Safeguarding leads are seeking government action over the shortage of placements for children with complex needs, including those who are autistic and have co-occurring mental health needs.
The Child Safeguarding Practice Review Panel has written to officials to highlight issues raised by a 2024 case review about the "vanishingly rare" provision available for young autistic people who need intensive mental health support.
In a post on LinkedIn, the national panel, which oversees learning from serious child protection cases, said it wanted to "highlight these issues of concern and to understand what more can be done", in particular to support children at risk of being placed on, or already subject to, a deprivation of liberty order.
Such orders, issued by the High Court under its inherent jurisdiction and often involving placement in unregistered settings, have become increasingly common in recent years due to councils' struggles to find appropriate provision for children at significant risk or with the most complex needs.
Practice review concerning boy arrested for murder
The panel's letter to the government was prompted by a child safeguarding practice review report, published last year by Southend Safeguarding Partnership, concerning a young man - 'Issac' - arrested on suspicion of murder in February 2023, when aged 17.Diagnosed with autism, attention deficit hyperactivity disorder (ADHD) and type 1 diabetes - the treatment plan for which he was unable to comply with - he often exhibited distressed behaviours, which had became increasingly challenging and aggressive over time.
In September 2022, after he was arrested for assaulting his mother, Southend-on-Sea council accommodated Issac under section 20 of the Children Act 1989 in September 2022.
Over the next few months, up to his arrest in February 2023, he endured multiple placement breakdowns from children's homes and semi-independent settings, due to these services being unable to manage his diabetes care or violent behaviour. He also had several missing episodes, during which he committed assaults, including on police officers.
Lack of available placement options
Clinicians assessed that Issac was not detainable under the Mental Health Act 1983. While the review questioned this judgment, it also warned that the experience of detention on a psychiatric ward, where other patients may have been aggressive or violent, could have been very traumatic for a vulnerable young person.The review found that the courts would likely have granted the council a secure accommodation order, enabling Issac to be placed in a secure children's home, following his multiple missing episodes and assaults on police and care staff, had Southend sought one. However, the review highlighted the severe shortage of secure beds, meaning that the authority would have struggled to find a placement, and also claimed that secure homes did not provide specialist autism care or effective therapeutic support.
The council, meanwhile, deemed a deprivation of liberty order to have been unsuitable, as Issac would likely have responded with aggression to attempts to restrict his liberty, meaning such a placement would have quickly broken down.
Provision for autistic children 'vanishingly rare'
The review concluded that what he needed was a specialist residential placement, with intensive mental health support, that was designed for autistic young people.However, it added: "Currently, these placements are vanishingly rare nationally, despite the increasing numbers of young people with autism and co-occurring conditions who require some form of secure bed, whether that be through mental health, social care or the youth estate."
It recommended that Southend Safeguarding Partnership or the national panel write to the Department of Health and Social Care (DHSC) and NHS England to call for a national plan to improve access to local secure and therapeutic accommodation for autistic young people, to reduce the numbers of acute admissions and avoid delays to young people receiving the care that they need.
Panel 'notified of many distressing incidents'
In its LinkedIn post, the panel said: "We know issues regarding the number, availability and quality of secure placements/beds and appropriate follow-up therapeutic accommodation is frequently raised by local safeguarding partners."The panel is notified of many distressing incidents that, upon review, highlight the issues local authorities face when accessing suitable placements for these children and young people that can meet their specialist needs.
"Indeed, too many children with challenging behaviour and complex mental health needs, often linked to trauma are being placed in unregistered or otherwise unsuitable homes, and even specialist services are not always integrated around the needs of the child."
Longstanding concerns about placement shortages
The panel's intervention follows longstanding concerns about national shortages of placements for children with the most complex needs that have led to them being placed in unsuitable provision, often far from home and at great cost to councils.In a 2024 study, based on surveys of councils and providers, Ofsted reported that most authorities struggled to find homes for children with complex needs due to shortages of secure and therapeutic homes, leaving some waiting months or even years for a placement.
Tackling the issue has been one of the key aims of the children's social care reform programme started under the previous government and continued under Labour.
What is the government doing about the issue?
In 2023, the then Conservative government set up a "task and finish group" to explore how the commissioning of care for this group of children can be improved. The group, which includes representatives from the Department for Education, DHSC, Ministry of Justice, NHS England, the Office of the Children's Commissioner and the Association of Directors of Children's Services, has been continued by the current government.As part of their work testing the regional commissioning of care placements, the regional care co-operative (RCC) pathfinders in the South East and Greater Manchester are exploring how to improve provision for children with complex needs.
The South East RCC is testing a new approach that involves having a multidisciplinary commissioning team, stated minutes from the task and finish group's meeting in May 2025.
Funding to refurbish and development children's homes
Successive governments have also allocated capital funding to refurbish or develop children's home provision, including for those with complex needs. The Conservative government allocated £259m for 2022-25, and a further £165m for 2024-28 for this purpose, with Labour then providing a further £90m in 2025-26 and £560m - some of which is for fostering provision - from 2026-29.Earlier this year, the government said that £53m of this resource was to help councils develop 200 placements for children at risk of being deprived of their liberty.
The funding comes with the government legislating, through the Children’s Wellbeing and Schools Bill, to create a new registered placement type for children who may need to be deprived of their liberty at times, but for whom restrictions will be able to be increased or decreased according to need.
