Recommendations for a more joined-up approach to the care of disabled children in care homes must be fully implemented otherwise “appalling harm” suffered by this vulnerable group could be repeated, experts have warned.
Health and education watchdogs should carry out joint inspections of residential settings and urgent training must take place on the use of physical restraints, the Child Safeguarding Practice Review Panel said.
It has made nine recommendations to government departments, inspectorates and NHS England, as it published its latest report on protecting children with disabilities and complex health needs from abuse in these settings.
The phase two report, published on Thursday, follows a review in October which found a culture of abuse and harm, including evidence of physical abuse, violence, neglect, emotional abuse and sexual harm.
Without the wholehearted commitment to implement these measures fully, these failings will come back to haunt us when the next group of disabled children fall foul of services that cost the taxpayer dearly but rob vulnerable children of their basic humanity— Dame Christine Lenehan, Council for Disabled Children
That review focused on three residential settings – Fullerton House, Wilsic Hall and Wheatley House – registered as children’s homes and operated by the Hesley Group in Doncaster, between January 2018 and March 2021.
Looking at the experiences of 108 children and young adults, it found that some of society’s most vulnerable people had experienced “systematic and sustained” abuse and neglect over a period of more than three years, with the safety net that should have protected them proving ineffective.
Dame Christine Lenehan, director of the Council for Disabled Children, warned that previous failings could be repeated if the panel’s recommendations are not addressed with “wholehearted commitment”.
She said: “We’ve been here before. Earlier reports have catalogued how disabled children with a complex mix of autism and health needs can be locked away behind closed doors, often in placements far from their families, with little concern for their quality of life or futures.
“These recommendations set out a roadmap to more humane treatment of these children.
“But without the wholehearted commitment to implement these measures fully, these failings will come back to haunt us when the next group of disabled children fall foul of services that cost the taxpayer dearly but rob vulnerable children of their basic humanity.”
There are believed to be around 1,700 children with complex needs and disabilities in residential settings in England currently.
This review has highlighted an acute need to do things differently, not only to prevent this repugnant story from being retold in another setting, but also to transform the education, health and care offer for children with disabilities and complex health needs— Dr Susan Tranter, panel member
The panel’s review recommends the Department for Education and the Department of Health and Social Care should “review and revise the regulatory framework for residential settings to reduce complexity and improve the impact of the current arrangements for monitoring, quality assurance and oversight”.
It also recommends joint inspections by Ofsted and the Care Quality Commission (CQC) of residential settings, although it stated that both watchdogs have indicated additional resources might be required to enable this.
The panel said evidence from quality and safety reviews indicated that “practice issues relating to the appropriate use of physical restraints and restrictive interventions and their authorisation are not well understood by practitioners in local authorities and residential settings”, adding that there is an “urgent training requirement” in this area.
Placing children into settings at a distance from family and friends “should be seen as a risk factor in planning”, the panel said, stating that if this is considered the best option “mechanisms must be in place as part of the child’s plan to support regular contact between children and their families”.
There was also a call for “more substantive action” to address concerns about leadership development, workforce standards and training, amid high levels of staff vacancies, turnover, and reliance on agency staff in the sector.
The panel said national leadership and investment by providers is “urgently required” to address longstanding challenges in recruiting, retaining and developing a skilled workforce in residential settings.
The panel said it expects a response from the government to its report within six months.
Panel chair Annie Hudson said there had been “widespread public shock and distress” to the findings about the abuse suffered at the Hesley Group residential settings.
But she added: “Despair and shock are never enough and will not address the fundamental and systemic problems that contributed to the children’s unspeakably distressing experiences, over an extended period, in environments that should have kept them safe.
“Today’s report draws on the learning from what happened to those children to make national recommendations that must be secured so that this very vulnerable group of children thrive, are safe and enjoy the rights that every child should be able to enjoy.”
We are already transforming how we support children in care and with special educational needs and disabilities, taking into account many of the recommendations from the review and we will continue to work closely with the sector to make sure that children are not only safe but fulfilling their potential— Education Secretary Gillian Keegan
Panel member Dr Susan Tranter said: “This review has highlighted an acute need to do things differently, not only to prevent this repugnant story from being retold in another setting, but also to transform the education, health and care offer for children with disabilities and complex health needs.
“We are recommending measures to ensure the care of children with disabilities and complex health needs is more joined up across education, health and social care.
“Additionally, we are urging government, Ofsted and the CQC to ensure there is a major overhaul of the arrangements for quality assurance and regulation of residential settings to help prevent abuse but also that when there are complaints or concerns, action is swift and purposeful.”
Stephen Kingdom, campaign manager at the Disabled Children’s Partnership, which is an umbrella organisation of 110 children’s and disability charities, welcomed the recommendations.
He said: “The government must make sure the panel’s recommendations are delivered in full. Experience has shown us that just saying ‘never again’ is not enough – all agencies involved must take the actions needed to ensure that children do not suffer in this way again.”
The Local government Association said the recommendations should be “an urgent call to action for the entire sector” and asked for councils to be given additional powers to hold local partners, including health organisations and schools, to account for their role in supporting children with specific needs.
The government said it will consider the review recommendations and respond in full “in due course”.
Education Secretary Gillian Keegan said: “We are already transforming how we support children in care and with special educational needs and disabilities, taking into account many of the recommendations from the review and we will continue to work closely with the sector to make sure that children are not only safe but fulfilling their potential.”
