“Unusual restrictions” for a 17-year-old

By Claire Martin, 25th January 2023

This hearing (COP 14169995 before DJ Glassbrook, sitting at Northampton County Court on 5^th January 2024) caught my eye in the CourtServe list because it mentioned “unusual restrictions to which the protected party is subject”.

Unfortunately, despite requesting them,  I’ve not been sent the parties’ position statements, so I don’t have much detail about the case.  

I think the parties had asked for the judge to make decisions ‘on the papers’ (i.e. without the need to come to court and hear evidence). However, DJ Glassbrook said in his very helpful nutshell explanation of why the case was in court that  “as will become apparent, restrictions to which he is subject are unusual and therefore in my view it needs particularly careful scrutiny of those provisions“. 

The protected party in this case is a young man, 17 years old . He is currently on Section 17 leave (which means he is detained under the Mental Health Act 1983) and is living in what the judge described as “bespoke” accommodation in a care home. He has been living in “an institution” since the age of six. The judge said that “interaction with his peers has not happened for years, however you classify peers“, and that “for a long period, interaction with anyone has been through a doorway – and my impression is pharmacological restraint as well, though detail is not clear. He tends to live in padded rooms“.

This was sounding very alarming and I was wondering why this person could not be in the same room with anyone at all.

The judge then said: “For reasons that are anything but clear he is not even allowed to turn over the channel on TV. To my mind those are unusual restrictions … My job of course is not to try and upset everything but most definitely is to consider those restrictions and to consider whether they are necessary and if there is anything less restrictive that would suffice for this young man”. 

I really have very little detail to form any kind of view on this case, and the hearing was mostly about setting directions for the next hearing, information required and who from. 

Savannah Laurent represented the Local Authority. She said that recent “updating instructions” suggest fewer restrictions that the judge described, such as P had “recently gone into the kitchen and poured his own cereal“, suggesting that he might be subject to a less restrictive regime in the home than in hospital. She went on to say that the Local Authority has agreed to provide an updated care plan, PBS (Positive Behaviour Support) plan and an updated EHCP. None of those documents was available for this hearing. 

DJ Glassbrook reiterated, understandably in my view, that he could “only go on the paperwork that I have got“, going on to say that it was clear that P’s bedroom was “padded out“, and that he received 4:1 staffing, describing that as “extraordinary, literally” and further that P had been: “… subject to significant pharmacological intervention. I saw mention that he’s had so much benzodiazepine that he may now be dependent upon it. This sort of thing is ripe for asking questions at the very least”. 

There was some discussion between the judge and counsel about who had primary statutory responsibility for P (the Local Authority or the hospital where he was under a section of the Mental Health Act) and about who could provide what information, and by when. The possibility of deputyship for P’s health and welfare was also mentioned by the judge. P’s grandmother was joined as a party (I think she might have been on the Teams call but I am not sure) and it was helpfully acknowledged that P’s family will have views and wishes in relation to P’s care and treatment, which I don’t think were known at the time of the hearing. 

P was due to be reassessed under the Care Act as an adult, but the social worker he has met will soon be leaving. The judge commented on how there been “a turnover of social workers for a while” and asked that P be allocated a social worker who is not likely to be leaving. 

Nia Gowman,representing P via the Official Solicitor, asked for the court order to include a request to the treating hospital that the outcome of an upcoming mental health tribunal is provided to the court (Judge: “Yes“) and that the Local Authority evidence should give information about how P is getting on in his current care home. 

Finally, Nia Gowman raised some concern about the wording of the restrictions that the court is being asked to authorise. She reiterated that 4:1 care is still in place and that P is not able to leave his room. The judge added to this, asking that the draft court order made it clear that: “The restrictions are unusual and will require unusual scrutiny and whatever is authorised at the moment is done on an interim basis, given we don’t have a great deal of information. The court will be expecting to look in detail at what these restrictions are. I’d like that recording please”. 

This was a short hearing, forty-eight minutes, and I thought the judge was given very little information to form any view at all, even for the interim court order. I don’t know whether this was anticipated and planned, and that parties had all discharged their duties fully in readiness for the hearing. This could have been the case. Regardless, as the judge emphasised, the restrictions to which P is subject remain, and remain “extraordinary“. P has just moved to a new home and will be subject to these restrictions for at least another three months. I assume that he must have been deemed to lack capacity to make his own decisions about residence and care (since it seems that best interests decisions are being made on his behalf) but I don’t know what impairment or disturbance in the functioning of his mind or brain has been diagnosed, or what his needs are, what he would like for himself (or how he communicates his preferences) or, indeed, anything about him! None of these things were mentioned in the hearing.

It would obviously have been helpful to me as an observer to have been provided with a fuller summary of the case and/or the position statements: without it, this case is less than transparent. 

The case is due to come back to court the week beginning 21^st March 2024. 

Claire Martin is a Consultant Clinical Psychologist, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Older People’s Clinical Psychology Department, Gateshead. She is a member of the core team of the Open Justice Court of Protection Project and has published dozens of blog posts for the Project about hearings she’s observed (e.g. here and here). She tweets @DocCMartin