Some care homes in England are refusing to take children with complex needs because they are worried it might affect their Ofsted inspection ratings, fuelling concern that vulnerable young people in the social care system are having to wait months or even years for a stable home.
Last month, an Ofsted report said nine out of 10 councils often struggle to find homes for children with complex needs, with some local authorities having to resort to unregistered placements as an alternative to registered care homes.
Demand for care home placements is outstripping supply, with rising numbers of children in care, many care homes only having a small number of places and new settings often opening hundreds of miles from where they are most needed.
But sector representatives said that in addition to this, some care settings are unwilling to accept children and teenagers with complex needs, in response to Ofsted’s inspection regime, fuelling accusations of “cherrypicking”, which care providers deny.
“There can be an unwillingness of some providers to take children with any level of complexity, or increasingly serving immediate or inappropriate notice periods, for fear of the impact on their Ofsted rating,” said John Pearce, president of the Association of Directors of Children’s Services (ADCS).
“This can mean children and young people with high levels of need, who are equally deserving of our love, care and support, are placed miles away from their friends, families and communities. This is not in the best interests of children, and it has a knock-on effect on the availability of homes and local authority budgets. It’s a vicious cycle.”
Individual councils have recently raised concerns about the practice. Last September, a Norfolk county council report referred to “an unhelpfully rigid approach” from Ofsted, “challenging care settings in a way which makes them unwilling to work with young people with complex needs or drives a demand for very large packages of additional support”.
Then last month, a Somerset council report stated, in the context of unaccompanied asylum-seeking children and young people with significant mental health needs: “Many registered children’s homes are reluctant to care for these children through fear of a negative impact on their Ofsted rating.”
Dr Mark Kerr, interim chief executive of the Children’s Homes Association (CHA), which represents children’s home providers, said some of its members are worried that accepting children with complex needs would lead to a high number of incidents that have to be notified to Ofsted.
“There is a perception among providers of residential care – both independent and local authority – that a high volume of notifications for incidents will trigger additional inspections,” he said. “Notifiable incidents include a child being restrained, going missing, or making an allegation against a staff member. The CHA are working closely with Ofsted on this issue.”
The situation has sparked accusations that some care home providers are cherrypicking children with less complex needs, leaving those with complex needs in limbo. “Local authorities increasingly can pay tens of thousands of pounds per week for places, yet providers can choose which children to accept and at what cost,” said Pearce.
Katharine Sacks-Jones, chief executive of Become, a charity for children in care, said: “Reports that care home providers are cherrypicking which children to accept are deeply worrying, putting further hurdles in between children and a stable home.”
The CHA has rejected these claims, arguing that many children’s homes are full and that care homes struggle to accept high-needs placements when that may affect other children in the home.
“If there is a risk that accepting a placement will have a detrimental impact on the children already living there, they must decline the new placement,” said Kerr.
“These [risk-]assessments will be reviewed when a home is inspected by Ofsted. This is neither ‘cherrypicking’ nor ‘gaming the system’; it is good practice to ensure the welfare of children already living in a home.”
Ofsted has said that taking on children with complex needs would not by itself affect a home’s inspection rating. “Some children’s homes believe that caring for children with complex needs can result in lower inspection grades,” the regulator said last year.
“This perception is understandable but it is incorrect. As we have said previously, how complex a child’s needs are will not affect how we grade a home.
“What we do on inspection is recognise where services are adapting and responding appropriately to children.”