don’t think so,’ Neave said. ‘Amanda, Melody’s mother, won’t be coming. She’s still in hospital.’
‘Let’s begin then,’ the IRO said, and he opened the meeting by thanking us for coming. ‘This is Melody’s first review,’ he said. ‘Can we start by introducing ourselves?’ He gave his name and role, and we then went round the circle giving our names and roles. I learned that the young man who’d come in with Neave, Gareth, was a student social worker on his final work placement. There were eight of us, so it was a medium-sized review. The number attending a review varies depending on factors including the complexity of the case. As is usual at reviews, the foster carer – with up-to-date information on the child – was asked to speak first. I drew myself more upright in my chair and glanced at the sheet of paper I held on my lap. I began by saying that Melody had settled in and was eating and sleeping well, and had reasonably good self-care skills, although she needed reminding to wash and brush her teeth sometimes. I said she’d arrived quite dirty and with head lice, but I’d treated those straight away, and that I’d seen none of the aggression mentioned in the referral.
‘So you wouldn’t describe Melody’s behaviour as challenging?’ the IRO asked.
‘No. She was obviously upset at being parted from her mother, but generally she’s settled in well.’ He nodded and made a note. I then spoke a little about Melody’s routine and what she liked to do in her spare time.
‘Does she attend any clubs outside school?’ the IRO asked, looking up from the notes he was taking.
‘Not yet, but I’m hoping she will do soon. I’m trying to find out what she’s interested in.’ Children in care are expected to have the same opportunities as the average child; sometimes they have many more.
‘I’ll put that as a target then,’ he said. Reviews like targets.
‘On that subject,’ I said, ‘Melody has swimming lessons at school and I would like to take her swimming sometimes at the weekends and during the school holidays. I understand from Melody that her mother is very anxious about her drowning and wouldn’t be happy if I took her, so I haven’t yet. Can I have permission to do so?’
The IRO looked at Neave as he spoke. ‘I think that’s reasonable, don’t you? We can give permission. Melody is on a care order and her mother has been sectioned.’
‘Yes,’ Neave said. ‘I agree.’
‘You’ll obviously supervise her,’ the IRO said to me.
‘Yes, and she’ll be wearing armbands as she does at school.’
‘Good.’ He made a note.
‘I took her for the medical,’ I continued. ‘All was well. A copy of the paediatrician’s report has gone to the social services. I also took her to the dentist and optician.’ I gave the results.
‘Has she had the fillings now?’ the IRO asked.
‘Not yet,’ I said and hesitated. This was awkward. ‘I’m waiting for the permission slip to be returned.’ I looked at Neave.
‘Sorry, it’s on my desk,’ she said. ‘I’ll let you have it back ASAP.’ It’s usually parents who sign their children’s permission slips, but children in care proceedings generally need them to be signed by their social worker.
The IRO nodded, made a note and looked to me to continue. I glanced at my notes. ‘Melody had missed a lot of school before coming into care and is a long way behind. I’m working closely with Miss May, her TA, to try to help her catch up. We do a bit of extra work each evening.’
‘And Melody is happy to do schoolwork in the evening, rather than playing or watching television?’ the IRO asked.
‘Yes, a little,’ I said. ‘Her mother told her she needs to do well at school and pass her exams to get a good job. She’s remembered it.’
‘Good,’ the IRO said. ‘That’s positive. And what about contact with her mother? I understand it’s been suspended. How does Melody feel about that?’
‘She misses her mother a lot. They were very close. Melody helped her mother and now worries about her. My feeling is she needs to see her mother soon. I understand we are waiting for a report from the hospital.’
‘Yes, I’ll be covering that,’ Neave said.
I glanced at my notes again. ‘I think that’s everything,’ I said.
‘And you’re aware of the care plan?’ the IRO asked me.
‘Yes.’
He now turned to Neave. She opened the file on her lap and began by giving the background to the case and the reasons for bringing Melody into care – neglect, non-attendance at school and being left home alone. As I already knew, this had been building for years, and despite support being put in the situation at home had deteriorated. Neave gave the date Melody had been brought into care and also when Amanda had been sectioned. She confirmed that Melody was in care under an Interim Care Order and that the social services were applying for a Full Care Order with a final court hearing date in November.
‘And the mother’s medical condition?’ the IRO asked.
Neave nodded. ‘She has been diagnosed with clinical depression, acute anxiety and dementia. The former is largely a result of the dementia. Alzheimer’s has been mentioned and I’m waiting to speak to the consultant. When she was first admitted it was thought that her confusion and aggression could be a result of still using drugs, but that’s been ruled out now. She hasn’t had access to drugs or alcohol since she’s been in hospital and her condition hasn’t improved. The most likely diagnosis is dementia brought on by years of substance misuse. Apparently, those using for prolonged periods are three times more likely to suffer brain damage than those who don’t use drugs.’ She paused to let the message sink in.
‘So is there likely to be any improvement in her condition?’ the IRO asked, looking up from writing.
Neave shook her head. ‘I’ll have a better idea of the prognosis once I’ve met with the consultant, but Amanda is likely to need long-term care. They are already looking for a care home that can manage her dementia. She will have to leave the hospital where she is, now the assessment is complete.’
There was another moment’s silence as the full impact of what Neave had said hit us.
‘So there is no chance of Amanda ever going home?’ Nina, the Guardian, asked.
‘No. The assessment has shown she needs help with even the basics, like washing and dressing herself. Her mood swings and aggression have to be managed too. She could only be discharged home if there was a relative willing and able to look after her, and there isn’t.’
‘I hadn’t realized she was that bad,’ I said, shocked.
‘I suppose Melody has been helping her a lot,’ Jill added.
‘Has Melody given you any indication of how much she has been helping her mother?’ Neave now asked me. ‘The support worker we put in noted that Amanda relied on Melody. The contact supervisor said the same and that Amanda appeared confused sometimes, but those were the only indications we had.’
