Section 4. Outcomes for children but remaining on normal location had substantially worse access to a regime; poor recording practices and an absence of effective oversight to address these issues meant that there was no evidence that some children had received any time out of their cell for several consecutive days. Recording was so poor across the four English YOIs that it was not possible for managers to tell us or inspectors where to find accurate information on how long some children had been subject to solitary confinement conditions while in custody. However, in interviews children separated on normal location confirmed that there were often days when they did not receive contact with other people, a shower or exercise. There were many children across all sites and locations who did not receive daily education. One child told us: The regime is better on the [dedicated segregation] unit. You are guaranteed your regime every day. On the wing at the moment I get nothing. 17-year-old child separated on normal location Table 3: The regime of seven children separated in different locations at one YOI Child Location Days Number of separated days paperwork missing Days Days exercise shower recorded recorded A Normal location 23 5 6 Shower in cell 5 B Segregation unit 7 0 5 4 1 C Segregation unit 9 0 7 5 0 E Segregation unit 36 0 10 19 8 G Segregation unit 3 0 1 1 0 H Separation unit 87 9 40 Shower in cell 14 I Normal location 7 1 1 Shower in cell 4 Days when no time out of cell recorded Children waiting for hospital transfers 32 4.57 At the time of our inspection, eight children currently separated were waiting to transfer to a secure hospital to be treated for mental health conditions. Together, these children had spent a total of 373 days subject to separation. One child held at Cookham Wood had been separated on the segregation unit for 89 days before moving to a hospital bed. Throughout large parts of this time he received a very basic daily regime of 30 minutes exercise, a shower and a telephone call. As his health deteriorated further he was assessed for a bed in a secure adolescent forensic unit in April. While he was suitable for the unit it did not have a bed available and he was eventually moved to a similar unit at the end of May, having spent another 29 days separated in a constant observation cell. Most staff across the YCS do not have the training to work with children with this degree of mental ill-health. 4.58 While these children were placed inappropriately in custody rather than hospital they were unable to access a therapeutic regime that met their health care needs. Some cases had been escalated to NHS England, but there was no effective way to ensure that these very vulnerable children received the health care to which they were entitled. Separation of children in young offender institutions