Finding the right care placements for children and young people with high-level or complex needs continues to be a challenge for local authorities.
Ofsted research published last year found 91% of councils struggle to find homes for children with complex needs meaning some wait months or even years for a stable placement.
“That's despite the fact we've got more children's homes registered than we've ever had and Ofsted is getting huge numbers of applications – about 50 a month,” says Ofsted's national director for social care Yvette Stanley.
The Association of Directors of Children's Services says it is not unusual for a referral for a child with complex needs to be rejected by dozens and sometimes hundreds of providers.
Ofsted ratings concerns
Shortages of staff, an overall lack of placements and a lack of joined-up working are part of the problem. But concern about Ofsted ratings can also be a factor with 60% of local authorities reporting this was “often” or “always” a reason that homes rejected referrals.
Providers with “good” or “outstanding” ratings were said to be more hesitant about making referral decisions due to concerns about being downgraded.
“Providers report that they are anxious about taking children with the highest level of multiple needs for all sorts of reasons, not least the pressure in an Ofsted inspection of showing they are doing the best for children whose progress won't be linear, whether that's a child who's been hospitalised with anorexia or a child that's got a long history of running away to meet mum who is still misusing drugs and alcohol,” says Stanley.
Ofsted has continued to stress that settings won't be downgraded for taking on children with complex needs but the perception persists.
“We've said many times that our inspectors understand that children's needs are complex and that won't impact on judgments – and the grade profile doesn't suggest it does impact,” says Stanley.
Ofsted found there was almost no difference between Social Care Common Inspection Framework (SSCIF) grades for homes that care for children with complex needs and those for all homes, with about four in five judged good or outstanding.
In April this year Ofsted made a series of changes to the SCCIF designed to encourage more children's homes and fostering agencies to look after this highly vulnerable group.
Ofsted's research identified aspects of practice that contribute to good experiences for children with complex needs (see box) including the need for stability and consistency.
One of the weakest areas of practice was when it came to preparing children for moving on from their current placement.
The updates to SCCIF place more emphasis on how providers promote and sustain stability for children, prepare them for their next move, balance the needs of a child requiring a placement with those already living in a setting and work with partner agencies to manage risks.
Children's homes and secure settings are required to notify Ofsted about serious incidents, which may include a child running away, having unauthorised contact or an incident involving the police.
Ofsted receives about 40,000 notifications per year across children's home settings, according to Stanley, who says providers also worry about the impact of making multiple notifications about a particular child.
“People worry about inspections but I think notifications are also something that homes are really worried about,” she says. “I've got a child with complex needs, I'm making multiple notifications – will a number trigger an Ofsted response?”
She says Ofsted understands working with children with complex needs is not straightforward and will require perseverance over time and this – and the response to notifications – has been a focus of training for inspectors.
‘No notice’ placement endings
The hope is changes to the inspection framework will not only encourage settings to provide homes for children with complex needs but also reduce sudden or “no notice” endings to placements, which add to the instability, trauma and rejection children face.
“We are acknowledging that there may be several attempts to wrap different things around before things start to improve for a child. We're not expecting a eureka overnight,” says Stanley.
“I think sometimes providers’ response to a child in these circumstances is to think ‘I need to move them on’ but we're giving credit for the attempts to make a change over time rather than a quick change that actually creates more distress, more loss for a child.”
She says the response to the changes from providers and local authorities has largely been positive.
“People have appreciated our intent and the significant shift for us as a regulator,” says Stanley. “We're asking them to be risk aware, not risk averse and we're asking that of ourselves too and of our many regulatory inspectors. I think they want to see the impact of that on the ground.”
Difficulty in finding suitable placements for children with complex needs means they may be more likely to end up in unregistered provision.
A report published by Ofsted in December last year identified a worrying rise in the use of illegal, unregistered children's homes.
However, Stanley says there are some positive signs with some local authorities working with partners to create new local provision.
Meanwhile, she says recent children's services inspections have shown “tight oversight and a commitment to reducing [use of unregistered placements] and moving children”.
Proposals in the Children's Wellbeing and Schools Bill, which is currently going through parliament, would give Ofsted extra powers to clamp down on unregistered provision as well as hold large children's home providers to account at group level.
The legislation would also allow children subject to Deprivation of Liberty orders to be accommodated in a new type of provision – different to a secure children's home – that will provide more flexibility and help them move on.
Meanwhile, Ofsted has promised further changes to social care inspections including the removal of overall effectiveness judgments and introduction of report card inspection overviews.
This follows the scrapping of single-phrase judgments and the planned introduction of report cards for schools and other education settings in September this year.
When it comes to revamping social care inspections, Stanley says the starting point is somewhat different to schools in that satisfaction with the current regime is higher.
Ofsted has pledged to remove overall effectiveness judgments under the Inspection of Local Authority Children's Services (ILACS) regime in spring next year.
Changes to inspections for those inspected under SCCIF – where providers are currently rated on the overall experiences and progress of children – will take a bit longer and are likely to be implemented in 2027 rather than 2026, says Stanley.
She says Ofsted is conscious of the need to ensure local authorities are not overwhelmed by a raft of changes to inspections at a time when many councils are involved in local government reorganisation.
“The sector has really welcomed elements of SCCIF and ILCAS and we don't want to lose those – and we have used some of the best of it in the school space,” she says.
“But then we need to lean in the other way to the things that have worked in the school space that might enhance ILACS and SCCIF and do it at a pace that the sector can manage in the context of the Bill, local government reorganisation and other changes the DfE has in mind.”
KEYS TO SUCCESS
- 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 need
- 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
Source: How local authorities and children's homes can achieve stability and permanence for children with complex needs, Ofsted, January 2024
INSPECTION SHORTS
EDUCATION
Schools, nurseries and childminders shouldn't need to do anything special to prepare for inspection, says Ofsted's chief inspector. In a speech to education leaders in London, Sir Martyn Oliver said new guidance was designed to make it clear the regulator didn't expect schools and other education settings to do anything just “for Ofsted”. “It will make it clearer than we ever have that schools shouldn't be doing anything just for the days that our inspectors come in,” he said.
YOUTH JUSTICE
Caring professional relationships play a crucial role in helping to steer children away from crime, says a research paper published by HM Inspectorate of Probation. The paper, which explores desistance practice in youth justice, also highlights the need to look after practitioners and managers and ensure caseloads, case management systems, assessments, training and professional development and inspection all support relational practice.
EARLY YEARS
Ofsted has published a model for redistributing childcare provision more equitably across England. Research shows childcare is spread unevenly across the country with families in more affluent areas having better access and more choice than those in poorer communities. Ofsted trialled “optimisation modelling” for two sample areas to show how this kind of analysis could help local authorities and government target resources.
SOCIAL CARE
Leaders and staff have turned around a history of poor ratings for children's services at Surrey County Council, which were judged “good” following an inspection in March this year. Ofsted found services had “improved substantially” since the last inspection in 2022 when they were rated “requires improvement”. The service was previously rated “inadequate” in 2015 and 2018. Inspectors said children and families now receive the help, protection and care they need.
EARLY YEARS
Early years practitioners should be supported to improve their qualifications and experience as part of efforts to ensure high-quality care and education for babies and toddlers, says a new report by Ofsted. The report found the knowledge and skills of practitioners are crucial for child development, especially for children who are disadvantaged, vulnerable or have special education needs and disabilities. Ofsted said ensuring early years workers had time for professional development was especially important given childcare reforms due this September, which are likely to increase the number of young children in early education and care.
