Family doctor Niall Garvey logged concerns about the toddler’s “odd behaviour” and “poor speech”. He wrote in Liam’s medical notes that he “cries a lot, hides under blanket, hurts himself by pinching his ears and scratching himself”.
Dr Garvey added later: “In view of Liam’s history… health visitor has been in contact with the school nurses as obviously there are some alarm bells regarding what is possibly going on in this household.”
During evidence at the trial of Liam’s mother Rachel Trelfa and her partner Nyomi Fee, it emerged childminder Heather Farmer alerted a care watchdog over fears the toddler was being hurt by someone.
The witness, who looked after Liam at her home in Fife from July 2012 until January the following year, was in tears as she told the court she had been so worried about him that she could not sleep.
She said until then he had been a happy and responsive toddler.
Ms Farmer called the Scottish Childminding Association and the Care Inspectorate over her concerns after he turned up with scratches and bruises to his face, just days after arriving with a bruised head and legs which his mother had said he obtained from falling out of his cot.
She told Trelfa about alerting the care watchdog and social services but the couple brought him back the next day. She later told them she could not look after Liam any more.
The couple then enrolled Liam into a private nursery in Kirkcaldy to attend two days a week.
He started at the Sunshine Nursery in March 2013 but staff soon started noticing bruises and recorded the incidents using paper diagrams.
Manager Kimberly Trail said Trelfa told them he was “nipping himself” and added that she thought her son had autism.
But more injuries were appearing on the toddler, including a bruised bottom, swollen lip, black eye and bruising to his ears and nails.
By June, staff had contacted social services with their concerns before Fee withdrew Liam from the nursery.
Another concerned woman who knew the couple said she had contacted social workers after she saw them outside a shop in Fife in September 2013 and thought the toddler looked “deathly”.
• READ MORE: Liam Fee murder: Rachel and Nyomi Fee both guilty
Patricia Smith said something “felt wrong” when she spotted Liam sitting in his buggy with a blanket over his head.
“The stillness. There was something deathly about it. He was too still. It was very strange,” she said. “I didn’t know if he was drugged or dead.”
She said the incident had happened when she was on her lunch break and on returning to her office she phoned social work.
On day 15 of the trial, the court heard from a senior social worker who admitted Liam had dropped “off the radar” for a period of time.
Karen Pedder, a team manager with child protection at Fife Council, dealt with concerns about Liam in 2013.
She spoke about a meeting with social work, police and health representatives to discuss the toddler after concerns were raised by the childminder about an injury.
A social worker and police officer were sent to the couple’s home in January that year but Ms Pedder, 45, said a “plausible” explanation had been given that Liam had “bumped his head” and there was no criminal action taken.
The social worker who had been dealing with the case then went off sick in April and it was not looked at again until there was a contact made by the nursery in June, she said.
It has been announced that a Significant Case Review (SCR) to probe the facts will be chaired by Dr Jackie Watt, a retired paediatrician and child protection specialist.
Douglas Dunlop, vice-chair of Fife’s Child Protection Committee, said the review would chart the involvement of all services with Liam prior to his death “which will give us a picture of any lessons which can be learned.”
It will be the second SCR in Fife in two years after the murder of Mikaeel Kular, who was beaten to death in January 2014 by his mother, who was later jailed for culpable homicide.
It recommended 13 steps to aid future learning including a national case transfer ‘protocol’ across local authority areas.
Trisha Hall, manager of The Scottish Association of Social Workers (SASW) admitted cases such as Liam’s were tragic, but said problems with bureaucracy and resources had to be addressed.
• READ MORE: Liam Fee murder: Toddler ‘suffered horrendous abuse
She said: “I don’t think there are enough children and family social workers. There is a real issue about under-staffing.
“The main issue is that people still spend 80 per cent of their time writing reports or doing paperwork and only 20 per cent of actual social work time engaging with children and families.”
Questioning another witness, defence QC Mark Stewart told the court there had been “ongoing social work awareness and contact with the family” from January 2013 through to the time Liam died, none of which resulted in action being taken against the couple.
Senior investigating officer Detective Inspector Rory Hamilton said outside court that while police had dealings with the pair in relation to previous convictions for minor offences, he was not aware of any issues after they had moved to Fife.
Asked about the police accompanying a social worker to the address in 2013, Detective Supt Gary Cunningham, of Police Scotland’s Major Investigation Team in East Scotland, said it would be a matter for the local division.
Commenting on whether he thought there had been failings in the abuse not being stopped sooner, he said: “That’s not really for us to comment on whether we thought there were failings or not. There’s maybe a separate process that division could look at, but from a major investigation team stance we got brought in following the death of this child.”
He added: “Social work and the police in general have a lot of strategies in place to ensure the safety of children.
“It is upsetting and horrific when unfortunately and very occasionally these cases do surface where we see children being abused and I think everybody in the community has a focus, and should have a focus, on child protection, raising any reports when they think children are at risk.
“Then we will all be in a better position to ensure that children are better protected and we can intervene to ensure justice is done when we have individuals that do target children.”
Children 1st Chief Executive Alison Todd said following Fee and Trelfa’s conviction for Liam’s murder: “For now it is only right to wait for the findings of the planned significant case review to see if anything could have prevented his death. But we should be in no doubt that the responsibility for Liam’s death lies with his mother and her partner.
“This utter tragedy comes at a time when the Scottish Government is reviewing and improving its approach to child protection. At this stage we don’t know if differences in the child protection system could have saved Liam.”