A neglected baby - placed under a care plan before he was even born - fell through the cracks with social services and died at just seven-months-old.
While it is not yet known how the baby, known only as Roo, lost their life, investigations concluded in July 2023 that the youngster’s multiple brain bleeds were a “non accidental injury”. Then in August 2023, Roo suddenly died in his cot at home whilst sleeping.
A child safeguarding panel review report has now delved into the lives of the youngster’s family, including his mum, dad and siblings. The shocking documents uncovers drug use, domestic violence, “dirty” children, “poor” home conditions and neglect.
The independent review, completed by Hartlepool and Stockton Safeguarding Children Partnership in County Durham, has highlighted numerous recommendations regarding the communication between medics and non medics and the impact of neglect. The family had moved to the Teesside area five years before Roo was born, but mum had received support from Children’s Social Care in another part of the country prior to relocating. The mum had previously had a child adopted from her care.
Roo was living with his mother and two siblings at the time of his death. The three children were subjects of interim care orders, with the court agreeing that Roo and his siblings should live at home with their mother and that her care of them should be supervised by a family friend. In accordance with this plan, the family friend was living in the home and present at the time of Roo's death. An exclusion order was in place to prohibit Roo's father from attending the home address.
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Brain bleeds
Roo didn’t have the easiest start to life, being born prematurely at 30 weeks and spending the first four weeks of his life in hospital. An ultrasound of his head done routinely due to his prematurity showed a small bleed on his brain - this was described as “typical” for premature babies and was unlikely to cause any problems.
However, at five-months-old Roo was admitted to hospital with poor weight gain. It was noted that his head was large in circumference and therefore an ultrasound scan was booked as an outpatient which took place four weeks later.
The report states: “This showed evidence of subdural collections. These were subjected to further exploration and a second opinion from a specialist hospital. The conclusion was that these were bleeds on the brain and were not due to Roo's prematurity. While these exploratory investigations were ongoing, the Local Authority implemented a safety plan whereby a family friend supervised mother's care of the children in the family home.”
Medics confirmed that the cause of the two bleeds in the brain was more than likely inflicted injury and the local authority issued care proceedings. An interim care order was agreed, allowing the children to remain in mother’s care, subject to the supervision and safety plan which had already been in place. Roo’s father had been living outside of the family home for several weeks and an exclusion order was granted to prohibit him from attending the address. Roo died one week later, Teesside Live reports.
Other children
Roo’s eldest sibling was also known to authorities, including Child Adolescent Mental Health Services (CAMHS), due to concerns over her “escalating behaviour”, alongside “dirty” clothes and face at school. The report outlined an incident where she had “thrown a bike” on school grounds saying ‘I want to kill all my teachers’ whilst trying to hit a teacher.
Children’s Social Care made an unannounced visit to the home and noted “a smell of cannabis and smoke” as well as “extremely poor” home conditions. Child protection enquiries concluded there was a risk of significant harm and an initial child protection conference was convened. The outcome of the initial child protection conference (ICPC) was for the children to be made subject to child protection plans under the category of neglect. This was six months prior to Roo’s birth.
The middle child was noted to copy his siblings' behaviour and was also "dirty". "Loads of people talk to my Mum about my brother and sister but no one wants to talk about me," the report states.
Roo’s birth
When mum disclosed her pregnancy with Roo a meeting took place and a pre-birth social work assessment was completed leading to an ICPC where Roo was made subject to child protection plan under the category of neglect, prior to birth alongside his siblings, in December 2022.
When Roo was born a home visit took place. “Roo was seen in his Moses basket fully swaddled, and his face completely covered,” the report states. “Mother had explained that the swaddling was just holding his dummy in place. Sibling 1 was seen to be pulling the swaddling up over Roo’s nose and was positioning toys around his face. Mother also advised that father was no longer living in the property due to sibling 1 lashing out at him but he resided nearby and was still involved.”
Roo was admitted back into hospital due to concerns over his low weight and he remained for two nights. Investigations were arranged for an ultrasound of his head and further follow up. A subsequent home visit carried out by the health visitor in which Roo’s weight was observed to have decreased again since his previous growth monitoring.
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Then in another visit a bruise was noted above Roo’s eyebrow. His mother gave an explanation that Roo’s youngest sibling had thrown a toy which had hit Roo. A child protection medical was not instigated.
During a routine ultrasound on Roo’s head, small ‘collections’ were observed on Roo’s brain, thought to be possible small subdural bleeds. A CT scan showed two bleeds at the front of Roo’s brain: a larger one on the right and a smaller one on the left.
The report states: “The outcome of the child protection medical was suspicious of head trauma but inconclusive. CT scans were sent to another hospital for a second opinion. Safety planning was addressed by the Local Authority with a family friend to remain in the home to provide continuous supervision until further information was obtained.
“A strategy meeting was held and section 47 enquiries commenced which concluded that legal advice was to be sought. The local authority issued care proceedings, with a plan to place the children outside of mother's care with a family member. The guardian challenged the plan and agreed an interim care order but with the children to remain in their mother’s care, subject to the supervision and safety plan which was already in place. Roo died one week later.”
Recommendations
The review recommended clarity between medics and non-medics following the bleed on the brain Roo suffered. Following Roo’s death medical professionals explained that a toy would not be able to cause this. "There was a lack of understanding as to whether the bleeds on the brain should have been picked up earlier,” the report states.
“There was a lack of understanding regarding the potential cause for the subdural bleed, with Children's Social Care under the impression that the toy which had caused a bruise on the side of Roo's head in June could potentially be the cause. It was only following Roo's death in August that Children's Social Care became clear that the toy could not be the cause.”
A practitioner considered what life was like for each child in the family; and outlined that ‘nobody comes when Roo cries’ but he had ‘basic needs but no nurture’.
The review explored nine identified learning themes leading to eleven recommendations for the partnership to consider and one single-agency recommendation. Here’s the summary of recommendations:
Stockton Children Social Care - expectations and level of supervision
Cumulative Impact of Neglect – Recording and Evidencing
Evidence of Domestic Abuse without disclosure – recognising behaviour as evidence
Recognition of signs and symptoms in young children of abuse and neglect; particularly in those with extremes in violent behaviour / ‘adultification’
Learning Disability / Learning Difficulty – professional’s understanding of impact
Clarity of explanation between medics and non-medics to support collective understanding for all 7. Designated Doctor to deliver multi agency training, on understanding child protection medical
Management of Bruising in Non-Mobile Babies – Adhering to the procedure
How race, culture and ethnicity impacts decision making by professionals
Fathers - behaviour and parenting capacity
The Child’s lived experience
A spokesperson for the Hartlepool and Stockton-on-Tees Safeguarding Children Partnership (HSSCP) said: “The Local Child Safeguarding Practice Review was commissioned by the Partnership to consider the multi-agency safeguarding responses following the sudden unexplained death of “Baby Roo” at home. The review into this very sad case explored nine identified learning themes, resulting in 11 recommendations for the HSSCP to consider and one single agency recommendation. It is important that lessons are learned from this case, and work is on-going with all relevant partners to implement the recommendations.”
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