Mental health provision in children’s homes patchy

Mental health provision in children’s homes is a postcode lottery, according to Ofsted.

In an evaluation of 27 children’s homes across eight local authorities, the inspectorate found access to child and adolescent mental health services (CAMHS) inconsistent. While nine of the homes reported no delays in accessing CAMHS, 11 said they had experienced delays of between three and 12 months.

Chief inspector Christine Gilbert said, “It is essential that all young people have consistently good access to mental health services that meet their needs, wherever they are cared for and whoever provides the care. Inconsistencies between areas need to be addressed.

“While this is a small survey, it points to important issues in caring and supporting young people experiencing mental health problems.”

Shortcomings were particularly pronounced in cases where the child had been moved from their home local authority and across private homes generally. Thirteen of the 27 children’s homes visited reported delays in a service being provided. Of these 13, ten were privately run.

Young people in local authority homes with a service level agreement were the most likely to access CAMHS easily.

John Goldup, Ofsted’s social care director, said the reasons for this particular discrepency were unclear.

“To what extent it’s to do with communication between the provider and local authority, to what extent it’s to do with the way priorities get set, it’s difficult to say,” he said.

Goldup pointed to an example highlighted in the report of a local authority that had a clear policy to treat private homes and local authority homes differently. In this council, local authority homes have a much more direct route to CAMHS.

“I find it hard to understand the rationale for that kind of policy,” said Goldup. “I think that kind of thinking needs to be reexamined.”

A failing identified by most of the homes was the absence of suitable forums with the local authority children’s service and the healthcare trust to shape and improve mental health services.

Children’s homes in only three local authorities said they attended monthly or quarterly meetings with other healthcare professionals to discuss topics such as waiting lists, transfers, funding and delays. Two providers of private children’s homes reported feeling professionally isolated because of a lack of effective partnerships.

Some managers said young people in their homes were at a disadvantage due to a low level of staff knowledge. In four of the homes evaluated by Ofsted, managers recognised that their current staff had limited knowledge and experience of mental health.

Access to training and development varied across the children’s homes visited. Staff in specialised children’s homes demonstrated greater commitment to training and updating their practice.

In seven of the homes, staff received no additional training in mental health. Lack of resources, limited funding and high costs were identified as prohibitive factors.

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