Kaylea Titford: What the judge told parents as he jailed them for 'horrifying' manslaughter of disabled teenager

Sarah Lloyd-Jones, 40, was imprisoned for six years while Alun Titford, 45, was told he would spend seven years and six months behind bars for the criminal negligence that caused Kaylea's death.

Here are the words of Mr Justice Griffiths, who sentenced the parents at Swansea Crown Court on Wednesday.

"Her physical disability from spina bifida left her without much feeling or movement in her legs, but she was an accomplished wheelchair user who was competitive in national wheelchair sports. She went to a mainstream school. She had a learning assistant to help her with things in school she simply cold not do herself, but she would not allow people so much as to push her wheelchair or open a door for her. Everything she could do for herself she did. But she died just after her 16th birthday.

He continued: "You Sarah Lloyd-Jones, her mother, and you Alun Titford, her father, caused her death by a shocking and prolonged neglect over lockdown which you, by your guilty plea Sarah Lloyd-Jones, and a jury by a unanimous verdict, Alun Titford, have proved to be gross negligence manslaughter on your part. For those crimes, I now pass sentence."

After summarising the relevant facts of the case, the judge continued.

"Kaylea Titford was born with hydrocephalus and spina bifida in 2004. She was born with normal weight, but by the time she was three her weight had risen to the heaviest 99.6th centile of relevant weight on a scale from 0-100. At four years old she started mainstream primary school and at six she was already good at physical activities and games in her wheelchair. At 11 or so she went onto mainstream secondary school.

"Concerns about her weight led to a concerted effort by professionals to work with the family to improve her diet and stabilise her weight. Sarah Lloyd-Jones did not attend these appointments after the first one, but Alun Titford attended instead. For two years from 2011 there was success for which the family was given credit, but in 2013 when she was nine or 10, a number of years before Kaylea's death, the stabilisation of her weight came to an end and weight gain was an issue until she died.

"There was a history of missed appointments. Some of these ended the provision of relevant services because professionals took the view that there was no point in scheduling appointments which were not being attended.

"Both defendants were aware that help was available from a variety of agencies but they did not make full use of that help as time went on. By the end, they were not accessing or accepting any significant help at all for Kaylea. The whole burden therefore of looking at her fell on them, but this was not for reasons beyond their control. It was part of their gross negligence towards the wellbeing of their daughter.

"I do not accept that Alun Titford thought Sarah Lloyd-Jones was looking after Kaylea well enough on her own. It was obvious that she was failing. He did not need to look at her legs to see that. He would go into Kaylea's room from time to time, as he did on her birthday, and when he got back from work on other days. But he ignored the smell and the dirt and the flies and the chaos and the evidence of his own eyes and nose that she was not getting the care she needed.

"There were texts in which Sarah Lloyd-Jones begged for his help. He didn't give any help.

"His long hours at work are not an excuse. He liked working, he did not like helping. He was, as he freely accepted, too lazy to help. He expressed some scruples about getting involved in the personal care of a daughter who had reached puberty, but his neglect was total, and he could and should have done more to help, and ask others for help. Instead, when he was not at work, he sat in his bedroom upstairs watching television.

"Equally, I do not accept that Sarah Lloyd-Jones can throw the blame onto her husband. It was too much for her to do on her own, that I do accept. But it was her duty to ask for help and to accept it from the agencies which over the years she either ignored or turned away.

"When she had a telephone appointment with Birmingham Children's Hospital in May 2020 she did not say that help was needed for Kaylea. She was positively offered help in August 2020 by contact from a young person's lymphedema specialist, and later contact from a young people's specialist, and later contact from youth intervention service. She did not take up any of these offers.

"When Kaylea's non-attendance was queried after schools reopened in September 2020 she made various excuses for not sending Kaylea back without disclosing what was really happening.

"I find it impossible to say that one parent was more to blame than the other. They were both equally responsible and they were both equally culpable.

"Kaylea was found dead in bed on the morning of October 10, 2020. However, Sarah Lloyd-Jones' guilty plea and the facts proved to the criminal standard at Alun Titford's trial show that their failure to take reasonable care for Kaylea's health and welfare needs took place over a period between the start of lockdown on March 23 2020, when Kaylea stopped going to school, and her death, a period of over six months.

"This was not a lapse on the part of the defendants. It was a long and sustained period of criminal negligence. I say that having taken full account of the better care taken of Kaylea before lockdown.

"The particulars of criminal negligence, again accepted in the basis of plea and proven at trial, include the increase in Kayleigh's weight, which rose from 16st 12lb (107kg) when she was last weighed alive in March 2018 at the age of 13, to her post-mortem weight of 22st 13lb (146kg) on October 11 2020 , which was shortly after her 16th birthday on September 27. Her body mass index was 70.

"There was no attempt to control her diet. She could only eat what she was given, which by the end was the same fattening takeaways everyone else was eating. It was perfectly obvious from her physical appearance, and would have been to both defendants, that Kaylea was morbidly and dangerously obese.

"Not only did her parents not watch her diet as they had been taught to do, they failed to get her a wheelchair to replace the one she had grown out of. This left her completely bed-ridden, and her lack of ability to move herself caused still greater increase in weight. Her inability, also, removed her ability to extricate herself from the general squalor into which the defendants sank her.

"She was in a specially adapted room in a specially adapted house with her own disabled toilet, but she had long since been unable to toilet herself. By the time of her death, she was lying in her own filth, surrounding by flies which bothered her and maggots that fed on her. Her flesh was disfigured by ulcers which left her skin open down to the fat and in one place down to the bone.

"The stench created as her body rotted away alive and from the excrement left to dry unattended around and on her body and in the room, made paramedics and police officers of long experience wretch and feel physically sick when they attended on the body.

"The ulcers on Kaylea's body caused by pressure sores, lack of hygiene, lack of movement and lack of professional care were the worst the expert had seen."

Mr Justice did not go through the specific evidence but continued: "This was a horrifying case, a case of sustained neglect leading to the death of a completely dependent, bed-ridden, vulnerable, disabled child at the hands of her own parents. And it is not only the death.

"I have no doubt that the suffering and degradation she experienced before she died was prolonged and significant. While it is true that she had no feeling in her lower limbs, where most of the ulcers were, she could see and smell her own filth. She called for her help in text messages. What was happening was obvious to anyone in the room and it would have been obvious to her.

"Kaylea could see the flies and the maggots. She complained about the flies. She could see the bottles of urine from her catheter left unemptied and uncollected from the floor. She could see that her wheelchair was out of reach. She would know that it was now too small for her anyway. She could see dirty bedding and the mess in the room and she knew she had not been properly washed for a long time, even if she could not see her own blackened armpits and had limited or no feeling in her visibly crusty and ulcerated skin.

"For a girl of her age and independent spirit, this was a particularly terrible state to find herself in.

"In her last hours, the night before Kaylea's body was found cold and dead, her father heard her screaming. She had already turned her mobile phone off for the last time.

"Her father's reaction to the screaming was to text her telling her to stop, twice. He did not go and see what the matter was or get whatever help was needed, she was left to die alone."

Mr Justice Griffiths then said the following facts were clear: "Both defendants owed Kaylea a duty of care as parents with the care of their disabled child. They breached that duty by failing to take reasonable care for her health and wellbeing needs. They failed to take reasonable steps to prevent Kaylea from becoming morbidly obese, to ensure that Kaylea did not stay immobile for periods of time which were bad for her health and wellbeing, to ensure she had a safe and hygienic environment to live in, to ensure that Kaylea maintained a hygienic physical state, or to ensure her physical health needs were met and that medical assistance was sought when needed.

"It was reasonably foreseeable at the time that this gave rise to a serious and obvious risk of death and it was a significant cause of Kaylea's death. It was gross negligence, so gross as to be a crime."

The judge detailed how he had submissions from prosecution and defence counsel, pre-sentence reports and a report on Sarah Lloyd-Jones from a doctor with a doctorate in psychology.

"I do not accept that this was a case of lapse in an otherwise satisfactory standard of care. The standard of care had been inadequate for a long time before death.

"It was criminal through the whole period of lockdown. There was plenty of time to get help for Kaylea and to put things right for her.

"In all of that time things went from bad to worse. I do not accept that either parent can claim a lesser or subordinate role in the responsibility to Kaylea or in their gross negligence in discharging that responsibility and causing her death. They are both equally responsible.

"I do not accept that any blame that may have attached to outside agencies for not being more proactive can be used to reduce the defendants' primary responsibility as parents to reach out for the help which they knew from experience was available.

"Help was there for the taking. It was there for the asking. It had been given before. Both defendants completely neglected to get the help that Kaylea needed and sometimes it was ignored when it was offered. This can be seen at earlier periods from the evidence and from the chronologies from medical and other records.

"The failure to get any help at all even from Kaylea's GP was particularly significant in the crucial lockdown months leading to Kaylea's death.

"I have considered whether either defendant's responsibility was substantially reduced by mental disorder, learning disability or lack of maturity, and I have also considered the separate guideline on sentencing offenders with mental disorders."

He referred to a report on Sarah Lloyd-Jones from November 2022 after an interview with her, more than two years after Kaylea's death. He said the report was "not a reliable guide" to her mental state at the time of the neglect.

He said that lockdown impacted on many people's mental wellbeing, but that for most people it did not result in serious crime being committed.

"I am satisfied that Sarah Lloyd-Jones was fully aware and fully responsible for what was happening when Kaylea was alive. She had no mental disorder, learning disability or lack of maturity which substantially reduces her responsibility. Her intelligence was in an average range albeit low average."

Turning to Alun Titford, the judge noted that the father had been diagnosed with depression and had previously been taken to psychiatric hospital, but said that no episodes had been alleged in recent times.

"He was not on any medication and says he did not want any support from the community mental health team.

"Having heard him give evidence I see no reason to disbelieve his self-description as simply lazy.

"Being lazy meant not doing unpleasant work that he didn't want to do. It is not inconsistent with enjoying the work of a removals man. He accepted in evidence that he could have done more for Kaylea.

"In his case also I find that he had no mental disorder, learning disability or lack of maturity which substantially reduces his responsibility."

He said he was confident of placing both defendants in a sentencing category of B with a starting point of eight years in custody.

"The conditions in which Kaylea was left to die were fairly described by the Crown as unfit for any animal. However, there was no deliberate cruelty, there is no evidence of dislike or of targeting. It is a case of criminal neglect and gross negligence, it is a particularly serious case of its kind and that does require some upward movement from the guideline starting point. There are no other aggravating factors which I have not already taken into account.

"I now turn to mitigating factors. Sarah Lloyd-Jones has no previous convictions and Alun Titford has no recent or relevant previous convictions - that is mitigation. I accept the personal mitigation put forward on behalf of both defendants. I accept that both parents have been grieved by the loss of their daughter and that Sarah Lloyd-Jones is now correctly diagnosed as suffering from a major depressive disorder. I accept that she struggled with the care of Kaylea. Alun Titford also has personal mitigation to which I have given weight.

"I accept that lockdown created unusual circumstances although both defendants were going out to work after March 2020. Neither defendant was cut off from the outside world.

"It is clear to me that what the defendants could not do and the stress and pressure of looking after a number of children including Kaylea with her special needs was within their power to deal with by calling for appropriate help, which they did not do.

"Their failures were not for reasons beyond their control. They never asked for help they did not get. They did not ask for help at all. It was made easy for them to ask for help.

"I do not accept that either defendant has shown remorse that should count as significant mitigation. Alun Titford pleaded not guilty and even to the author of the pre-sentence report blamed his partner and even his daughter. Sarah Lloyd-Jones pleaded guilty and will get credit for that."

He said he made no finding of dangerousness and there was no need for an extended licence period. He said that Lloyd-Jones entered a guilty plea at a pre-trial hearing in December 2022.

He ordered both defendants to pay a victim surcharge before addressing both defendants directly.

"Alun Titford, stand up. For the gross negligence manslaughter of Kaylea Titford, I sentence you to seven years six months in prison. You will serve two thirds of the sentence, namely five years in custody before you are released on licence. When you are released you will be on licence until the end of the sentence. You must comply with the terms of the licence and commit no further offence or else you will be liable to serve a further period in custody. You may go down.

"Stand up, Sarah Lloyd-Jones. For the gross negligence manslaughter of Kayle Titford, having regard to your guilty plea I sentence you to six years imprisonment. You will serve two thirds of the sentence, namely four years in custody before you are released on licence. When you are released you will be on licence until the end of your sentence. You must comply with the terms of the licence and commit no further offence or else you will be liable to serve a further period in custody. You may go down."