Home care situation for woman with complex needs may break down in weeks, court told

It will take between three and 18 months for a residential disability service to be available for a young woman with complex needs whose home care situation will likely break down in a “matter of weeks”, the High Court has been told.

The woman has been diagnosed with a moderate to severe intellectual disability, and she suffers from episodes of anxiety and agitation, including aggressive and self-injurious behaviour, according to an affidavit from the court-appointed guardian ad litem, who represents the child’s interests in the proceedings.

Derek Shortall SC, representing the woman's mother, said his client's ability to care for her daughter at home is "reaching its end point". He said it is probable that the current situation will break down in a "matter of weeks" and there is "enormous concern" for the mother and daughter.

If the mother needs to go to the bathroom, she sometimes has to lock her daughter in the living room for her safety, he said, adding that it is hoped the application to make the young woman a ward of the court will be progressed.

Brian Barrington BL, for the guardian ad litem, said there is “no doubt that the situation is urgent”. The young woman recently threw a large candle at the guardian without any identifiable provocation, and there are clearly risks in the home, he said.

In an affidavit, the guardian said it is clear the mother is “burnt out and at the end of her tether”. The young woman requires “highly unusual” two-to-one staffing levels at her day service due to her behavioural difficulties, said the guardian.

The guardian referred to a December 2021 social work report that places the situation at “red risk” due to the potential for incidents of physical abuse that could lead to injury, incapacity or death of the young woman or her mother.

Representing the HSE, Donal McGuinness BL said measures to support the care of the woman at her home cost €165,000 per year. He said the woman currently attends adult day services five days a week and also receives home support packages, although he acknowledged there were difficulties with this.

It is accepted that the woman would now be better served in a residential service, and a service operator has committed to identifying a suitable facility, Mr McGuinness said. However, he explained that there is no existing service that meets her needs, and a new venture will take between three and 18 months.

Hearing that the HSE is now looking for a placement, President of the High Court, Ms Justice Mary Irvine noted that the woman’s situation has been going on for a “really long period”, dating back to 2017. She said it is “very worrying” to learn that the circumstances are deteriorating, but she said she has “limited powers” in wardship proceedings other than to apply pressure.

Ms Justice Irvine ordered that the woman’s parent and guardian ad litem be updated every four to six weeks of the progress made in securing a placement.

The case will be reviewed in three months, but the judge said the parties can return before the court earlier if the current arrangement breaks down.