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Looking after children with complex needs: Dispelling myths about inspections and the need for suitable homes

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A girl looking out of a window through a set of blinds

There is a growing need for highly specialist homes that can provide good quality, nurturing care for children with multiple and complex needs. In some cases, these are children who are deprived of their liberty, Many have mental health needs that are not being met elsewhere.

I am aware that some providers are worried about caring for some children and the perceived ‘impact’ on inspection grades. We know that the progress of many children will not be linear, with new crises arising and risks identified. We want to see homes and services adapt and respond appropriately to children, and we know this takes time and tenacity. But ultimately, this should not affect the grading of a home. To provide some context, provision for the children with the highest level of need continues to be good and outstanding in line with other provider types.

What does children’s homes data tell us?

I also want to use this opportunity to caution against overly simplistic conclusions being drawn from data on children’s homes and the quality of children’s care. Our statistics for private, voluntary or local authority run provision shows no significant difference in quality. Of course, all sectors have good quality provision and, sadly, poor provision. There is no simple narrative that one sector is ‘good’ and the other is ‘bad’. Nonetheless, I am concerned by placements that are costly while not being high quality or giving specialist support. ’

With provider notifications, for example, children’s homes are required to tell Ofsted about a range of serious issues. Many of those notifications tell us that providers are managing difficult situations well. Simply looking at numbers can miss the complexity of practice that so often sits underneath.

However, we know that some providers are concerned about taking children on whose behaviour is likely to increase the number of notifications to Ofsted, and assume this will lead to an investigation or an early inspection.

A high number of notifications does not automatically lead to either of these activities. We do review all notifications thoroughly, but if we are satisfied that the provider has managed the situation or incident appropriately, then there is no need for us to take additional action.

So much of what children’s homes do is managing risk, not eliminating it. Our inspectors are charged with drawing the distinction between providers that are equipped to manage difficult and risky situations and work to high standards, and those who lack the experience, knowledge or support to respond to the needs of the children living in the home. This needs careful assessment by our inspectors. When things are challenging for children and they are expressing their anger or frustration or hurt, then the home may ‘feel’ unstable.

Concerns about unregistered provision

However, too many children, usually with the most complex needs, are placed in unregistered provision because local authorities can’t find registered homes that are willing to open their door to them. It’s not right that children are being cared for in homes with no oversight. The volume of applications we receive continues to rise, but two problems remain:

  • Providers that are operating without registration remain reluctant to come forward and register, so we can see that they are suitable, preferring to ‘dip in and out’ of offering temporary homes to children. Those that do are not always suitable, and do not have the skills or experience to provide the right level of care.
  • These unscrupulous providers would not be used by local authorities if registered providers were ready and able to offer caring homes with skilled staff.

As ever, we continue to look very carefully at capacity pressures on children’s homes and the other areas we regulate across children’s social care. I will continue to speak out about what we see as the gaps in the provision across the country, both geographically and in terms of meeting specific needs of children.

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