Section 4. Outcomes for children 6. Children are separated for the shortest possible period before being reintegrated to a normal regime. 36 4.73 We found no examples where required reviews did not take place for the children identified as being on rule 49. Those for children in designated units were often multiagency, including a mental health care professional, and focused on the child’s ability to cope with separation. The quality of reviews attended during the site visits was often better than the records suggested. However, reviews for children separated on normal location were less well developed. Generally, children attended the review process, but we found several examples where the child was not invited and the outcome of the review was communicated to him through a locked door. 4.74 Most establishments commissioned a short-term assessment of risk and need (STARN) through the review process, which aimed to give residential staff advice on how to manage separated children on their units. However, there was a wide variation across the estate about when these were undertaken, from 72 hours to two weeks after the initial separation. 4.75 In some establishments, casework officers attended reviews, plans were focused on getting the child out of separation, and issues from other plans that were influencing the separation were included. However, this level of planning and involvement from casework was not universal, leading to many perfunctory and vague plans. 4.76 Every child was given several targets at each review. Most of these were behaviour-related. The quality of these targets was inconsistent across establishments and their aims varied. Some establishments focused on behaviour, and this was the driving factor in determining whether a child would remain in separation; others looked at the reasons for the behaviours and tried to engage the child in resolving them with more detailed plans. 4.77 The regime that applied to children while separated was linked to their behaviour and formed a large part of the planning process. The aim of most plans centred on the child behaving well and stopping the behaviours that had led to separation. However, for most children we found their time out of cell was so restricted they were not given an opportunity to show that their behaviour had improved or their risk reduced. Some establishments provided children with a copy of their plan but this was not done everywhere. 4.78 We saw no examples of input from outside the establishment (such as families or local authorities) into the separation review process. Children were often encouraged to give some input and we witnessed some good engagement, especially at initial reviews. This initial engagement presented a window of opportunity for managers that was too often missed, and the longer the separation the less inclined the child was to engage. 4.79 Health care staff were always in attendance and we also regularly saw psychology input. As the review was the decision-making process for continued separation, the attending health care professional completed the safety screening at this point. 4.80 A key part of the review process is to address any signs of declining emotional and mental well-being; however, we found no evidence that children had been removed from separation or returned to normal location because of a decline in their mental health. Managers did try to identify risk through increased observations or relaxing a part of the regime, but implementation of these changes was too often poor. 4.81 For most children reintegration planning was poor. In the 57 cases we reviewed only 11 had plans to enable the child to reintegrate to a normal regime. Practice in this area was significantly better at Werrington, where nine of the 10 cases we reviewed had a Separation of children in young offender institutions