‘Missed opportunities’ to protect murdered toddler Lola James

There were missed opportunities to protect a Welsh toddler who was murdered by her stepfather four years ago, a review has found.

Lola James, who died in July 2020, was fatally attacked in her home in Haverfordwest, Pembrokeshire, by her mum’s boyfriend, who claimed she had fallen down the stairs.

A report into the two-year-old’s death published on Thursday has identified a range of issues at various organisations, including proper processes not being followed.

Kyle Bevan, 32, of Haverfordwest, Pembrokeshire was given a life sentence for murdering Lola in July last year.

Her mother, Sinead James, 31, also of Haverfordwest, was also found guilty of causing or allowing the youngster’s death and given a six-year jail term.

The judge concluded Lola’s mother was asleep when the little girl suffered the injuries that caused her death but that she was aware that Bevan had been abusing Lola, “yet did nothing” to protect her.

The child practice review by the Mid and West Wales Safeguarding Children Board set out a series of failings, with reports closed without any real detail, overworked staff and visits not made when they should have been.

Violence

The report said that Lola suffered a violent attack by Bevan on the evening of July 16 2020 and into the morning.

Ambulance staff raised concerns that the injuries were inconsistent with falling down the stairs, as the mother had claimed on the phone to 999.

Lola was taken to the local hospital and later pronounced brain dead.

Bevan was known to the police since at least March 2019 for domestic incidents related to his own mother, who told the court he had an “anger problem”.

The review said concerns had been raised in January 2020 by a health visitor to Lola’s home, who said the mother was finding her daughter demanding, and at previous visits, she was unwashed, with her feet black with dirt.

While the health visitor submitted a multiagency referral form – to bring in social services – the review said there were a number of “missed opportunities” to arrange additional home visits, which could have allowed Lola’s well-being to be ascertained.

Those visits could also have uncovered that Bevan was living at the address, which James had not revealed to the team, and the condition of the home, which “would (on its own) have raised child protection concerns”.

Children’s Services opened a report on Lola which the review criticised as “lacking in detail and analysis”.

The board said a report had been dated February 2020, but it became apparent that the assessment had not been completed by the named social worker and had instead been created and closed by a team manager in March of that year.

The social worker named had been on sick leave, with the team “struggling under the pressure of the relentless workload”.

She told the review board that she had not anticipated that her assessment would be closed by her supervisor while she was off, as it was not usual practice.

The review found the closure of Lola’s case was “not appropriate”.

It said: “This is not a practice that was endorsed by children’s services at the time, or to date.

“The consequence of what happened in this case is that an assessment of (Lola’s) needs was not properly undertaken by children’s services, as required.”

It was also found that Lola’s father had not been contacted by social workers, nor had he been informed by police about incidents at the home.

Had he known, he suggested she could have been moved into his “bubble” during the pandemic.

The report admits Lola’s death may not have been prevented if the case had not been closed by social services or more health visits had been carried out, but more should have been done.

The report listed seven learning points and 11 action points for improvements to be made to prevent future deaths.

Actions recommended include ensuring adequate staffing levels and that information be better shared between agencies.

Pembrokeshire County Councillor Tessa Hodgson, cabinet member for social care and safeguarding, said: “Pembrokeshire County Council would first like to convey their sincerest condolences to the family of Lola James and to all those who have been affected by her murder, over four years ago.”

She described the review as a chance for the authority to reflect on its practices and to learn from the observations in the report.

She insisted that an action plan to deal with the issues was already being implemented with a social care improvement board being established.

She said: “We hope also that the report, will contribute to wider ongoing learning and improvement in relation to a number of key safeguarding issues across all agencies with safeguarding responsibilities in the West Wales region and beyond.

“It is imperative that we take all opportunities to improve our services, and ensure that children and families receive the best quality of support available.”

A joint statement on behalf of Pembrokeshire County Council, Hywel Dda University Health Board and Dyfed Powys Police said: “All agencies involved in this report wish to convey their sincerest condolences to the child’s family and to all those who have been affected by the murder of a child in such appalling circumstances.

“This review has been an opportunity to reflect and share learning amongst all partner organisations and practitioners on a multi-agency basis, and we acknowledge the commitment and contribution of those who have taken part in the review process.

“All agencies take very seriously the opportunities that this review presents, to consider our practice and improve how we protect vulnerable children.

“We hope that the report will also contribute to wider ongoing learning and improvement in relation to a number of key safeguarding issues across all agencies with safeguarding responsibilities.’

“Lack of focus”

The Children’s Commissioner for Wales shared: “We’ve heard that Lola James had a passion for the outdoors, and a laugh that filled the room with joy. But amongst the failures documented in today’s report is a lack of focus on her experiences and needs, and a failure to take a child-centred-approach, at a time when she desperately needed the professionals around her to act quickly and decisively to keep her safe.

“Whilst the review’s recommendations centre around improvements required at a local level, for us, the review’s reach stretches far wider- it’s clear to us that there are national learning points from this report.

“Some, like inadequate information-sharing, are consistent themes in child practice reviews that point to a weakness in how the learning from individual cases effectively improves national practice.

“We continue to be deeply concerned about this element of our child protection system – despite us requesting time and again for clarity, the fact remains: we do not know who has responsibility for driving systemic improvements on the back of these reviews, and who is responsible for holding agencies to account for improving practice.

 “I’m also worried about the pace of change. These investigations cover the most heinous actions against children, and yet we know from work we’ve done that there are actions from previous Child Practice Reviews that haven’t been fully implemented years after they were published.

“We need a much stronger system of clear ownership, clear direction, and clear accountability. Quite simply, there are serious questions for the Welsh Government, questions that I’ve asked consistently over the past two years, that remain unanswered.”

“Horrendous”

Carl Harris, Assistant Director at NSPCC Cymru, said: “Lola deserved a happy and healthy future, but that was cruelly taken away by the horrendous actions of Kyle Bevan and the failure of her mother, Sinead James, to intervene.

“The findings in this report highlight yet again the need for greater investment in children’s services in Wales to provide comprehensive support to any child at risk of harm and to be better equipped to prevent a tragedy such as this happening again.

“It is time to make child protection a national priority. The Welsh Government has committed to transforming children’s social care, but we need to see more details on timescales, activity and progress.

“We need systemic changes that ensure children like Lola are better protected.

“We can all look out for children’s welfare, and anyone concerned about a child can call the NSPCC free helpline on 0808 800 5000, or email [email protected] . If a child is in immediate danger, please call 999.”