A report into the case of a mother who smothered her three seriously ill children to death suggests that officials failed to act on concerns which ought to have led to child protection intervention.
Tania Clarence, 44, has been detained in a psychiatric hospital since last November, when she admitted the manslaughter by diminished responsibility of Olivia, four, and three-year-old twins Ben and Max at the family’s home in New Malden, south London.
A serious case review launched by Kingston council has concluded that the children’s deaths could not have been predicted or prevented. However, it said professionals working with the family failed to act on concerns that the children were being neglected and at times emotionally abused.
The report said: “Within Kingston’s children’s social care the child protection threshold was reached in 2013 but the focus became on legal proceedings with this being mentioned several times… ”
It went on: “Legal intervention should have been the last stage, preceded by the use of strategy discussion, child protection inquiry, child protection conference, child protection plan and ultimately, if no other option, legal proceedings.”
Olivia, Ben and Max had the muscle-weakening condition type 2 spinal muscular atrophy. The rare, genetically inherited condition affects children’s physical development and activity, including moving, eating, breathing and swallowing. Although there is no cure and the condition can shorten life expectancy, with the right care people affected by type 2 SMA can live long, fulfilling and productive lives.
However, Clarence and her husband Garydisagreed with doctors and other professionals over the best care for the three children, the report said. The Clarences wanted their children to have good quality of life, and to experience as little pain as possible. “They characterised this as putting a priority on the quality of their children’s lives as opposed to extending the length of their lives,” it said.
Concerns were first raised about Tania Clarence at the end of 2010, shortly after Ben and Max were diagnosed, according to the report, when professionals from some of the agencies working with the family first advised her to seek counselling.
“Starting from this early period professionals were identifying mother’s need for support and balancing this with the concerns that her perceived lack of cooperation was impacting on P’s [Olivia’s] development,” the report said. “This worry became more critical following mother’s opposition to medically invasive treatment and request that her children should be designated DNR [do not resuscitate].”
There were also concerns from some medics working with the family that she did not “consistently” act on their advice about feeding, physiotherapy and the use of aids for the children. The concerns led to professionals meeting to discuss whether child protection thresholds had been met, but it was never agreed.
Legal intervention was mentioned to the family, but never acted on after the father agreed in April 2014 that Olivia, who was dangerously underweight, could have a gastrostomy to help her get more food down, ahead of possible spinal surgery.
That same month, Clarence was caring for the three children alone when she decided to take their lives. Her husband, an investment banker, had days earlier gone to South Africa, where the couple were from, to visit relatives.
In the early hours of 22 April 2014 she smothered the twins, her trial heard. She hesitated before killing Olivia, but went on to smother the child after writing a letter to her husband informing him of her intention.
The report dismissed a consideration that the family’s social status may have led professionals to take a different approach, while conceding that it may have led to them being “cautious” in initiating child protection procedures.
Deborah Lightfoot, chair of Kingston local safeguarding children board, said: “The deaths of three siblings is nothing short of a tragedy. They could have gone on to lead long, fulfilling lives. While the review states that all of the deaths were not predictable or preventable, it has found there are learning points for practitioners involved.”
