See also: • Cascading Oppression • Uncle Adolf Syndrome • Educating Children • Arbitrary Art
Children Services Abuse:
First reaction to the Initial Assessment
12 May 2011
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Having read the Initial Assessment Dave was upset.  He wrote a draft response aimed at the Children Services but intended more for his own use in getting to grips with the dreadful content.  This is the duly redacted initial response.  It covers a lot of what is wrong with the assessment as well as some of what was wrong at the hospital.


THIS IS FOR MY OWN USE AND HAS NOT BEEN SENT TO CHILD SERVICES

Dear Obelix Mahjong

Thank you for your visit on Thursday 23 September 2010 at 4 p.m. with your trainee colleague Cathy.  It was pleasant to see you and at the time it was reassuring that the Children Services are interested in Helen's well being.

I have just read the "Initial Assessment" that you left with us.  It bewilders me.  At the moment I do not understand how you see Helen.  On the one hand she is a child deserving of societies protection and support.  On the other hand she is an adult and can be given a report like this for her to read and only her to read if she so wishes.

During your visit the report was given to Helen with the explanation that it was for her.  You did explain that if she wished I could read it also.  As we talked and Helen perused the report Helen got up and left the room.  You expressed your interpretation of her actions as being that the report had upset her.  I said I thought she had probably just gone to the toilet or something.  She came back some time later.

After you left she explained to me that the report had so distressed her that she left and burst into tears.  She had only read part of the section entitled "REASONS FOR INITIAL ASSESSMENT, INCLUDING VIEWS OF CHILD/YOUNG PERSON AND PARENT/CARERS" on page 1 & 2 of the document.  As I write she has declined to read any more of the report on the grounds that it distressed her too much.  I have read it several times.

I have a serious question that I would like addressed.  Why did you interpret her leaving as her being upset by the report?  I did not expect her to be that distressed.  I could well understand that some things in a report of this nature might upset her a little but I would not have expect her to be as distressed as she was after reading less than 18 sentences.  Having read the report I now fully understand.

Bearing in mind that the intention and purpose of the Children Services is the well being of Helen in this case I would like to address issues raised in this report.  You have expressed the view that your interest is to help us jointly and Helen in particular.  I hope you can stay focused on that objective.

My overview of this Initial Assessment is that it is shocking.  I am dismayed at the number of errors, inaccuracies, lies, implications, allusions, prejudices and interpretations contained within such a limited number of words.

Specific Comments in response to the Initial Assessment left with us on 23 September and dated 6 September 2010.

CHILD/YOUNG PERSONS DETAILS

On page 1 the Main Contact Number is incorrectly stated as being 01234 567890.  The correct number is 01234 567890.

REASONS FOR INITIAL ASSESSMENT, INCLUDING VIEWS OF CHILD/YOUNG PERSON AND PARENT/CARERS

This section has a very clear heading in capital letters and bold.  But the content clearly lacks a significant part of what is required.  The "REASON FOR THE INITIAL ASSESSMENT" has hardly been addressed.  This section simply seems to paraphrase a few statements from a nurse.  Is the "reason" for the assessment meant to be assumed from the nurses remarks?  The section heading quite clearly states "INCLUDING VIEWS OF CHILD/YOUNG PERSON AND PARENT/CARERS" but the only "view" is that of one nurse.  Not even social services' have offered an interpretation or reason.  No care has been taken to clarify what are the views of the nurse and what are assumed "facts" by the social services.  Helen was seriously ill in hospital and somewhat traumatised by the event.  Instead of being cared for she was demonised and "accused" of refusing treatment.  This accusation, which is incorrect, led to the hospital staff actually stopping her vital treatment with an attitude of "It's not our fault it's hers because she refused treatment."  Whilst I was seeking a solution to this unfortunate state of affairs the social services turn up and want to "investigate" us.  Ironic that they can arrive and talk to me for an hour and a half and interview the 16 year old "patient" for an hour and a half and yet the hospital had no facility to actually help with a deteriorating situation.  So, for three hours of interviewing Helen and myself there is not a mention of our views in this section.  This is an appalling and unacceptable omission.

The 5 paragraphs in this entry starting on page 1 contain factual errors, allusions, serious prejudice, omissions, assumptions and implications which are worrying.  The overall content of this section would appear meaningless except in so far as it is the opening statement to a serious report by the social services with a remit to act "in the interest of the child".

Following are some detailed comments about some of the problems encountered on reading the first 18 sentences of this report.

In this section there is a statement ... "Helen has expressed some concerns to the staff stating her parents separated some time ago and her father took her out of school a year and a half ago and started to home school her.  Sandy [the Sight (sic) Nurse] said Helen does not appear to have any outside contact."

Given the nature of the English language it would be difficult to assert that the statement is factually false.  However, given that the objective of the language is to convey the reality to which it refers then this statement is false and misleading.  In one sentence it states that Helen expressed concern (worry?) that her parents separated and that her father "took" her out of school.  This is entirely wrong.  Helen did express that she had had a hard time of her parents separating as a way of helping the nurses understand that she was nervous and vulnerable.  A situation that was openly discussed and understood at the time by many people involved in her treatment and care.  To take this subject and to portray it as Helen expressing concern about her parents separation is a serious misrepresentation of the facts.  To go on in the same sentence to refer to her "concern" that her father took her out of school is a serious deviation from the truth and represents a situation which is wholly untrue.  The implication is clearly that Helen is unhappy that her father took her out of education against her wishes.  This could not be further from the truth.  A more detailed description of the chain of circumstances can be provided but the truth is that Helen was finding it difficult to cope with the authoritarian and oppressive nature of school after several dislocations in her life.  Starting with the traumatic events of a bitter divorce and a very controlling, manipulative and treacherous mother Helen was then subjected to four house moves and three new schools in the course of two years.  This was intolerable and should never have been allowed to happen.  At the High School in Biston she was experiencing difficulties and a nervousness about going into school.  A very kind headmistress understood this and helped her achieve 100% attendance.  However, a less kind headmistress got involved and on one occasion when Helen was clearly unwell interrogated and intimidated her for over an hour whilst she was constantly in tears before phoning me and telling me a set of lies about Helen and that I should take her away from the school.  There was nothing I could do about this except to physically take her home.  Helen, understandably, would not go back.  We tried the Hospital School in the local hospital where the staff would not allow Helen to phone home if she was frightened.  I suspect this is illegal but I am not a lawyer.  It is still unacceptable and particularly since their specific role is to help children who are having difficulties.  This made this option impossible too.  We also sought help from CAMS and Helen did get some counselling.  I was then threatened with jail by the education department for "failing to provide a suitable education".  This is ridiculous because it was the education system that was failing both Helen and me in providing a suitable education.  But on the advice of a professional social worker I took the pragmatic route of home education to avoid depriving Helen of her father on top of all her other misfortunes.  Bearing in mind that Helen was already being deprived of any schooling this was the only way to prevent the situation getting far worse for the subject of this "assessment".

So in summary those two quoted sentences are a serious misrepresentation of what Helen said and of the situation in reality.  The implication is that she was expressing worry about her parent's divorce and her father " taking" her out of school as if that was against her wishes.  As it happens she was trying to help the staff understand that she was vulnerable and on a point of fact she was thrown out of the High School by Mrs. Jane Thornbush, acting Head, in what can best be described as a fit of emotional disturbance of her own probably brought about by the pressure of current SATS and the  impending OFSTED Inspection due the next day.

Then we come to one of several bizarre and blatantly untrue and disturbing claims in this report.  It states "..., he [the father] was laying on the bed with her on the ward."  The reason I say it is bizarre is because on the one hand there would be nothing wrong with such an action and on the other hand we live in such a paranoid culture that the implications and allusions are obvious and dreadful.  I am fully aware of our cultures erroneous assumptions and fears and of the acceptable conventions and behaviours.  On that basis I would not dream of resting, let alone lying, on her bed in the hospital.  That statement was not incidental.  There must have been a reason for the nurse to make such a claim and it is seriously worrying especially since nothing like that ever happened.  It is not incidental that it has been included in this report and I request and expect a complete retraction in writing from either the social services or, if necessary, from Nurse Sandy Shore.

The next sentence states "... and staff persuaded him to go home."  Again it is a complete misrepresentation of the facts.  The staff did not "persuade" me to go home at all.  I was anxious to go home.  I needed some sleep.  It was because Helen expressed the view that she thought she could cope if I went home for some sleep for a few hours that I decided it was reasonable to leave.

Now out of all the "facts" that could be represented on paper there are a select few chosen for this "assessment".  So each one seems to have its purpose.  What is the purpose of adding "...she stated she was into witchcraft."?  This is inaccurate, misrepresentative, out of context, and seemingly intended to conjure up prejudice.  This is an appalling abuse of this "assessment" process.  Read her notes and the forms that she was obliged to fill out, and all the disclaimers, in order to get treatment.  To suggest someone is "into" Christianity illustrates how the term "into" is deliberately demeaning  " ... er, like I'm, er, into Roman Catholicism! Doh!"  She was asked what religion she was.  In itself it is a dubious and presumptuous question which veils an agenda.  "Are you religious?" might be an appropriate first question.  However, Helen, not being guarded against such prejudice, thought about it and said Wiccan (a perfectly respectable if not mainstream religion).  To belittle and denigrate this elicited information for the purpose of besmirching a child is medieval and not befitting a 21st century social services report.  I suspect this information was confidential and that the nurse was not at liberty to divulge it let alone use it abusively.

The very next sentence chooses to impart another nugget of information.  I am beginning to wonder what the compiler of this report is trying to suggest.  I am wondering what the originator of these statements was trying to suggest.  What is the point of mentioning that Helen, on being asked if she was pregnant said that she wasn't but wishes she was?  What exactly is the point of this piece of information?  There is serious allusion and prejudice creeping into this report at this early stage.  For the record Helen was being innocently light hearted because she actually looks forward to having a family (apparently a laudable aspiration in our society).

The next sentence is yet another untruth.  It states "Helen had to undress and undressed in front of her father".  These choice nuggets, from all the available things that occurred during the period in question, are beginning to indicate a sordid undercurrent and agenda.  In this statement there is both a blatant misrepresentation and an insidious prejudice evident.  If taking your t-shirt off is "undressing" then Helen did undress in front of me.  However, to the reader of such a statement it is clearly meant to suggest that she was naked or at the very least that some of her private parts were revealed.  There is nothing inherently wrong with nakedness and this statement is clearly attempting to allude to something else.  But she never once revealed anything close to a private part either to me or any of the doctors or nurses.  There is something very sordid about this statement and given the surprising lengths to which doctors have to go to have "chaperones" if they are simply looking at a person's stomach the fact that a nurse has made this false claim is worrying and, since it is in this report, needs addressing.  It is a lie.  It is meant to imply something inappropriate and it needs removing or investigating.  The closest thing to Helen undressing in front of me was when a doctor asked her if he could look at her tummy and I asked Helen if she would like me to leave.  Helen expressly didn't want me to and there was a chaperone "witness" brought in for the doctors safety.  On top of that nothing close to anything "private" was revealed.  This statement is a disgusting, blatant and deliberate attempt to suggest something inappropriate.  Having dealt with the untruth now to deal with the insidious prejudice.  Would the same statement have been deemed relevant to include if I were Helen's mother?  I suspect not and there lies the prejudice.  This is appalling in the extreme and I suspect the nurse in question, if these "facts" are not being reported incorrectly or out of context, has her own problems.

The next statement "Sandy said the father is persistent he wants to stay on the ward." is another case of misrepresentation.  The implication is clear that somehow I, quite independently and inexplicably, wish to stay on the women's gynaecological ward.  No, I am Helen's father and her sole parent.  Particularly because of what she has been through she is more insecure and dependent than an average 16 year old might be.  She was understandably extremely disorientated and frightened.  She wanted me to stay and as her father and sole carer I would stay with her.  Had she had a mother it would have been more appropriate for her mother to stay with her until she settled down.  Would the same issues have arisen if I were her mother?  I was not persistent that I wanted to stay on the ward.  Helen was "insistent" that I be there when she was being medicated.  Here is another frightening example of prejudicial interpretation and representation of events.  The report does go on to say that "Sandy and the staff are finding his [my] behaviour quite strange."  I have to say that with such prejudicial and unfriendly behaviour I guess that Sandy and some of the other staff are not used to having their orders either questioned, or refused if they are unreasonable.  They were certainly put out by the fact that Helen seemed to have a mind of her own and was able to be rational and coherent in her questions and answers to them.  The statement that "Mr Hook (father) stated to staff he would like Helen to see a counsellor as she is scared of staff" is misleading too.  It would be better put "Mr Hook asked the staff if they had any facility like mediators or counsellors to help in difficult situations where the staff and patients are getting polarised and the situation is getting out of hand."  It would be as true to say that Mr Hook stated to staff he would like the staff to see a counsellor.  As it happened the staff didn't understand what I was asking.  They didn't seem to recognise that there was a problem developing.  All they seemed to perceive was that something was going wrong so it must be the patient or Mr Hook.  I would speculate that this is part of the explanation for the previous bizarre explanation of events and misrepresentation of them.  It simply didn't seem to cross their mind that a solution was required not simply more of the same forceful insistence.  It took the head surgeon to understand the situation and it was clear to him, as he made clear to all present, that the well being of the patient was the primary concern and that if it were possible she should be on the child ward or at the very least in a single room so that her parent could be with her.  He understood and accepted that Helen required me to be with her when medication was being applied.  He put it to the nurses that part of his prescription for the treatment of Helen was that her father be with her when she was medicated if that was what she wanted.  That was all it took for all the staff to suddenly "understand" the situation and they behaved much more reasonably from then on.

Those are some of the more obvious problems with the individual statements in this section.  There is a serious problem with the content of this section as a whole.  It does not include the views of the child or parent.  It does nothing to explain the relevant circumstances.  It focuses on a very limited number of comments alluding to a dark interpretation of Helen's father.

Helen was on an adult women's ward.  Helen is only just 16 and all staff and doctors involved considered she would be better off on the children's ward.  There is good reason for this.  There is much research which indicates that all humans survive and recover better with tender loving care.  Because children are more vulnerable emotionally there is even a special case made at the Biston Hospital and many National Health Hospitals.  They provide a "children's ward" where the children are treated more gently, with more affection, with less robustness and more understanding.  They also facilitate a family member staying with the child if required because they know this is a significant benefit.  It follows that the reverse, to disallow a parent staying, is quite overtly an unhelpful and un-therapeutic thing to do.  Especially when the child is overwhelmed by the whole situation and frightened.  Helen was in a fundamentally inappropriate situation and this context is not even alluded to in this report.  The fact that she was on a women's gynaecological ward which would prefer not to have "males" present was another unfortunate inappropriateness.  Given that the false allegation that Helen (as a child) had refused treatment was what gave rise to the social services investigating I am bewildered as to why the decidedly and obvious inappropriateness of the circumstances have simple been ignored.  It is as if Helen was behaving abnormally in a "normal" situation.  The report is in danger of suggesting that "therefore" there is something wrong with Helen.  And of course as it is the Children Services doing the investigation on "behalf of the child's interests" there is a danger that another "therefore" follows and that is that there is something wrong with her parent.  This opening gambit of the report heavily suggests there is something wrong with "Mr Hook's" behaviour.

The innuendoes, allusions and implications of some inappropriate sexual issues in this report are extraordinarily worrying.  It was seven years ago that the divorce occurred and my ex-wife, Helen's mother, tried every trick in the book to cause distress to both me and Helen.  She tried social prejudice, financial prejudice and sexual prejudice.  She tried to suggest that I was mentally ill, she tried to suggest that Helen was mentally ill, she tried to suggest I was impoverished, she tried to suggest I was violent, she tried to suggest I was alcoholic, she tried a vast range of assaults.  A huge amount of damage was done.  She constructed an illegal referral to a psychiatrist for Helen which, incidentally was turned down, and the doctor involved wrote an apology to me for his mistake in believing her and representing what she said as fact.  She self harmed to convince the police that I was violent.  She alluded to serious sexual abuse which led to an intensive investigation.  I mention all of this because this is the context in which these current events are placed.  Given that less than 5% of contested residence cases in Britain are granted to the father and all of those involve either male children or groups of sibling it was a severe battle and a vindication of any suggested or actual accusations against me that after lengthy and detailed investigation and consideration the courts awarded residence for Helen with me.  There is no statistical indication of a sole, young, female child being granted residence with the father by the courts in this country.  I tried numerous solicitors before I found one who would even take on the case.  The sexual prejudice is rife in our culture.  In spite of all that pressure and investigation not only did CAFCASS recommend that Helen reside with me but the social services were delighted to report that there was NO QUESTION about anything inappropriate going on.  The courts granted residence and because of the ex-wife's continued and extreme harassment a judge even ordered (without agreement from the interested parties) a reduced contact time for the mother.  I was informed by my solicitor that this was a precedent in English law.

The reason for stating all of this is because the whole affair for the first two days in the hospital was rife with prejudice and it has evidently carried over into this report.  The issues of manipulative, controlling people lying and using trickery to get Helen to do what they want without giving her due respect as a human being was understandably very provocative of the tragic and traumatic divorce.  I don't suggest that the nurses deliberately lied but they denied her feelings, they deceived both of us and it was clear that they were more concerned that they couldn't be accused of doing anything wrong than with their patients recovery.  It seems to me this is the consequence of this blame culture in which we live.

It may seem serious to claim that we were lied to but it is the fact.  It is also a fact that we were deceived and tricked.  Assuming that the nurses were not consciously intending to be malicious and did not think of their actions and words as deceptive and manipulative then it would give some understanding to why, when our response to them was not as they expected, that the conclusion was that we were acting strangely.

I am Helen's father and as such I will stand by her and where appropriate support her and defend her rights as an independent human being.

SOURCES OF INFORMATION

Date(s) Child/Young Person And Family Members Seen/Interviewed

I am a little surprised, given that the ONLY source utilised in the previous section (a failing in itself) was one nurse who had been with Helen for a fraction of her time in hospital, that the ONLY "sighted" source of information in this section is Helen.  This is unacceptably inaccurate.  Helen, a patient in hospital, was interviewed for an hour and a half and I was interviewed for an hour and a half whilst exhausted but there is no mention of me.  There is no mention of the nurse or any other staff interviewed.

And the date is wrong it was 6 September 2010 when Helen was interviewed and not 11 August 2009 as stated in the report.

Involvements Contributing To Initial Assessment

It also seems lacking that there were two people from the Children Services who interviewed both Helen and myself and it was the other person (other than Obelix Mahjong mentioned here) who did nearly all the talking and questioning.  This "other" person is not mentioned.

HEALTH

Stunningly wrong!

Child's needs:  Please give details including strengths and current needs

I simply do not understand the content of this section.  It claims that nursing staff state that Helen would not allow medical staff to examine her and refused x-rays and scans, so a diagnosis was not made until 5/09/10.  What is that about?  It is simply totally untrue.

I phoned the medical services and was told to take Helen to the hospital where someone would see us at a specified time which if I recall correctly was 02:20 hrs on 3 September 2010.  We arrived at the allotted time and there was NO MEDICAL STAFF in evidence.  Two male cleaners had to let us in.  We waited at the medical reception area for at least 15 minutes.  The only human contact in this area was a pair of female cleaners who got Helen a plastic cup of water.  When a doctor finally arrived Helen was diagnosed with suspected appendicitis and we were moved to another holding bay.  The wait was extremely long.  No one offered an explanation.  No one paid any attention or made sure that Helen was comfortable.  I had to independently locate some water for her.  Eventually a team of medical personnel arrived and immediately examined Helen, took blood and fitted a cannula.  I can't speak for when they made a final diagnosis but there is no question that Helen complied with all their suggestions for examination and treatment.  There was no suggestion of an x-ray or scan to be refused.  Helen was then moved to the adult gynaecology ward and as far as I recall given antibiotic intravenously.  There was a point later in the day that Helen was being given more medication and it was painful and she was frightened and she was getting no respectful consideration by the staff and a strange lady arrived with a wheelchair and told Helen that she was going for a CT scan.  The lady made no effective communication with Helen and Helen asked what this was for.  The lady evidently didn't deem it required to explain anything to Helen and as far as I recall the only information that was given to Helen was that it might cause her never to be able to get pregnant and she was asked if she accepted this.  Helen did not either accept or refuse.  She wanted to know what this was about as she had not been told anything about what was happening to her.  At this the lady said that if she didn't come now she would miss her slot.  She waited for about 30 seconds and left.  There is no question that this was an appalling way to treat any human being let alone a frightened 16 year old girl and it is not equivalent to "refusing treatment".  What was refused was any respect for the patient or explanation.  It was clumsy to say the least to simply present the frightening prospect of her reproductive system being destroyed.  It was alarming to place that responsibility on a 16 year old by surprise in an intensely disorientating situation.  The poor girl, already ill, tired, exhausted and frightened was effectively presented with an ultimatum out of the blue "Come with me now for a procedure that might ruin your married life or don't."  To present the fact that the child didn't accept within 30 seconds as a child refusing treatment as if she has a problem is extraordinarily perverse.  At a later time a more sensitive human turned up and explained a little more about Helen's condition and the reason for the proposed treatment and scan.  Helen went for the scan.

For the record there were several incidences where significant amounts of air in the form of bubbles travelled via the intravenous cannula into Helen's arm.  Significant being more than 10 mm in length.  On one occasion I watched a bubble of at least 100 mm casually sail up her arm.  About 2 seconds later Helen clasped her chest.  I asked her what it was and she said she was finding it hard to breath.  Now I am not a medical expert but I do know that air bubbles in veins are not recommendable and that they can cause embolisms in the lung.  Not wanting to distress Helen unduly I simply said I would go and tell the nurse and walked out of the ward.  I explained briefly to the nurse at the desk that I had seen a four inch air bubble travel into Helen's blood stream and then Helen had clasped her chest saying she couldn't breathe.  The nurse immediately went to Helen and ascertaining that she was alright (as she was) the nurse simply said that bubbles were nothing to worry about.  This was  a case of medical carelessness at the very least.  The nurse had dropped the tube prior to fitting it to the cannula and whilst she primed the drip.  This is against recommended procedures as it allows air into the bottom of the now dangling loose tube.  I mention this because there were numerous occasions of the medical services not being up to scratch if not seriously incompetent.  I mention it because we seem to be being accused of some inappropriate behaviour.  I have made no complaints against the hospital or the staff.  I accept that they are doing the best they can.  But if anyone is at fault here it is the Biston Hospital and their behaviour and treatment of a patient.  Had Helen actually refused treatment I would suggest that she had good grounds for it.  But neither did she nor have we made any complaint.

On the subject of Helen refusing antibiotic treatment this is a false claim and a disturbing one too.  There are two issues that might be getting muddled up here and there are several aspects to both.  I offer a brief explanation in case anyone is interested in understanding what happened to possibly instigate this unfair claim.  Helen was administered intravenous antibiotic.  The regular application of this was painful to Helen.  She was also offered paracetamol intravenously to reduce the pain in her stomach if she wanted.  Helen was not experiencing significant pain in her stomach.  It was clearly stated that this was not part of any remedial treatment and was an offer of a pain killer if she wanted it.  She quite reasonably declined the offer.  However, on future occasions, both of us were lied to by a nurse attempting to force Helen to accept the paracetamol because it was on her "list" of things to do.  The nurse explicitly stated that it made the anti-biotic work better.  She evidently did not have the medical training or knowledge to make such a statement.  There were other occasions when nurses tried to slip the paracetamol past her by simply administering it without question.  I do not know if they succeeded on any occasion but it might be a interpretable as a criminal offense to administer a non therapeutic drug to a patient wilfully against the patients expressed wishes.  The situation with the paracetamol was somewhat clarified by the head surgeon when he clearly explained that this was not at all necessary and had nothing to do with her therapy.  He understood and accepted Helen's wish to not take it.  However, the nurses, presumably because of procedural inflexibility, continued to enter a code indicating "Patient refused treatment." on her medical notes three times a day.  On the subject of the intravenous antibiotic it was a nurse who stopped her treatment and that was when Helen had indicated explicitly an acceptance of it.  How the nurse interpreted Helen's response as a refusal remains a mystery to me.  Having established that it was reasonable, correct, desirable and permissible for me to be with Helen when she had her medication administered a nurse then conspired to exclude me.  In my attempt to comply as much with their wishes to be on the ward as little as possible because it was a gynaecological ward for women I asked the current staff nurse if it would help her if I phoned to say when I was coming.  She said yes.  That evening Helen phoned me and said that she wanted me to come in for her medication.  I said ok and duly phoned the site nurse.  She told me I could not come onto the ward.  I tried to explain that this was against her previous agreement and our understanding and the surgeons advice and it was unfair and unsympathetic to Helen.  She said she would have to speak with the site nurse  and would phone me back immediately.  I waited over half an hour.  Eventually I decided I had better phone Helen to let her know what was going on.  Surprisingly the staff nurse was with Helen.  Because the nurse was attempting to administer the intravenous medication I asked Helen if my staying on the phone would suffice given the situation.  Helen was understandably unhappy and agreed.  Out of respect for the nursing staff and their job I asked Helen if I could speak to the nurse to ascertain that this was okay.  I spoke to the nurse and she perfectly accepted that this was fine.  I was then on the phone and heard the ensuing verbal exchanges.  I believe the process started with what they call a flush.  The nurse was administering this and Helen was crying and the nurse was trying to stop her.  First she stated that "It doesn't hurt." which is an unbelievable claim.  Then when Helen refuted this it seemed to anger the nurse and she claimed she wasn't doing anything.  I'm not sure if she felt that Helen's crying was somehow a criticism of her or what.  The nurse then asked Helen if it hurt.  Bizarre again since Helen was crying and had refuted her claim that it didn't hurt.  Helen said yes and the nurse offered her paracetamol.  Helen said no thank you.  Immediately, as if already primed, the nurse asked angrily "Are you refusing treatment?" and before Helen had time to answer she asked "Well are you going to take your antibiotic?"  I heard Helen clearly say "Yes" but the nurse acted as if Helen had said "No" and without another word she packed her equipment up and left.  At this point it appears that Helen's medication was stopped.  This is, I believe the point at which a report to the social services was made.  As it happens Helen was later offered tablet antibiotic and she accepted.  Why wouldn't she?  It was explained that she could either have intravenous or oral and it was her choice.  She made her choice and that was reasonable.  She started on the oral antibiotic.  It was later explained to her by a surgeon that the intravenous was more effective and why.  He treated Helen with respect as an intelligent and sensitive human being.  Helen asked a couple of intelligent questions and got intelligent and rationally consistent answers.  It was clearly stated by the surgeon that it was her choice which she decided to take.  Helen considered this and said that she would try the intravenous drip method again.  The treatment was started and continued uninterrupted to its conclusion.

To represent this as the patient refusing treatment is unfair, inaccurate and raises very serious questions about the methods, procedures and practices of the staff at the hospital.

Parenting Capacity:  Please give details including strengths and current needs

It claims I supported Helen's refusal of treatment.  Helen never refused treatment and so I could not have supported it.  I do however support her rights as a human being.  I support her right to ask sensible questions and to expect reasonable answers.  On many occasions in the first few days Helen was treated as an object and with no respect.  There were attempts to bully her, to intimidate her, to frighten her, to reject her, to coerce her and to deceive her.  I made no significant interference to the nurses actions.  I suspect, however, that my being present made it harder for them to succeed in their attempts to control or manipulate a child (on an adult ward) and gave Helen support by the very act of my being there.

EDUCATION

I agree with the statements in this section with one exception and that is the claim that I removed Helen from school.  She was explicitly thrown out by the acting headmistress Mrs. Jane Thornbush.

EMOTIONAL AND BEHAVIOURAL DEVELOPMENT

Child's needs:  Please give details including strengths and current needs

I agree with this and would add that her "emotional difficulties" are also related to attempts to control her.  It was clear during the divorce that some of her mother's insidious attempts to entrap Helen caused her serious distress.  It was treacherous and a profound and fundamental betrayal of the deepest kind.  I'm quite willing to explain in more detail if required.  It is also worth pointing out that in her first two years of secondary school following the divorce Helen basically advanced from serious anxiety about the controlling mechanisms within school to virtually none.  By the end of her second year she was handling school as an average person of her age of 12/13 year old would.  Moving to Notherton and the subsequent catastrophe there rather undermined her achievements of the previous two years.  The subsequent move to Biston proved even more difficult.  Biston High School is far more authoritarian than either of her two previous secondary schools.  This proved to almost be the last straw.  But with the Education Officer's help and the help of Mrs Copeland (a headmistress) at the High School Helen's attendance got up to 100% for a complete term.  Why Mrs Thornbush had to get involved on a day Helen was sick and requested to go home I do not know.  Why she denied Helen's right to phone me and why she held her in a room in solitary confinement for over an hour and then interrogated her for another hour before telling me to take her away I do not know and can only speculate.  But that was the last time she attended school.  Helen is a very strong, independent minded and resilient person.  She would not have survived her ordeals in one piece if she were not.  However, no matter how strong she is, the events have caused her significant pain and difficulties.  She is currently very sensitive to any attempts to manipulate or control her.  Her experience at ESOS is giving her more room and experience to recover and I am confident that her enrolment on the Biston College Course has all the potential to help her even more.

Parenting Capacity:  Please give details including strengths and current needs

This statement is simply slightly off the mark for two reasons.  Firstly it is misleading to suggest that "my removal of her from school" has reinforced her emotional behaviour.  I did not remove her from school.  Secondly, as we discussed in our meeting at the hospital, it is not separation anxiety.  Helen does not have separation anxiety and this is evident when she has been away on school trips, visits to the Lake District with a friend's family, and many visits to her friends in Sumbury without me, including an extended one of two weeks.  There is simply no separation issues.  What does appear to be the case is that Helen can get seriously anxious when in the hands of authoritarian adults.  When Helen gets repeated signals that make her feel the adults are not trustworthy she becomes afraid and quite understandably wants the one person she knows she can trust to be with her.  I don't know how this might be described or defined clinically but it is not separation anxiety.

IDENTITY

Child's needs:  Please give details including strengths and current needs

I agree with this entry.

Parenting Capacity:  Please give details including strengths and current needs

No comment.

FAMILY AND SOCIAL RELATIONSHIPS

Child's needs:  Please give details including strengths and current needs

A possibly inconsequential comment.  I have never heard Helen describe herself as a recluse.  She regularly describes herself as a hermit.

The reference to me saying that she "doesn't like to engage with people" is a misrepresentation of what I said.  I said she is nervous about meeting new people.

Parenting Capacity:  Please give details including strengths and current needs

The claim here is unsubstantiated and false.  I would request that the statement "...that there was inappropriate physical contact and attention from Helen's father." to be explained.  What exactly do the "nursing staff" consider to be inappropriate contact?  I have no idea what that is supposed to mean but I am clear about the potential implications in this report.  As it happens there were always witnesses in the form of other nurses, doctors and patients and so if this claim is to be taken seriously it must be corroborated.  The fact is that there has never been any "inappropriate" physical contact between us.

SOCIAL PRESENTATION - CHILD/YOUNG PERSONS DEVELOPMENTAL NEEDS

Child's needs:  Please give details including strengths and current needs

No comment.

Parenting Capacity:  Please give details including strengths and current needs

I might not have "seemed" concerned and I was not very concerned although I suggested several times that Helen at least put on her dressing gown which, I am pleased to say, she began to do later in the week.

SELF-CARE SKILLS - CHILD/YOUNG PERSONS DEVELOPMENTAL NEEDS

Child's needs:  Please give details including strengths and current needs

Essentially I am in agreement with the sentiment expressed here.  It is interesting that Helen is represented as concurring with the claim that she "refused treatment".  I think the issue is that if a figure of authority attempts to make Helen do what they say with no other (or rational or comprehensible) reason than because the authority requires it and that they require Helen to act of her own volition there is a perfectly understandable conflict which, as Helen suggests, gives her a sense of loss of identity.  My suspicion is that this is a deep seated response largely exaggerated by her mother's severe attempts to control her.  It could be illuminating to read up on the psychological issues relating to the way that the denial of a person's feelings and autonomy result in the person feeling a loss of identity.  It is no coincidence that there was an immense amount of that behaviour in the hospital.  This is not (yet) a criticism of the staff.  They have a job to do and they do it the best way they know how.  But with amazing denials of Helen's feelings e.g. stating "It doesn't hurt" whilst sticking a needle into her arm and effective denials of her autonomy e.g. by telling her that she must go for a scan which could ruin her reproductive system and it must be her choice (with no attempt at any other information or explanation) it is hardly surprising that the situation was deteriorating.  Helen is an intelligent and articulate individual and her remarks that this was possibly behind the "refusal" is, in my opinion, extremely perceptive.

Parenting Capacity:  Please give details including strengths and current needs

The report says "Dave's caregiving (sic) behaviour is encouraging Helen's dependence on him which is inappropriate for a child her age."

I'm afraid I disagree with this comment in this context.  What I would accept is to question the benefits of my parenting in general as I am always open to improvement but as the previous point in this box illustrates Helen needed a lot of support in what was pertinently a very difficult situation for her.  As I explained to the nurses at the time I didn't expect them to know anything about Helen but I tried to explain exactly the above vulnerability.  The nurses simply didn't get it and I think I did a very good job in spite of incredible resistance and obstruction from the nurses in preventing Helen being pushed over the edge.  My only request was that if Helen requested me to be present whilst the nurses were administering medication that they allow it.  It was their inexplicable level of resistance to this simple requirement that escalated the situation to one verging on dangerous for Helen's health both physically and psychologically.  I'm amazed because although Helen is an exception from the "norm" in terms of her vulnerability around these issues it is not as if this request would be unreasonable anyway.  It is fully understood for "normal" children on the children's ward so what happens on Helen's 16th birthday?

FAMILY AND ENVIRONMENTAL FACTORS

This is perfectly factually correct except two minor points.  It was December 2007 when we moved to Biston not 2008 and I think Helen describes herself as a hermit not a recluse.

ANALYSIS OF INFORMATION GATHERED DURING THE INITIAL ASSESSMENT

Although I agree in the main with the comments in this section I have to question the pertinence or even the meaning of the remark that Helen's difficulties have "...been reinforced by her father's emotional responses towards Helen."  I am perfectly open to discussing this further but at the moment I reserve the opinion that my "emotional responses" have possibly prevented Helen from a catastrophic insecurity initiated by the incredibly ruthless divorce and consequential instability in her life and escalated by forced moves from house to house, school to school and town to town.  4 house moves, 3 school moves and 3 town moves in 3 years.

We are the victims here not the perpetrators of the misfortune.


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