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(Family Division, Keehan J, 1 April 2014)
Fact-finding hearing - Non-accidental injuries - Factitious illness disorder
A fact-finding hearing found the mother had lied about serious injuries sustained by her two children because she was culpable for them.
Care proceedings were initiated in relation to two children aged 6 and 4 due to allegations of fabricated illness and physical abuse by the mother. The mother and father accepted most of the allegations in relation to fabricated illness but the mother did not admit to the physical abuse of the children. A fact-finding hearing was convened to determine the cause of physical injuries sustained by the children.
A report was obtained from a consultant psychiatrist who diagnosed the mother with factitious disorder by proxy in addition to pathological lying, there was also early evidence of emotional instability and borderline personality disorder with evidence of anti-social personality traits.
The court heard evidence from a consultant paediatrician who reported that the co-existence of factitious illness and physical abuse were exceptionally rare.
The judge gave himself a modified Lucas direction in respect of the need to ask whether there was any reasonable explanation for the mother's untruthfulness or if there was no such explanation the only conclusion the court could draw was that she lied because she knew of or was responsible for the injuries.
The judge found that the mother's account of how various injuries to the children had been sustained was inconsistent and untruthful. The judge stopped short of finding some of the injuries were non-accidental due to a lack of other evidence supporting such a conclusion. In relation to other injuries he did find that the reason for the mother's false account was that she was culpable for the injuries and had failed to give a truthful account.
The judge concluded that the children had undoubtedly suffered considerable harm and that without significant change by the mother it was difficult to see how the risk posed to the children could be lessened.
Neutral Citation Number:  EWHC 1325 (Fam)
Case No: TK13C0079
IN THE HIGH COURT OF JUSTICE
Royal Courts of Justice
Strand, London, WC2A 2LL
THE HONOURABLE MR JUSTICE KEEHAN
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GS AND LS (3)
(by their Children's Guardian)
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Richard Hadley (instructed by the Local Authority) for the Applicant
Fiona Jamieson (instructed by PCB Solicitor LLP) for the First Respondent
Caroline Baker (instructed by Mortimers Solicitors) for the Second Respondent
Mair Mihangel (instructed by Wace Morgan Solicitors) for the Third Respondent
Hearing dates: 24, 25, 26, 27, 28, 31 March 2014
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Mr Justice Keehan:
 These care proceedings relate to two young children GS, who was born on 27 March 2008 and is 6 years of age, and LS, who was born on 3 March 2010 and is 4 years of age.
 Their mother is LG, formerly known as SL. She was born on 1 May 1987 and is 26 years old. Their father is DS. He was born on 18 March 1963 and is 51 years old.
 In July 2013 medical professionals became seriously concerned about the honesty and accuracy of accounts and histories given by the mother in relation to the medical presentation of LS. A referral was made to social services. A child protection plan was implemented. The local authority commenced these proceedings on 10 October 2013.
 There are separate proceedings relating to the girl's half sister IG. She was born on 11 February 2014. Her mother is LG. DNA testing has established, however, that her father is not DS. The mother has identified the man she says is IG's father. The local authority is continuing its inquiries to make contact with him.
 The father agreed at the last hearing to care for IG. Very shortly afterwards he realised he could not care for the girls and a very young baby. The father's decision is wholly understandable. He contacted the social worker and in a planned way IG was placed with foster carers.
Application and Issues
 The local authority filed and served a comprehensive threshold document setting out the findings of fact sought to satisfy the criteria of s31 (2) Children Act 1989. This matter was set down for a fact finding hearing to be immediately followed by a welfare hearing.
 The case relating to IG is listed for case management directions and cannot be concluded at this hearing.
 The mother denied many of the matters alleged in the local authority's threshold document for a considerable period after the involvement of the local authority. The father to some substantial degree vacillated in his acceptance of the actions alleged against the mother.
 In her response to the threshold the mother unequivocally accepted the vast majority of the findings of fact sought against her [A55a‑k]. The father in his response similarly accepted the vast majority of matters alleged in respect of the mother [A56‑65].
 The broad findings of fact accepted by the mother are:
a) she fabricated symptoms of epilepsy in respect of LS in accounts she gave to medical professionals on no less than 9 occasions between 23 June 2011 and 8 May 2013;
b) as a result of those false accounts LS was prescribed unnecessary medication;
c) she gave a false account to the school, the nursery and the health professionals that LS had been diagnosed with a brain tumour. Very unfortunately GS and LS became aware of this false account;
d) on 2 occasions, 26 June 2011 and 23 October 2012, she gave false histories of prescribed medication for LS to health professionals;
e) she falsely claimed LS had a peanut allergy which led to the prescription of an epipen; and
f) she falsely reported to nursery staff that she had been medically advised that LS should drink 3000ml of liquid per day.
 On the basis of these admitted facts the parents concede the threshold criteria of s 31 (2) Children Act 1989 are satisfied. They are right to do so.
 There are three findings of fact which the mother and/or the father do not accept. In light of the concessions made in their respective responses to threshold, however, the local authority considers it neither necessary nor proportionate to pursue findings of fact against the mother and/or the father. The children's guardian supports that approach.
 Those disputed findings of fact relate to:
a) the mother's allegation that GS had been hit by a car on 6 December 2011;
b) there were numerous incidents of domestic violence between the parents some of which the children when the children were present; and
c) on 13 September 2013, in breach of the child protection plan, the parents met at the railway station when LS was present.
 I agree with the approach adopted by the local authority. I cannot resist making the observation, however, that the mother's allegation that GS was hit by a car travelling at 45‑50 mph without being killed or suffering extensive and serious injuries is absurd.
 The local authority raise an issue about the extent to which the father failed to protect either child from the mother's actions and falsehoods. The issue can be summarised as follows - to what extent was the father's approach of:
a) ‘taking a back seat';
b) not challenging the mother's accounts;
c) not following up on his suspicions about her accounts and actions; and
d) not attending any medical appointments with either child prior to June 2013;
reasonable or excusable in the circumstances of this case?
 I agree with the approach adopted by Mr Hadley, on behalf of the local authority, and of Mrs Baker, on behalf of the father, that this issue ought more properly to be determined, if at all, at the welfare hearing to follow rather than at the fact finding stage of this case.
 There are three remaining disputed issues of fact for me to determine. On the basis that the issues relate to potential episodes of physical abuse, as opposed to factitious disorder by proxy, the local authority submit that findings on these issues are required to inform the care planning for both of the older two children. Dr Mecrow, the consultant paediatrician, and Dr Durand, the consultant psychiatrist, both experts instructed in the case, advise that there is important distinction between factitious disorder by proxy, which results from psychiatric disorder or mental illness, and acts of physical abuse, which do not [E56 and E116].
 Those issues are whether:‑
a) the mother gave a truthful account of the circumstances in which GS suffered fractures of her left radius and ulna on 28 February 2011;
b) the mother gave a truthful account of the circumstances in which LS suffered a wound to her abdomen on 23 October 2012; and
c) the mother gave a truthful account of the circumstances in which LS suffered fractures of her left radius and ulna on 8 May 2013
 In the case of each of the three injuries, if I find the mother has not given a truthful account I must determine whether:
a) she is the perpetrator of a non‑accidental injury; or
b) she knows but has not revealed the true version of the events which led to the injury.
 The burden of proving these disputed findings of fact rests with the local authority.
 The standard of proof is the simple balance of probabilities: Re B (Care Proceedings: Standard of Proof)  2 FLR 141.
 The full background of this matter is set out in a chronology prepared by the social worker. For the purposes of this judgment I need only to refer to the salient features of the history, which are relevant to the limited findings of fact I am now invited to make.
 The mother had an extremely troubled childhood. She was seen by consultant child and adolescent psychiatrists on a number of occasions because of her behaviour. She has alleged she was physically and sexually abused by her father when she was 9, 11 and/or 13 years of age. These matters are fully set out and considered by Dr Durand in her report of 19 March 2014 at E103‑112.
 The mother and father met when the father began a relationship with the maternal grandmother. There came a time when the relationship between them changed from a platonic friendship to a sexual relationship by which time the father's relationship with the maternal grandmother came to an end. The parents assert their relationship began only after the mother was, at least, 16 years of age. The maternal grandmother has alleged that the parents' relationship began when the mother was below the age of consent.
 In 2008 GS was born and in 2010 LS was born. The mother was their full time carer. The father was gainfully employed and accordingly played a less involved role in the day to day lives of the children.
 On 28 February 2011 GS suffered the fractures of her left radius and ulna.
 The presentation of LS to health professionals with fabricated symptoms of epilepsy began in June 2011. These presentations continued periodically through until May 2013.
 On 6 December 2011 the mother reported to the police the incident in which GS was allegedly struck by a car.
 On 23 October 2012 LS was taken to hospital by her mother. She told the health professionals that LS had had an epileptic seizure and had an injury to her abdomen. The mother reported that the latter was sustained when LS fell down four stairs when holding a pen. There are significant inconsistencies in the history provided by the mother to the different health professionals who examined LS.
 The treating doctors noted a small puncture wound to the upper part of the right side of her abdomen. The view was taken that the wound was superficial only and did not require treatment but, because of the alleged convulsions, she was admitted for observations overnight.
 The mother continued to present LS to health professionals alleging she suffered from epilepsy and was prescribed and given medication which was, as we now know, wholly unnecessary.
 On 8 May 2013 LS sustained fractures of her left radius and ulna. She was taken by her mother to hospital. From the date of this presentation the mother has given seven different explanations as to how LS sustained these fractures.
 These explanations are as follows: -
a) a consultant paediatrician at the Hospital caused the injury when examining LS;
b) when LS was getting off a bus with her mother she experienced an epileptic seizure and caught her arm in the bus door;
c) LS had been banging her arm;
d) LS' arm may have become trapped in her pushchair;
e) the mother simply did not know the cause of the fracture;
f) in October 2013, the mother told the social worker that her sister and her sister's boyfriend had been giving LS a ‘leg and a wing' in a local park when her arm got bent behind her back. The mother said LS ran to her saying ‘my arm' and that she could see a curve in LS' arm. Rather than seeking immediate medical treatment the mother waited until a scheduled medical appointment arranged for that day to report the injury; and
g) during a conversation with the mother and the social worker on 27 February 2014 the mother gave a finesse on the sixth explanation, namely that during her sister and her sister's boyfriend giving LS a ‘leg and a wing' she had been dropped and the boyfriend had then stood on LS' arm causing it to fracture.
 It is now accepted by the mother at this hearing that the first five explanations offered by her are false. The mother still relies on the sixth and/or seventh explanations to account for LS's fractures.
 I have helpfully been provided with a comprehensive reading list. I have read all of the documents the parties invited me to consider.
 I heard oral evidence from Dr Chapman, an extremely well renowned consultant paediatric radiologist, CK, the social worker, the maternal grandmother, LJ, one of the mother's sisters, CL‑J, and her partner, CG, and the mother.
 Dr Chapman remained of the view that if the mother's account of GS' accident on 28 February 2011 was accepted, that could provide a plausible explanation for the same. The mother claims these fractures were sustained when GS was about to fall downstairs and the mother grabbed her left arm to prevent her falling down the stairs.
 Dr Chapman was clear that the sixth explanation offered by the mother could provide a plausible explanation for the fractures suffered by LS on 8 May 2013 namely that (a) she was dropped in the course of this activity or (b) her arm was bent behind her back when she fell. Dr Chapman accepted that either account could explain the fractures. His view was that the finesse to the sixth explanation, namely that after LS had been dropped, CL‑J's boyfriend stood on LS' left arm (the seventh explanation) would not, on the balance of probabilities, have caused a fracture to her left arm.
 Dr Durand, who was not required to attend this hearing to give evidence, diagnosed the mother as suffering with factitious disorder by proxy. She made the following further diagnoses: -
a) pathological lying;
b) some historic traits;
c) early evidence of emotional instability and emerging borderline personality disorder traits; and
d) evidence of anti‑social personality traits [E112‑113].
 The maternal grandmother, in her evidence, confirmed she had been told by the mother that LS had a brain tumour and she had been told by the mother to give LS anti‑epileptic medication when LS was in her care.
 She gave evidence about the events of 8 May 2013. The grandmother maintained she was not present when the ‘leg and a wing' incident took place in the park.
 CL‑J and her boyfriend, CG, told me they were playing with the children in a local park. At one point they played the ‘leg and a wing game' with LS. CL‑J said she had hold of LS' hands and CG held her feet. As they swung LS slipped from her aunt's hands and fell to the floor.
 Each described LS as being upset and seeking comfort from her mother. Neither described LS' left arm being bent behind her back nor CG standing on LS's arm after she had fallen to the ground. Moreover both described LS settling quickly and the family group returning to the mother's home. During their time there neither of them heard LS complain about her arm or of being in pain nor did they observe LS appearing to be other than normal and happy.
 The maternal aunt and her boyfriend denied telling the mother that LS had fallen with her arm bent behind her back or that CG had stood on her arm.
 The mother gave evidence last Friday morning. She spoke about the events leading to the fracture of GS's arm, to LS' abdominal injury and to the fracture of her arm. In examination in chief and in the initial stages of cross‑examination by Mr Hadley, on behalf of the local authority, she was emotionally flat.
 There came a time during the latter stages of cross‑examination when she disclosed that she would not do anything to hurt GS or LS. She then broke down. I rose for a short time to allow her to compose herself.
 During that time she attempted to speak with her legal team and told my clerk she could not continue to give evidence. Eventually, however, she did.
 The mother said she had told people LS had a brain tumour because her mother had told her to do so. She claimed her sister, CL‑J, had telephoned their father immediately after LS' fall in the park and that he had telephoned the mother and threatened her if she linked LS' fracture to the fall during the leg and a wing game. Thus, says the mother, that is the explanation for the initial false accounts given to professionals.
 I note the first allegation was not put to the maternal grandmother in cross‑examination. Further, the issue of the telephone call was not put to the maternal aunt when she gave evidence.
 Of far greater concern, however, is my sense of the mother's evidence that she was starting to resile from the admissions made in her recent response to threshold. At the very least the mother demonstrated that she was not accepting full responsibility for the events of 2011 - mid 2013.
 In relation to the mother's account of the events leading to GS sustaining a fracture the local authority accept that the mother has given a single consistent version of events.
 The mother admitted that her account of LS having a convulsion or fit on 23.10.12 was false. It was part of the history given by her to health professionals at the hospital. Further she accepts she gave a false history in alleging that LS had previously been given 11 courses of antibiotics and had suffered meningitis.
 When cross‑examined by Mr Hadley the mother could not give any explanation for the inconsistent histories given by her at the hospital. I set out those inconsistencies at para . They relate to whether the incident was seen by the mother, who extracted the pen and to what extent, if at all, there was bleeding from the wound.
 The mother maintained that on the 8 May 2013 there was a family gathering in a park in some significant distance from where she lives. She said her mother was present as was her other sister and her daughter. She said GS was not present because she was at school.
 She saw CL‑J and CG each take hold of one of LS's hands and legs. The next matter that occurs is LS coming to her, distressed, saying her arm hurt and seeking comfort. The mother says she saw LS's arm was bent.
 Thereafter the mother said she took LS for her pre‑arranged appointment at hospital at 11:30am. The medical notes do not reflect the mother's evidence that she reported the deformity in LS' arm to a nurse on arrival at the hospital. Rather the notes indicate that it was a doctor who observed the deformity and referred the child to the Accident and Emergency Department.
 The mother could not give any explanation why she continued with the charade that LS was suffering from epilepsy when she knew the child had suffered an injury and was in pain. The hospital appointment had been arranged to consider the issue of LS's medication during which the mother asserted LS' seizure/epileptic symptoms had got worse.
 When the court rose on Friday the father telephoned the hospital to inquire about the time of LS' appointment on 8 May 2013. All parties accepted, without the need for the father to give sworn testimony, that he had been told the appointment was at 9:30am. Nevertheless, I was told by Ms Jamieson that the mother maintained her account that the appointment was at 11:30am.
Analysis and Findings
 I remind myself that factitious disorder by proxy is not generally associated with acts of physical abuse of a child. Indeed the contrary is the case, namely the expert evidence is that, although a finding of factitious illness behaviour does not exclude a finding that a parent has physically abused a child, it is, at least, an unusual presentation. Dr Mecrow went so far as to describe the co‑existence of factitious or induced illness (‘FII') and physical abuse to be exceptionally rare [E56].
 The mother's admissions recently made in relation to the findings of fact sought by the local authority, very seriously call into question the mother's credibility. They call into question the extent to which the court is able to give any credence or rely on any account given by the mother in respect of any of the injuries sustained by the children.
 In my judgment it would be wrong, in light of the opinions of Dr Durand and Dr Mecrow, for me to take account of the mother's admissions in relation to fabricated illness to support a finding or findings that she was responsible for the physical injuries sustained by GS and LS.
 I do not ignore those admissions and the diagnosis of Dr Durand. Any adverse findings about the physical injuries must, however, stand or fall on a close analysis of (a) inconsistencies in the accounts given by the mother for each episode; (b) the surrounding circumstances of each event; and (c) to consider the three events in the round.
 The mother's admissions of fabricated illness and the diagnosis of Dr Durand do not and must not lead to a conclusion that the mother has physically abused one or both of her children. The two issues are quite separate.
 I, of course, give myself a modified Lucas direction. Insofar as the mother has been found to have lied about a material issue, I must ask myself whether there is any reasonable explanation for her untruthfulness or whether there is no such explanation and the only conclusion the court can draw is that she has lied because she is responsible for the injuries sustained by GS and/or LS or she otherwise knows the truth about how these injuries were sustained and has not revealed the same.
 In contrast to the other incidents in issue, the mother has given only one account for how GS sustained her fracture on 28 February 2011. Further she has been consistent in advancing that explanation. I was not referred to any significant inconsistencies in her account.
 Dr Chapman is of the view that the mechanism and circumstances of this incident are compatible with GS having sustained the left arm fractures of her radius and ulna.
 I have deep suspicions about the mother's explanation for this injury in light of the considerable body of evidence of her untruthfulness. I am not, however, satisfied on the balance of probabilities that this was a non‑accidental injury or that it was perpetrated by the mother. In so concluding I have taken account of the opinions Dr Mecrow and Dr Chapman expressed in their reports [E70 and E77c].
 LS' abdominal wound for which she was taken to hospital on 23 October 2012 is a curious incident. Accidents at home with young toddlers do happen. I am concerned, however, that the history given by the mother at hospital included LS suffering a convulsion after her fall. That part of the history is plainly and admitted to be false.
 There are inconsistencies in the accounts given by the mother as recorded in the medical records:
a) when seen in triage at 14:05 on 23 October 2012 the mother is recorded as reporting ‘child pulled pen out of wound in R upper abdomen blood on pen to 1.5cm' [GA24];
b) when LS was examined by a doctor at 14:15 the notes record ‘accidental stabbing [with] pen ...... Child fell onto floor [with] pen → stabbed. No blood loss 3cm deep mum extracted' [GA25];
c) when examined by a surgical senior house officer at 15:35 the history and presenting complaint reported by the mother is recorded as ‘landed face down hand to pen in side - LS pulled out pen was in her hand (by the time mother got to LS pen was out) went in [about] 1.50cm Bleeding after some time' [GA28].
 The mother is unable to give any satisfactory explanation for any of those inconsistencies in the history given to the various medical professionals.
 It is right to record, however, that the nature of LS' injury is described variously in the hospital medical notes:
a) on examination at 14:15 it is described as a ‘small puncture wound [no] bleeding' [GA 26];
b) on examination at 15:35 it is described as a ‘self sealed wound ... [no] bleeding ... wound soft no evidence of foreign body in wound' [GA28a];
c) in the hospital notes at GA29 the injury is described as a ‘stab wound' but in the treatment codes below there is no reference to the wound being dressed, cleaned or closed;
d) the discharge summary described the injury as a ‘non penetrating injury to abdomen' [GA398]; and
e) in the nursing notes at 1000 on 24 October 2012 there is a reference to ‘wound site clean and dry' [GA215];
f) in those notes at 1400 there is a reference to ‘dressing changed. Wound clean and dry. [illegible] dressing applied [GA 216];
g) the general practitioner's note of a consultation on 26 October 2013 reads ‘penetratin (sic) abdominal wall injury ...... dressing on abdomen changed'. There is reference to LS being prescribed a course of antibiotics [GA 267].
 On the basis of those medical notes and notwithstanding the reference in the discharge summary to a non penetrating injury, I am satisfied that:
a) LS suffered a puncture wound to her abdomen which was observed at hospital;
b) during her short admission the wound was dressed and the dressing were then changed; and
c) her general practitioner changed the dressing on 26 October 2013 and prescribed antibiotics. In the absence of any other presenting complaint described in the notes for that consultation, I can only assume that prescription was given because the wound was infected.
 In respect of that puncture wound suffered by LS, however, I am not satisfied that the mother has given a truthful account of the events which led to that injury.
 I make those findings for the following 6 reasons:
a) the mother gave a false history at the hospital of LS suffering a convulsion that day;
b) the various accounts given of how far the pen punctured LS' abdomen, who extracted the pen and whether there was any bleeding are wholly inconsistent one with each other;
c) I do not believe the mother has given a truthful account of the events which caused the wound;
d) I have considered whether this is in fact a non accidental injury inflicted by the mother;
e) I consider it unwise to make such a finding in the absence of any other evidence supporting such a conclusion;
f) The injury occurred when LS was in the sole care of her mother.
 Is there any alternative explanation for the inconsistent accounts given by the mother other than she is culpable in the cause of this injury? In my judgment there is not.
 I am satisfied that the only explanation for the inconsistent, and in my judgment false, accounts given by the mother is that:
a) she is culpable for the injury sustained by LS; and
b) she has failed to give a truthful account of the cause of the same.
 The implications of my findings are serious. Her diagnosed psychiatric conditions and mental illness may explain why the mother fabricated illness in LS. They do not, in my judgment, explain why this mother has chosen to lie about the circumstances which led to LS sustaining a puncture wound.
 In relation to the fractures sustained by LS for which she was presented to hospital on 8 May 2013 I have to consider the conflicting accounts given by the maternal grandmother, CL‑J and CG, on the one hand, and the evidence of the mother, on the other.
 I found LJ, the maternal grandmother, to be disarmingly frank in her evidence. She readily conceded the very difficult relationship she had had with her daughter, the mother, over the years. She accepted that from time to time she and the mother had arguments and fell out. At the conclusion of her evidence she was at pains to tell me that, whatever her daughter had admitted about fabricating symptoms in LS, she did not believe her daughter would ever physically abuse her children.
 The maternal grandmother was adamant that:
a) she was not present in the park when the ‘leg and wing' incident took place;
b) she had never told the mother that the best way to improve her relationship with the father was to say that LS was ill;
c) she had never suggested to the mother she should make up a story about LS' fracture; and
d) the mother had never told her that the cause, a possible cause, of LS' fracture was a result of falling during the ‘leg and a wing' game.
 Having watched and listened carefully to the maternal grandmother, I am satisfied that she was being truthful about each of those matters. Accordingly I accept her evidence on those material issues.
 The maternal aunt was unclear about the date and time of the ‘leg and wing' incident. She was clear about what happened during that game and accepted that LS slipped out of her hands, fell and subsequently was upset. She asserted that LS soon settled and thereafter was normal and happy. She denied LS appeared injured or in pain or uncomfortable.
 In my judgment the fact that she had some difficulty recollecting surrounding events, supports her evidence about this matter. LS fell, was upset and then seemed fine. Nothing out of the ordinary or of concern occurred. Accordingly, it is entirely understandable that she had problems fully recalling events of many months ago.
 I certainly did not conclude that her vagueness resulted from a desire to avoid being blamed for injuring LS.
 CG was an extremely nervous and anxious witness. He too struggled with his memory in recalling events surrounding the ‘leg and a wing' game. For the reasons just given above I am not surprised by his difficulty and I do not conclude that the same resulted from a desire to avoid blame for LS' fractures.
 He recalled the ‘leg and a wing' game. He told me LS slipped from his girlfriend's hands, fell and was upset. She was comforted by her mother and after 5‑10 minutes appeared fine.
 I accept this evidence. I find they were honest witnesses attempting to do their respective best to recall past events. Both of them denied seeing LS' left arm bent behind her back as she fell or of CG standing on LS' arm. Further, both denied telling anyone that either of those events had occurred. I accept their evidence on these issues.
 In relation to LS' fractures, I do not accept any of the various explanations offered by the mother. The explanations are extremely different and diverse. I reject all of her accounts of the cause of LS' fractures. Just as she has admitted that the first five explanations are false, I find the sixth and seventh explanations are false they were invented by her.
 In my judgment it is not without significance that the mother's explanations of these injuries were given at a time when the mother was at the height of giving and maintaining false accounts of LS' presentations and reported symptoms to health professionals.
 The mother says she gave her early false accounts of the cause of LS' fractures because of pressure from her mother or her father or both of them not to blame or involve her sister, CL‑J in the cause of the injuries.
 In light of my assessment of the mother and of her family members, I do not accept there is any credence to be attached to that explanation. This account does not explain why after divers unfounded allegations for the cause of these injuries, the mother should finally adopt explanations, the sixth and/or seventh, which hold her sister and/or her sister's boyfriend responsible, albeit by way of accident, for the injuries.
 On the basis of all of the evidence, I am satisfied that the mother's account of a meeting in a park on 8 May 2013 is a complete fabrication. I accept there was around this time a leg and a wing game involving the aunt and her boyfriend but it occurred before that date.
 No one described LS' arm appearing bent or deformed, or of the child being reluctant to use her left arm or of her appearing to be in pain before the morning of 8 May. Accordingly I am bound to conclude that that fracture was sustained on the morning of 8 May.
 In all of the circumstances of this case and because of my rejection of the mother's various allegations for the cause of the injuries, I am satisfied that the mother has not provided a truthful account of the events of that day and/or how LS sustained her fractured arm. This injury was sustained when LS was in the sole care of her mother. There is no account given by her which would explain that these injuries were sustained in an accident.
 Is there any alternative explanation for, as I have found, the mother's lies other than that she is culpable for LS' fractures? In my judgment, there is not.
 I am satisfied that the only explanation for the various false accounts given by the mother is that:
a) the mother is culpable for the fractures sustained by LS; and
b) the mother has failed to give a truthful account of the cause of the same.
 I regret that the mother's evidence was in so many respects wholly unsatisfactory. The mother's capacity and willingness to lie remains undiminished. During this hearing the mother invited the court to listen to a recording of a conversation that she had with the maternal grandmother. She asserted that during the recorded conversation the maternal grandmother admitted being with the family in the park on 8 May 2013.
 In the event counsel listened to the recording. The maternal grandmother, as the mother must have known, made no admission whatsoever about being in the park. The mother could not explain why she had told that blatant untruth.
 The evidence and presentation of the mother at this hearing and the findings I have made lead me to conclude that the mother poses a grave risk of physical, emotional and psychological harm to her children. Her failure to give a truthful account of past events and her failure to be honest and that she continues to lie, complicates an assessment of the degree of risk she poses, but in my judgment it is a high risk.
 I find it difficult to see how, without some significant change in the mother, that risk can be ameliorated or reduced to a manageable or acceptable level. In acting as I have found the mother has she has failed to act as one would expect of a loving, caring, and protective parent.
 The impact of the same on her ability to parent safely any child is very considerable.
 I am told, and noted during the course of the hearing, that the father was troubled by the evidence. I regret that any hope he fostered of the mother being able to return to the family home to live is a forlorn one.
 The children, GS and LS, have undoubtedly suffered considerable harm as a result of this mother's actions.
 The parties will consider this judgment and in due course will file and serve evidence and make submissions on the appropriate final order which should be made in this case.
 I will determine the final orders to be made at the hearing now listed for 9‑11 April 2014.
Covers the law, practice and procedure in respect of FGM and also includes wider contextual...