Children are left to face unknown risks at home in the same area where tragic Arthur Labinjo-Hughes was killed by his dad and step-mum, an inspection has found.
A probe into the state of children's safeguarding in Solihull, West Midlands by Ofsted said local bosses need to take urgent action to understand and identify the initial needs and risks kids face.
The inspection was launched following the death of Arthur in June last year, who was seen by social workers two months before he was killed at the end of a sadistic campaign of torture.
At the beginning of December Arthur's step-mum Emma Tustin was jailed for life with a minimum term of 29 years at Coventry Crown Court, while is dad Thomas Hughes was handed down 21 years for manslaughter.
The jail sentences have been referred to the Court of Appeal for being too lenient.
The Mirror has since reported that Tustin's food has been laced with salt by fellow prisoners and that she was moved to isolation for her own protection.
The horrific campaign of abuse was carried out by Hughes and Tustin at her council-owned home in Solihull, West Midlands, a lengthy and disturbing court case heard last year.
The report into multi-agency responses to risks to children in Solihull was carried out by Ofsted, the Care Quality Commission (CQC), the Chief Inspector of Constabulary and Fire & Rescue Services (HMICFRS) and the Chief Inspector of Probation (HMIP) for England and Wales,
Inspectors said they were concerned by incomplete police records which had left children potentially "at risk of significant harm".
They saw examples of separate records for the same person because their name had been spelt incorrectly, while children had not been linked on the system to family relatives who could pose a risk to them.
"This means that when officers and staff research 'Connect' (the police record system) they may miss important information, potentially leaving children at risk of significant harm," the report says.
Inspectors reviewed the records for one young child who was not linked to her father in the system, despite his history of domestic abuse and drug use and the fact he is subject to a non-molestation order.
"Consequently, a domestic abuse incident the child was exposed to, involving her father, does not appear on her 'Connect' record," the report said.
Some frontline police officers have also recorded children in the wrong place in the system or not at all when making referrals, it adds.
The Local Safeguarding Children Partnership in Solihull had suffered from regular staff losses, leading to a loss of experience.
The multi-agency safeguarding hub is under-resourced, meaning that "too many children in Solihull face drift and delay" before services intervene to protect them, the report added.
The report also found that the local authority has faced "long-standing difficulties in ensuring there are enough social workers" in the area, and that attempts to improve this in 2021 had "limited impact".
"These difficulties were compounded by concerns raised following the court case for the murder of Arthur Labinjo-Hughes in early December 2021, which made social workers highly reluctant to work in Solihull either on a permanent or agency basis," the report says.
It adds that the current workforce is "committed and knowledgeable and dedicated to meeting the needs of children" but that they face "immense pressure" to meet daily demands and that this "reduces their ability to respond swiftly to all concerns for children".
The report calls for agencies in Solihull to send a written statement of action to Ofsted by May 30 2022.
During the court case jurors heard how Tustin carried out a fatal assault on Arthur which left him with an un-survivable brain injury while she had sole care for him at her home in Cranmore Road, Solihull, on June 16, 2020.
She was said to have fetched her mobile phone immediately afterwards to take a photograph of the youngster as he lay dying in the hallway.
Tustin then took 12 minutes to call 999, instead first ringing Hughes, before lying to medics and later telling police that Arthur "fell and banged his head".
The boy died in hospital the following day.
In his sentencing comments, Mr Justice Mark Wall QC said the couple’s behaviour towards the boy was often "spiteful" and at times "sadistic".
The police later released footage of Tustin and Hughes scoffing McDonald's food and eating an ice cream while Arthur starved in the hallway.
The adults can be seen relaxing on the sofa at their home in the video which was released by West Midlands Police.
In another video released by the police force, Tustin was filmed tucking into two McDonald's Happy Meals in her front room using a toy as a table.
Footage taken from a camera in Tustin's house ended up playing a key role in the court case.
In one haunting video played to jurors, Arthur can be seen waking up and attempting to carry his bedding out of the room, clearly in severe distress.
He was so frail on the morning of June 16 last year he is visibly unable to pick up his duvet off the floor of his living room in Shirley, Solihull.
A couple of hours after the babycam clip was taken, he collapsed from head injuries which lead to his death.
Today Minister for Children and Families Will Quince, Minister for Care Gillian Keegan and Minister for Safeguarding Rachel Maclean released a joint statement on the report.
“Arthur's death was horrific and deeply disturbing," they said.
"The two individuals responsible are in prison – but we must do everything we can to prevent any more cases like this.
“His death serves as a daily reminder of the urgent need for all the agencies tasked with protecting vulnerable children to work together.
"That’s why we commissioned this joint inspection of services in Solihull, which has identified two clear areas where priority action is needed.
“Each agency – police, health and children’s services – has an equal duty in this work and we are writing to all three to make clear our expectation that they participate fully in producing and delivering on a written statement of action.”
It emerged at trial that Arthur had been seen by social workers just two months before his death, after concerns were raised by his paternal grandmother, Joanne Hughes, but they concluded there were "no safeguarding concerns".
In her victim impact statement, Ms Hughes said Arthur would "be alive today" as a "happy, contented, thriving" child had her son not met Tustin.
Arthur's death led to a great out-pouring of grief across the country and particularly among those in Solihull.
Two days after the court case concluded a large crowd gathered in the West Midlands town and released balloons in his memory.
The gathering was organised by Kerry Vines, a resident of Cranmore Road, where Arthur lost his life, who said: "It's about showing Arthur that we are all thinking of him, and he was a very loved little boy.
"It will also be a celebration of his life. He finally got the justice he deserved."
