The Family Court has ruled that it is in the best interests of a 13-year-old girl with complex needs to remain in hospital against her will until a bespoke placement in private accommodation becomes available. 

The girl, referred to as J, was the subject of an interim care order.  

The local authority, Manchester City Council, had a statutory duty to find her a placement. However, due to the lack of provision for children with complex needs, J had been living in a hospital for three months.  

She had no mental or physical health requirements for inpatient treatment and the hospital environment was not suitable for her needs.  

There were several options available as an alternative, namely a return to home, a foster placement, secure accommodation, placement in a children’s home or placement in bespoke accommodation.  

However, her mother was unwilling and unable to accommodate her, a foster placement was not viable, secure accommodation was not suitable and a children’s home would not accept her due to her behaviour.  

The local authority had identified a private landlord who would provide a property, to be rented by the local authority, at which care could be provided to J. The proposed placement would allow J to continue at her school.  

The aim was for her to be able to move into that placement within a month. At seven previous hearings, the court had authorised the deprivation of J’s liberty in the hospital against her will.  

The court agreed to extend the order for her confinement, pending her move to the suggested accommodation. 

It noted that, under the Care Planning, Placement and Case Review (England) Regulations 2010, a local authority could place a child in a hospital.  

However, the court had to be satisfied that it was necessary, proportionate and in the child’s best interests for authorisation to be given.  

The least restrictions necessary would be those previously authorised by the court. Those restrictions, which included the potential for using physical restraints, amounted to a deprivation of J’s liberty.  

She was continually confined and was not free to leave the hospital other than on the terms set down. Had there not been the alternative bespoke placement available within a reasonable time, the court would have been unlikely to authorise the continuation of J’s deprivation of liberty.  

A hospital was not a suitable place for a 13-year-old girl who had no need for treatment.  

However, due to the national lack of resources to accommodate and care for children with complex needs, that appeared to be the only place where she could live until the local authority was able to arrange and have ready the proposed bespoke placement.  

Accordingly, the continuation of the restrictions whilst she remained at the hospital was authorised as being necessary, proportionate and in her best interests. 

The court declined to amend a reporting restrictions order to prevent the authority from being identified. It held that there was a strong public interest in knowing the local authority’s identity. It was a public body and was accountable.  

It was also pertinent that it was a large local authority covering a large population. Even with its resources, it was struggling to find an alternative placement for J. It was in the public interest to know the reality of the problems highlighted in the case. The risk of identification of J was much lower than it would be if the local authority covered a smaller population.  

Case citation: J (Deprivation of Liberty: Hospital), Re  Also known as: Manchester City Council v K  

Family Division  [2022] EWFC 121 Judge  Poole J  

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