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ADCS comments on Ofsted's children with complex needs report

Date:29 JAN 2024
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Last year, Ofsted published a report about how local authorities plan for sufficiency in their social care provision. This report highlighted the lack of suitable homes available for children with complex needs, and the difficulty local authorities face in finding homes for them. Although they are only a small proportion of all children in care, children with complex needs are some of the most vulnerable and experience a lot of placement instability. Local authorities need a substantial amount of time, resources and money to find supportive homes for children with complex needs. 

Ofsted summarised the main findings in the report as:

  • "Social care staff use the term ‘children with complex needs’ to describe children who have multiple needs of different types. These children require care and support from an array of professionals to meet their needs. They tend to be the same children that staff have most difficultly finding homes and caring for. These are typically children with severe mental health difficulties, or whose needs manifest in behaviours that place the child or others at risk. Staff said that the trauma experienced by many of these children can underlie, contribute to, or exacerbate needs.
  • The vast majority of local authorities that responded to our survey (91%) said they frequently have difficulty in finding suitable homes for children with complex needs. As a result, children wait months – or in the worst cases, years – for a stable home. Therapeutic and secure homes are often the preferred option for children with complex needs. A lack of these homes contributes to the problem.

  • Most local authorities reported that children with complex needs are frequently placed out of area, experience unplanned placement moves, have referrals rejected by homes and/or are served notice by their setting. All these things can disrupt children’s stability. 

  • The lack of suitable homes means local authorities are resorting to placements they do not want to use. Commissioning staff think some homes could accept the child they have referred but choose not to, opting to wait for a child they perceive as presenting fewer risks.

  • Increasingly, children who are seen as a risk to themselves or others are deprived of their liberty. Sometimes, these children are placed in unregistered homes because no registered alternatives are available. The lack of sufficient and suitable places in secure children’s homes and appropriate mental health provisions is contributing to this.

  • Clear communication and information-sharing between children’s homes, local authorities and other agencies are important to help find the right placement for the child. Referral decisions are supported when the information about children given to homes is clear and transparent and when homes’ statements of purpose accurately reflect their current ability to care for children.

  • Children with complex needs often have more staff caring for them than other children. This adds challenges for homes facing sector-wide issues in recruiting and retaining staff.

  • The most reported contributor to children’s stability is the commitment and consistency of staff around the child. This enables children to build enduring relationships with the people who care for them. These relationships also help children feel comfortable expressing their views about their care.

  • It is clear how the progress, sense of achievement and structure that education gives children contributes to their stability. For many children with complex needs, mainstream schooling might not be appropriate. We heard how multi-agency professionals worked together to find provision that suited children’s needs, interests, abilities and aspirations.

  • Across our case studies, there were some common elements of practice that resulted in good experiences for children. These were:

    • well-planned moves into the home, at a suitable pace for the child

    • providing consistency, through relationships, education and other activities

    • getting children access to the specialist services they needed

    • facilitating a sense of belonging for children, through knowing staff would not give up on them and that this is their long-term home

    • capturing and implementing children’s views on their care

  • The weakest area of practice in our case studies related to planning for a child’s future after their current placement or when they turn 18. Preparing children for the next stage needs to begin early and at a pace suited to the individual child’s needs. Professionals struggled to get multi-agency work started in this area."

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ADCS President John Pearce, says: “Finding homes for children in care is a challenge because of a lack of suitable homes nationally. The needs of children have changed over recent years, for example, children are coming into care with increasingly complex needs, often as teenagers, and local authorities are facing growing difficulties accessing the right support and homes for them. We want children in care to stay as close to the people and communities they know but this is not always possible due to a lack of local provision. Local authorities are the only purchasers of placements, yet providers can pick and choose which referrals to accept or not, with some providers increasingly reluctant to accept children with highly complex needs, as they perceive it may impact their Ofsted rating. We recognise Ofsted does not want its work to impact on a local authority’s ability to place children, however, this can be an unintended consequence of the current regulatory framework supported by inspection. We urgently need a comprehensive national placements strategy to ensure the right homes are available in the right places for all children who need them whatever their needs. As well as a comprehensive review of the regulatory system and care standards, with a view to achieving a more fluid system that better meets the needs of children.

“When a place in a secure children’s home or inpatient mental health bed is required but not available, local authorities have no choice but to create bespoke arrangements within the community, while waiting for a permanent placement to become available. This is always a last resort, but the report demonstrates that this tailored provision can be thoughtful, considered and crucially work well for the child. Local authorities are doing what they can to meet children’s needs, such as establishing their own children’s homes to accommodate children with complex needs, but we need government’s support with this. A wholly new approach and therapeutic offer is required for children with acute needs, as is a range of appropriate step-down arrangements in the community so that children can be successfully reintegrated into the community when they are ready.”