Cruel to Be Kind

by Cathy Glass

  ‘Thank you,’ the IRO said with another smile and then she looked at Caz.

  ‘I’m Max’s mother,’ she said.

  ‘Thank you,’ she said, making a note.

  ‘Kelly, Max’s sister,’ Kelly said, stifling a self-conscious grin.

  ‘Thank you,’ the IRO said again, and finished noting their names. She then addressed us all. ‘This review is about Max, who at present is living with Cathy, a foster carer. He’s accommodated under a Section 20. That hasn’t changed, has it?’ she asked Jo.

  ‘No,’ Jo confirmed.

  ‘I’d like to start by hearing how Max has been settling into his foster home. Then we’ll hear from everyone else in turn who wishes to speak.’

  Although there were only a few of us, reviews tend to be formal and I straightened in my chair and glanced at my notes. I always start with the positives. Even if a child is behaving badly and has been excluded from school, I find something positive to say. In Max’s case it was easy, as there were plenty of positives. ‘Max is a lovely boy, intelligent, caring and thoughtful,’ I began. ‘He’s settled well into my household and plays nicely with my children, Adrian and Paula, although he obviously misses his own family. He understands why he is in care and seems to be taking all the changes in his stride.’

  ‘He never says much,’ Caz put in, and the IRO nodded.

  ‘He’s eating and sleeping well, and is happy to join in my family’s outings and activities,’ I continued. ‘I’ve met his teacher, Mrs Marshall, and he’s doing well at school.’ (I didn’t elaborate on his progress at school, as Jo had a report from Mrs Marshall.) ‘His teacher has been lending Max books, as he loves to read. We have plenty of books at home and we’ll visit the library during the summer holidays.’ I paused to allow the IRO, who was minuting, time to catch up.

  ‘Health-wise,’ I continued, ‘Max has been diagnosed with asthma and has an inhaler, although he only used it on the first day he came to me. As far as I know he’s only used it once at school too. He gets out of breath after exercise, but his chest isn’t tight and he doesn’t struggle to breathe, so he carries the inhaler with him just in case.’ I paused again to allow the IRO time to write.

  ‘Max snores very loudly when he’s in a deep sleep,’ I said, ‘which I understand can be due to enlarged tonsils or adenoids. But the paediatrician found no evidence of this and said his snoring, breathlessness and the rash he sometimes gets are most likely caused by him being overweight. He hasn’t had the rash since he’s been with me, but I will take him to the doctor’s if it appears to try to get a diagnosis.’

  ‘The cause of the rash hasn’t been identified then?’ the IRO asked, glancing up from writing.

  ‘No. Not as far as I know,’ I said. ‘Caz thought it might be an allergy.’

  ‘It’s always gone by the time I get a doctor’s appointment,’ Caz said, and the IRO nodded.

  ‘The paediatrician said it might be due to sweating,’ I said.

  ‘Has the paediatrician’s report arrived yet?’ the IRO asked Jo.

  ‘No, not yet,’ Jo said.

  The IRO looked to me to continue. ‘During the medical, the paediatrician weighed and measured Max and said he was considerably overweight. She has put him on a diet and fitness plan.’

  ‘How much does he weigh?’ the IRO asked.

  ‘Eight and a half stone,’ I said.

  She frowned. ‘What does the average child of his age weigh?’

  ‘Approximately three and a half stone,’ I said, avoiding Caz’s gaze. This was a sensitive subject, but it had to be said, as a review is concerned with all aspects of the child’s wellbeing.

  ‘What does the diet and fitness plan involve?’ the IRO asked me.

  ‘Nothing too drastic. I have a copy of the plan here,’ I said, taking the printed sheet from my folder.

  ‘I haven’t got one,’ Caz said.

  I slid it across the table towards her so she could read it.

  ‘Perhaps you could photocopy it when we’ve finished,’ the IRO said to Jo, ‘so Caz has a copy and we have one on file.’

  ‘Yes,’ Jo said.

  ‘Thank you, Cathy. Is there anything else this review should know about Max’s health?’

  ‘The paediatrician tested his eyesight and that was fine,’ I said. ‘He doesn’t need glasses, but he may need to have some more teeth extracted. He had some teeth out before he came into care and the doctor said he might need to have more. I understand he’s under his own dental surgeon.’

  ‘Yes, he is,’ Caz said. She’d taken a brief look at the diet and fitness plan and had passed it to Kelly to read.

  ‘When is his next appointment at the dentist?’ the IRO asked Caz.

  ‘In a month or so,’ Caz said. ‘I can’t remember the exact date.’

  ‘We don’t know if Max will still be with Cathy then,’ the IRO said to Caz, ‘but if he is, she can take him if you wish. Let Jo know.’

  Caz nodded. She seemed more placid and less confrontational than she had been in hospital. Perhaps it was the formality of the review, although in my experience it rarely stopped parents speaking their minds.

  ‘Thank you, Cathy,’ the IRO said. ‘Is there anything else you want to say? I see from the questionnaire you returned that generally you feel Max is happy.’

  ‘Yes. He has settled in well.’ I would raise the matter of contact arrangements later, once everyone had given their reports.

  ‘And Max can stay with you for however long the placement is needed?’ This was a routine question.

  ‘Yes,’ I confirmed.

  The IRO now asked Jo to give her report and Jo began by stating that Max was in care under a Section 20, and briefly summarized the safeguarding issues that had brought him into care: that while Caz was in hospital he had been left unattended at home. I saw Caz glare at her daughters as if they were responsible, but to my mind surely Max’s father was more culpable? Jo confirmed that the care plan was for Max to return home once Caz, the main caregiver, was well enough to meet his needs and offer appropriate supervision. Jo would be visiting the family the following week to make an assessment. She said that in respect of Max’s education, Mrs Marshall had described him as ‘studious’ and a pleasure to teach. The end-of-year test results, which would be included in the school report and sent home on the last day of term, showed that Max was well above average, especially in literacy. His reading age was ten.

  ‘That’s very good,’ the IRO said, glancing up at Caz.

  ‘Don’t know where he gets that from,’ she said, almost embarrassed. ‘His father and I don’t read books.’

  Jo continued by saying that Mrs Marshall was encouraging Max to join in more with class discussion and interact with children outside the classroom. She was pleased he was now following a diet and fitness plan, as the school encouraged all children to have a healthy lifestyle. She would be his teacher again in September, as the teachers were moving up with their classes. Jo confirmed as a matter of formality that there had been no exclusions from school. Then she moved on to contact, saying it had taken place at the hospital from 5.30 until 7 p.m., but now that Caz had been discharged it would be at the family home.

  ‘And these arrangements are working well and will continue?’ the IRO asked.

  ‘Yes,’ Jo said. ‘Although during the school holidays contact will take place in the afternoon. Caz goes to bed very early.’

  I glanced at Jill, who said, ‘Cathy would like to take the children on some day trips during the summer holidays, which would be difficult if contact was every afternoon.’

  The IRO nodded thoughtfully and then said, ‘Perhaps we could alternate afternoon and evening, or is that going to be confusing?’

  There was a few moments’ pause and then Jill said, ‘So if it was alternated, contact could be in the evening on Monday, Wednesday, Friday and Sunday – five-thirty to seven. Then in the afternoon on Tuesday, Thursday and Saturday, say two to three-thirty. How would that work?’


  ‘I can mange that,’ I said. It would still be a lot of toing and froing, but at least it would give us the freedom to go on day trips. Max had a high level of contact because he was going home, so the bond between him and his family was maintained. Children who can’t or are unlikely to be able to return home – often as a result of abuse or neglect – have a lower level of contact and it’s usually supervised at a contact centre.

  The IRO was now looking at Caz for her response, and I was half expecting her to object and say that she wanted to see Max every afternoon, but to my surprise she said, ‘Yeah, but write it down for me or I’ll never remember.’

  ‘Jo will send you a letter with the revised contact times,’ the IRO said. ‘They will start once school has broken up.’

  As Caz seemed to be in a good mood, amicable and open to suggestions, I grabbed the chance and said, ‘It would be really helpful if Max’s diet could be continued while he is at home during contact.’

  ‘Yes, that would make sense,’ the IRO said, and she looked at Caz.

  Her cheeks flushed. ‘You really think I can stop him eating? Look at the size of me!’

  Chapter Fifteen

  Meetings

  There was an embarrassed silence when no one seemed to know what to say or where to look, then Kelly said, ‘I want to do what Max is doing.’ Which allowed us to look at her. ‘I was going to phone you,’ she said to Jo. ‘I want to go on a diet and fitness plan. Cathy told me I could get help at the health centre.’

  The IRO smiled encouragingly and said to Jo, ‘Do you have details of the help available?’

  ‘No, I’d have to find out,’ she replied.

  ‘The paediatrician mentioned that support was available when I took Max for his medical,’ I confirmed.

  The IRO nodded and then said to Jo, ‘Can you look into it and let Kelly and her mother know the details?’

  Jo nodded and made a note.

  There was another short pause. The atmosphere was still a bit awkward. My question hadn’t been addressed and I didn’t feel happy pursuing it, although of course it was in Max’s interest to keep to his diet during contact. Caz was gazing at the table. Then Paris said, ‘I’ll go with you, Kelly.’ Which was commendable but didn’t really help Max with his diet. Then Kelly added, ‘And I’ll try and stop Max stuffing himself in his bedroom.’

  ‘Thank you.’ I smiled at her.

  ‘See if you can stop me too,’ Caz said dryly under her breath.

  ‘I’m sure support would be available,’ the IRO said. ‘We’re all becoming more health-conscious as a nation.’ Which was tactful and diplomatic.

  ‘Easier said than done,’ Caz said in the same deadpan voice.

  ‘I can appreciate that,’ the IRO said gently. However, the review was about Max – now wasn’t the time to explore Caz’s eating issues – so moving the review on, the IRO said, ‘I’ll minute that Max will be encouraged to maintain the diet and fitness plan recommended by the paediatrician while he is at home during contact.’ We waited as she wrote and then she asked Jo if she wanted to say anything else. Jo didn’t. ‘And you’re satisfied that Max is receiving a good level of care with his foster carer?’ she asked Jo.

  ‘Yes,’ Jo said. The question is always uncomfortable for the carer(s) but is considered necessary, although in practice if there was any doubt that the carer(s) was falling short in their care of the child, it would be addressed immediately and wouldn’t wait for the next review.

  It was now Caz’s turn to speak and she didn’t know what to say. Embarrassed, she pulled her cardigan protectively across her chest and looked down.

  ‘Is there anything you want to add?’ the IRO asked. Caz shook her head. ‘Are you happy with the standard of care Max is receiving? Obviously, as his mother, you would do some things differently, but generally are you satisfied he is being well looked after?’

  ‘Yes,’ Caz said.

  ‘Anything you would like to say in particular, possibly about Max’s routine?’ she asked.

  I wondered if Caz would hark back to her initial complaints, but she shook her head. The IRO made a note and then said, ‘Kelly, Paris, would you like to add anything to this review?’

  ‘Is Max getting his pocket money?’ Paris asked a little defiantly. ‘My dad says that the foster carer gets money and some of it has to go to the kid.’

  Jill replied. ‘That’s right. The carer has a clothing allowance for the child, who at Max’s age will have his clothes bought for him. There is also an element in the carer’s allowance for pocket money, which Cathy has been saving for him.’

  ‘Why doesn’t he get it?’ Paris asked.

  ‘Because I have been buying Max everything he needs,’ I said. ‘He puts the money I give him each week into a money box in his bedroom, which he knows he will take with him when he leaves.’

  ‘Thank you, Cathy,’ the IRO said. Then to Kelly and Paris: ‘Do you have any more questions or comments?’

  They shook their heads.

  ‘Jill?’ the IRO asked. ‘Would you like to add anything?’ The supervising social worker usually attended the review, but their report was often short.

  ‘My role is to supervise and monitor Cathy in all aspects of her fostering,’ she said, looking at Caz, Kelly and Paris as she spoke. ‘I visit her regularly and we discuss Max’s needs and how Cathy is meeting them. I check her record-keeping is up to date and advise her on further training. She is a conscientious and experienced carer who provides a high level of care. We are also in regular contact by phone and I know she will ask for advice and help if necessary. I have no concerns and am happy with the level of care Max is receiving.’

  ‘Thank you,’ the IRO said, making a note. She looked at her checklist and then at us. ‘Has Max had any accidents or illnesses since he came into care?’

  ‘No,’ I said.

  ‘And he hasn’t run away?’ A standard question.

  ‘No,’ I said again.

  ‘Are there any complaints from anyone?’ She glanced at each of us in turn. This was another standard question, and while Caz had had plenty of complaints to begin with, they seemed to have fizzled out. There was silence. ‘I’ll write none then,’ she said. Then looking at Jo: ‘When are you next visiting Max?’

  ‘Next week,’ she replied.

  ‘So am I,’ Jill said.

  ‘Well, if no one has anything further to say, all that remains is to set the date for the next review in three months’ time. If Max is home by then, it’s likely the review won’t be needed, but we can confirm or cancel nearer the time.’ She opened her diary and chose a date at the beginning of October, which Jo, Jill and I noted. Then she thanked everyone for coming and closed the meeting. ‘Have arrangements been made for your transport home?’ she asked Caz.

  Caz looked at Jo, who said, ‘I’ll call a cab now.’ She stood and so did I.

  ‘I’m dashing off,’ I said. ‘I have to collect my daughter from nursery.’

  ‘Thank you for coming,’ the IRO said.

  ‘I’ll phone you,’ Jill said.

  ‘See you later,’ I said to Caz.

  ‘If I’m not in bed,’ she returned. ‘I’ll be exhausted after this lot.’

  I smiled sympathetically and, calling goodbye to everyone, left the room. Although the meeting had started late, I still had time to collect Paula from nursery. Overall, I felt the review had gone well. The minutes would be typed up and a copy sent to all of us who had attended. That Kelly and Paris had volunteered to help Max stick to his diet during contact and were going to attend the health centre themselves I thought was very positive. Perhaps they’d persuade Caz to go too. She hadn’t said much at the review, but at least she seemed reasonably amicable. There had definitely been a change in her over the last few days, so I assumed that her bad humour while in hospital was probably a result of frustration and anxiety about her operation.

  That evening, when I took Max to contact, Kelly let him in. She said her mother was resting on her bed
but would get up when Max arrived. Their father was out. Adrian, Paula and I had time to go home briefly and when we collected Max I left them sitting in the car directly in front of the house, with the pavement-side door open to let the air in and so I could see them clearly. Kelly saw Max out and Caz, who was sitting out of sight in the living room watching television, shouted goodbye.

  ‘How are you?’ I called.

  ‘Uncomfortable!’ she returned. ‘Kelly! Can you fetch me another cushion on your way back?’

  Kelly sighed in mild exasperation and rolled her eyes. ‘She was less of a problem in hospital,’ she said affectionately.

  I smiled, called goodbye to Caz down the hall and we left.

  The next day was Friday and that evening, before Max had his bath, I took the scales from where I stored them in my bedroom into the bathroom and weighed him. I was weighing him once a week as I’d been advised to and was keeping it all very low-key. I didn’t want him to become fixated or anxious and to start counting pounds or become disappointed if he didn’t lose weight one week. The diet wasn’t drastic, just healthier eating with fewer sweet and fatty foods and more exercise, so change was likely to be slow. He’d actually lost four pounds, but I simply said, ‘Well done.’ I left the bathroom for him to finish getting undressed and returned the scales to my bedroom, then I waited on the landing until he’d finished his bath. Max had a bath every evening now as part of his bedtime routine, just as Adrian and Paula did. Later, I recorded his weight in my fostering log.

  For the next few evenings, when I took Max to contact, one of his sisters answered the door when we arrived and saw him out when he left. After Kelly’s comments about fruit, I was now buying extra again so that Max could take some with him, as he had done at the hospital, but not the bag of sweets. When I asked him if he’d had a nice time he always said he had and that he’d shared the fruit with his sisters before going to his room to read. From what he told me, he spent most evenings in his bedroom because he didn’t like watching the television as his mother and sisters did. While this seemed isolating to me, it was what he was used to and happy with, although I suspected that had they all played a game of cards, for example, or watched a good children’s film or wild-life documentary, which Max loved, he would have joined in. He had started leaving some books in his bedroom at his home so he didn’t have to keep taking the one he was reading at my house. He brought them back when he’d finished them and exchanged them for different ones.