Section 4. Outcomes for children stated above, authorisation for continued separation was given in every single case, and in those we reviewed no recommendations were given to the establishment about how to manage the child or reintegrate them to a normal regime. Reviews 4.23 The separation of children is supposed to be reviewed regularly. The review is to ensure that it is safe for the child to continue to be separated and that the reasons for separation are still valid. Reviews should act to protect a child from a harmful regime or one that amounts to solitary confinement. We found reviews of separation were generally held on time and were well attended for children who were separated on designated units, but less so for those on normal location. Regardless of their location, children told us that they did not always know the people present at their review. They were often duty workers rather than the child’s specific caseworker, named officer or mental health nurse. For those separated on normal location, reviews were less likely to be well attended or detailed in nature. 4.24 One of the key functions of reviews is to protect children from the deterioration in wellbeing and mental health caused by spending long periods locked in their cells. It is therefore important that reviews consider and plan how to reintegrate a child back to a normal location. Except for Parc, which planned for reintegration from the 72-hour review and sometimes earlier, reintegration planning was almost always initiated too late, lacked specific time-bound actions and was poorly implemented. Unfurnished accommodation 26 4.25 Unfurnished accommodation (also known as special accommodation) consists of cells with all or some of their furniture and fittings removed. HMPPS policy states this should only be used if there is a well-identified risk preventing a child from being placed in a furnished cell. Unfurnished accommodation requires authorisation by an operational manager and a subsequent risk assessment by a health care professional. The frequency of observations of those held in such accommodation is mandated as part of the assessment, and is always a minimum of five times an hour at irregular intervals. 4.26 It was difficult for us to quantify how often unfurnished accommodation was used across the estate as record keeping was poor and establishments were not always sure what constituted unfurnished accommodation. Although Cookham Wood declared no use of unfurnished accommodation, we found evidence that it had been used and authorised twice in the 12 months before our visit. Feltham had completed the required authorisations and safety screens but the use of this type of accommodation was very high, with 77 recorded uses in the year to 30 April 2019. In contrast, over the same period Cookham Wood had used it twice, Werrington once and Wetherby and Parc had not used unfurnished accommodation at all. 4.27 We found children isolated in special accommodation solely because they had self-harmed and were not compliant with staff, so were subsequently restrained. This was contrary to the HMPPS rules governing special accommodation. We also saw examples where operational managers had reduced the frequency of observation to below the minimum of five an hour. The conditions some children were held in were poor. For example, at Feltham one child was on a constant watch, which meant he was always in the direct sight of an officer. This child, who was in crisis, was left to lie on a mattress on the floor of a filthy cell for more than 22 hours a day with no meaningful contact. Separation of children in young offender institutions