
The applications in respect of M with which the court is seised are an application made by North Yorkshire County Council, represented by Ms Jacqueline Thomas of Queen's Counsel, (a) for permission to invoke the inherent jurisdiction and make M a ward of court, (b) for an order under the inherent jurisdiction authorising the deprivation of M's liberty and (c) for an injunction prohibiting Leeds City Council from discharging M from her current placement.
Also a party to these proceedings are the NHS Commissioning Board (otherwise known as, and referred to in this judgment as, NHS England), represented by Laura Twist of counsel, which is responsible for providing the medium secure tier 4 bed M has been assessed as requiring, and Leeds City Council, represented by Karl Rowley of Queen's Counsel, which manages the secure children's home in which M is currently placed.
BACKGROUND
M is a young person with highly complex needs and a significant offending history. She is currently placed at XY. XY is a secure children's home. It has capacity for 24 beds. Of those, ten are ‘welfare beds’ predominantly for children who are subject to orders made under s. 25 of the Children Act 1989. Those beds are allocated via the Secure Children's Home Network. The balance are ‘justice beds’ and are contracted to the Youth Custody Service. It was through the latter route that M came to be placed at XY in September 2020 pursuant to a Detention Training Order (hereafter DTO) following her being sentenced after her conviction for further criminal offences.
Over three months ago, on 22 April 2021, M was also assessed as requiring a medium secure tier 4 bed in a Medium Secure Unit. This followed a period in which M's presentation at XY had become increasingly complex and dangerous, regularly presenting a risk of harm to herself and to others. M was in a highly agitated and distressed state from early February 2021, necessitating prolonged restraint by staff and high levels of supervision and segregation. Medium Secure Units accommodate young people with mental and neurodevelopmental disorders who present with the highest levels of risk of harm to others. Across England there are only three services currently able to admit young females into medium security beds.
Within this context, the Position Statement provided by Ms Twist on behalf of NHS England for this hearing asserted that the NHS does not currently have the capacity to provide a medium secure tier 4 bed for M and that NHS England continues to concentrate on making such provision available for her in the medium secure estate. However, as I will come to, the position is, in fact, not so clear cut.
M's DTO came to an end on 6 June 2021. Ordinarily, this would have resulted in the placement at XY having come to an end as M was occupying a ‘justice bed’. However, prior to the conclusion of her sentence, on 3 April 2021 North Yorkshire County Council questioned the viability of M returning to the care of her mother at the conclusion of the DTO. In circumstances where it was considered that this would not be a viable option, and in circumstances where it was considered unlikely that a bed in a medium secure unit would become available by 8 June 2021, North Yorkshire County Council commenced a search for secure and non-secure residential placements. NHS England committed to providing funding for additional mental health support in the interim at XY in the context of the high level of need M displays and committed to continuing its search for a bed in a Medium Secure Unit.
As at 28 May 2021, the search conducted by North Yorkshire County Council had been unsuccessful and, in those circumstances, Leeds City Council agreed that M could remain at XY following the end of her sentence and until 28 June 2021 in order to permit North Yorkshire County Council to purchase a welfare bed at XY. Leeds City Council was clear that this arrangement was on the basis that XY was able to keep M safe for a short period of time but that such a placement would not be able to meet her identified clinical needs in the medium to long term.
On 7 June 2021, a day before the DTO was due to end, an order authorising M's deprivation of liberty at XY was made by Peel J. Following that order, it became clear that M required a higher level of segregation, supervision and support, both in order to meet M's needs and the needs of other young people at XY in ‘justice’ beds and ‘welfare’ beds. Within this context, on 23 June 2021 XY communicated to NHS England and North Yorkshire County Council a proposal that they contended would permit them to continue to accommodate M in the short term, namely:
i) That, in addition to the costs of M's placement, North Yorkshire County Council purchase two vacant welfare beds that would become available by 29 June 2021 (at a cost of £2,868.57 per night including M's current welfare bed) so that XY could freeze admissions on those two beds and re-direct resources to providing care for M.
ii) An increase in the level of complex care support currently funded by NHS England to twenty four hour care to account for an anticipated increase in the level of risk presented by M upon being informed that she would be the subject of an extended stay at XY.
iii) The continuation of weekly multi-disciplinary team meetings (MDTs) to ensure shared accountability for M and to update XY on progress with respect to identifying a medium secure tier 4 bed.
Whilst, North Yorkshire County Council have this week agreed to fund the additional beds at XY in the interim to allow some sort of stability for M until a Tier 4 bed can be identified or a bespoke health bed, once again it is important to note that the placement at XY is not capable of meeting M's needs beyond the very short term.
M continues to demonstrate challenging behaviours. At the present time, M's situation is as follows:
i) As at 12 July 2021, M has required 192 restraints in 2021.
ii) M is self-harming at a minimum of twice a day.
iii) M requires segregation and seclusion away from other young people in a locked unit.
iv) M has three XY staff members allocated to her from 0730 hrs to 2100 hrs. Two members of staff funded by NHS England attend to her from 0800 hrs to 2100 hrs. Additional staff are required when M's dysregulation necessitates it, for example when physical intervention and/or restraint is required.
v) Five members of staff are required at night. Observation of M in her bedroom varies between constant, 5 minute and 15 minute intervals depending upon the perceived risks and restrictions required. When on constant observation she requires one staff member observing her at all times; two when she uses the toilet and five if she needs to be restrained.
vi) M does not leave the unit. When she has required emergency medical treatment staff support has been between 4:1 and 6:1 as well as police and/or ambulance staff support on occasions.
vii) M has damaged property, resulting in the need for separation and restraint on 21 and 22 July 2021.
viii) M has assaulted staff on 22 and 23 July 2021, the latter assault involving M headbutting and kicking a staff member in the head.
Within this context, on 26 July 2021, Dr S undertook a further assessment of M. Dr S concludes that M continues to warrant placement under the provisions of the Mental Health Act 1983 in a medium secure unit. Specifically, Dr S concludes that M:
“…she 'needs the inpatient care and...
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