Setting

Area SEND inspection of Cornwall Local Area Partnership

Inspection dates: 6 to 10 February 2023 Dates of previous inspection: 3 to 7 July 2017

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Inspection outcome

The local area partnership’s arrangements lead to inconsistent experiences and outcomes for children and young people with special educational needs and/or disabilities (SEND). The local area partnership must work jointly to make improvements.

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Inspection outcome

The next full area SEND inspection will be within approximately 3 years.

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Inspection outcome

Ofsted and CQC ask that the local area partnership updates and publishes its strategic plan based on the recommendations set out in this report.

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Information about the local area partnership

Cornwall Council and Cornwall and the Isles of Scilly Integrated Care Board (ICB) are responsible for commissioning and planning the services for children and young people with special educational needs and/or disabilities (SEND). ‘Together for Families’ is the name for children’s services run by Cornwall Council. This includes children’s community health, education and social care.

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Information about the local area partnership

There have been changes to some leadership posts in the local area recently. These include new appointments and changes to the leadership structure. The commissioning of health services changed across England in 2022. The responsibility for health services in Cornwall passed from Clinical Commissioning Group (CCG) to a new ICB. On 1 July 2022, the Cornwall and Isles of Scilly ICB took over the commissioning of health services from NHS Kernow CCG.

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Information about the local area partnership

Cornwall Council commissions a range of alternative provisions. A significant number of these places are commissioned through a single multi-academy trust. Alternative provision provides education for children or young people, including for those who cannot attend school due to social, emotional and mental health and medical needs, or for those who are at risk of or have been permanently excluded. The local authority maintains a list of registered alternative providers that it has approved following checks on the quality of provision and safeguarding arrangements. Area SEND inspection report: Cornwall Local Area Partnership 6 to 10 February 2023

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What is it like to be a child or young person with SEND in this area?

Children and young people with SEND in early years provision, and those moving into adulthood, generally have positive experiences and successful outcomes. For those children and young people of school age with SEND, their experiences are not consistently positive. At times, this is due to the lack of clear information about the availability of services and how children and young people can access them.

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What is it like to be a child or young person with SEND in this area?

Younger children and their families have a positive experience of the early years support and guidance available to them. The effective multi-agency approach to supporting the family from the early identification of need results in many families feeling well informed and the needs of the child or young person being met.

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What is it like to be a child or young person with SEND in this area?

The majority of young adults benefit from effective support which prepares them well to gain from adult education and health services.

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What is it like to be a child or young person with SEND in this area?

Many children and young people with SEND have their initial needs assessed in a timely way. Delays in the annual review process for Education Health and Care (EHC) plans are too frequent. This results in plans not fully reflecting the changing needs of children and young people. Leaders are improving oversight in this area, but this needs accelerating.

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What is it like to be a child or young person with SEND in this area?

Children and young people with SEND are supported well by health services in Cornwall. Waiting times to access services, such as child and adolescent mental health services (CAMHS), have been reduced significantly. And although some children and young people still wait too long for speech and language therapy, those waiting are now reviewed on a regular basis. However, this is not the case for children and young people accessing neuro-developmental pathways, where progress in reducing the wait time for neuro-development assessments has not been as successful. As a result, some children and young people are not able to access support when they most need it.

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What is it like to be a child or young person with SEND in this area?

Some children and young people with SEND waiting for a specialist placement are not in education that best meets their needs and are not receiving the specialist help they need. Leaders recognise that there is a regional and national shortage of specialist education places. This is further complicated in Cornwall due to the geographical size of the local area, its rurality and the high contrast between different localities in the area. Permanent exclusion rates for children and young people with SEND are high. Partnership leaders are taking action to address all of these issues, for example through strengthening the area resource base provisions and inclusion in mainstream schools. However, these actions have not yet brought about the improvement required.

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What is it like to be a child or young person with SEND in this area?

The majority of children and young people with SEND who live in Cornwall and need residential care are supported well to stay in the local area. Consequently, only a few children and young people with SEND are in residential placements outside Cornwall. Leaders have assured themselves of the welfare of those children living outside of Cornwall in residential settings through the completion of comprehensive quality and safety assessments. Area SEND inspection report: Cornwall Local Area Partnership 6 to 10 February 2023 Children and young people have had mixed experiences of short break support within the local area. However, leaders have effectively tackled issues around staffing and an increase in demand for short breaks.

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What is the area partnership doing that is effective?

▪ Partnership leaders are ambitious for children and young people with SEND. They have developed a joint commissioning strategy and have identified key priorities. Governance structures have been established across the partnership. There is positive evidence of how this focused work impacts on the lives of children and young people, predominantly in the areas of early years and in preparation for adulthood and post-16 education.

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What is the area partnership doing that is effective?

▪ Leaders from health, social care and education services and providers collaborate effectively to meet the needs of some children and young people with SEND. This has resulted in strong multi-agency working and established systems for continued improvement.

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What is the area partnership doing that is effective?

▪ Practitioners demonstrate their understanding of children and young people’s needs and aspirations as they move into adulthood.

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What is the area partnership doing that is effective?

▪ Many young people get the right help in readiness for adulthood and during crisis. Young people with SEND receive appropriate assessment of their needs, aspirations and capacity before and into adulthood to ensure that they receive the right support to promote their welfare. The work of ‘Care First’ is notable in this respect and partnership leaders have taken the components of the successful transition for vulnerable young people and are rolling this out for other groups.

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What is the area partnership doing that is effective?

▪ Leaders have strengthened their work to engage children and young people with SEND and their families to improve services and support. The inclusion of Parent Carer Cornwall (PCC) at a strategic level is central to this. Throughout the work of the local area partnership, there is evidence of true co-production (a way of working where children, families and those who provide the services work together to create a decision or a service). Leaders have developed roles for children and young people to be advocates and mentors for other children and young people with SEND, to ensure their voices are heard.

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What is the area partnership doing that is effective?

▪ The approach to locality working is a strength of the local area partnership. These multi-disciplinary teams, which include health, social care, police and education, work effectively to address the diverse needs of children and young people with SEND within the smaller areas of Cornwall that they cover. This results in a more targeted approach through the collaborative work they carry out.

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What is the area partnership doing that is effective?

▪ Service redesign in some therapy services, such as CAMHS, early mental health support and the occupational health service, have resulted in a reduction of waiting times. There has been an increase in access to a range of timely support for children and young people with SEND and their families to support social, emotional and mental health needs. This includes services such as the commissioned network of local hubs. Health practitioners are able to request Area SEND inspection report: Cornwall Local Area Partnership 6 to 10 February 2023 multidisciplinary meetings to secure early mental health support in addition to other support that may be beneficial. Social prescribing is used successfully to improve the well-being of young people. This results in the provision of tailored resources to meet the needs of children and young people with SEND and their families. As a result, some children and young people are confident to return to a

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What is the area partnership doing that is effective?

school setting, supporting the local area partnership’s ambition to keep children and young people in Cornwall in their local community.

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What is the area partnership doing that is effective?

▪ Partnership leaders have a comprehensive strategy for commissioning and oversight of alternative provision following an external review in 2018. Nevertheless, leaders are not complacent and know there is still work to be done to ensure that the experiences and outcomes for children and young people in these alternative placements are more positive.

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What is the area partnership doing that is effective?

▪ Partnership leaders are driving a shift in culture which is led by the needs of the individual child or young person. This is at an early stage. There is positive progress in areas where leaders have specifically focused their attention and they demonstrate the local area partnership’s focus on early intervention.

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What does the area partnership need to do better?

▪ The local area needs to mirror their overarching leadership oversight of working with children and young people in early years and through post-16 years provision across services and support for all children and young people aged 5 to 16 years. Currently, in this age range, services do not consistently meet children and young people’s needs in a timely way.

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What does the area partnership need to do better?

▪ Planning for children with more complex needs is not consistent. EHC plans do not routinely identify these children’s and young people’s health and social care needs, outcomes or provision precisely. As a result, some children and young people with complex needs do not get the right support at the right time. There is a need for better oversight of the quality of EHC plans. Leaders have plans in place for this. There are consistent gaps in EHC plans from some services. The contributions of practitioners involved in the child’s or young person’s care are not always reflected accurately in the plan.

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What does the area partnership need to do better?

▪ Leaders’ evaluation of the effectiveness of their actions is not thorough enough in some areas. There is a need to strengthen the range of information that supports decision-making and the improvement of services. This includes evaluating the rising rates of permanent exclusion and the success of children and young people placed in alternative provision and in education other than at school, and in ensuring that children and young people benefit from effective arrangements to avoid unplanned admission into hospital . The local area’s dynamic support register is not integrated into the area’s accountability and governance, and as a result, there is limited oversight.

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What does the area partnership need to do better?

▪ Leaders have not done enough to ensure that practitioners working in education, health and social care are clear about their accountabilities and responsibilities. Area SEND inspection report: Cornwall Local Area Partnership 6 to 10 February 2023 There is variability in practice. Some professionals do not have the necessary awareness and knowledge to secure what is available for children and young people with SEND. This leads to insufficient and unclear access to support and guidance and misunderstanding from families and practitioners of how placements in alternative provision are commissioned.

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What does the area partnership need to do better?

▪ The local area has not yet ensured that its priority focus areas are communicated as successfully as it would wish. Some families and professionals are currently not always clear about what the local area are working to improve.

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What does the area partnership need to do better?

▪ Practitioners’ knowledge and expertise are insufficient to support and guide children and young people with SEND. While partnership leaders recognise this, leaders at all levels across the local area have not yet addressed this issue. A significant consequence of this is that the services of groups such as SENDIASS (Cornwall’s independent advice and support service) and the PCC (Parent and Carers Cornwall, which is Cornwall’s parent carer forum) are in high demand. Although many highly regard these services, there is a limit to the level of support they can offer.

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Areas for improvement

Leaders across the partnership need to develop further the work they have started to improve the education offer and outcomes for children and young people with SEND.

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Areas for improvement

Leaders across the partnership should continue to address long waiting times for children and young people requesting support from health services.

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Areas for improvement

Leaders across the partnership must improve the quality of education, health and care planning and review.

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Areas for improvement

Leaders across the partnership should establish effective communication across the partnership to improve the experiences for children and young people with SEND and their families.

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Areas for improvement

Leaders across the partnership should improve their evaluation and analysis of information about the effectiveness of services for children and young people with SEND. Leaders should strengthen their monitoring processes in these areas to accelerate the improvement of SEND services. Area SEND inspection report: Cornwall Local Area Partnership 6 to 10 February 2023

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Local Authority Integrated Care Board

Cornwall Cornwall and Isles of Scilly ICB Meredith Teasdale, lead person Kate Shields, Chief Executive Officer www.cornwall.gov.uk www.cios.icb.nhs.uk Services for children, young people and families The Exchange New County Hall Treyew Road Truro TR1 3AY Part 25, Chy Trevail Beacon Technology Park Dunmere Road Bodmin PL31 2FR

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Information about this inspection

This inspection was carried out at the request of the Secretary of State for Education under section 20(1)(a) of the Children Act 2004.

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Information about this inspection

The inspection was led by one of His Majesty’s Inspectors (HMI) from Ofsted, with a team of inspectors, including: two HMI from education and social care; a lead Children’s Services Inspector from the Care Quality Commission (CQC); and another Children’s Services Inspector from CQC.

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Ofsted Care Quality Commission

Leanne Thirlby HMI, Ofsted lead inspector Jen Southall HMI, Ofsted Anna Gravelle HMI, Ofsted Tessa Valpy, CQC Lead inspector Sarah Smith, CQC Inspector Area SEND inspection report: Cornwall Local Area Partnership 6 to 10 February 2023 inspects to achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Ofsted Care Quality Commission

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Ofsted Care Quality Commission

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Ofsted Care Quality Commission

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Ofsted Care Quality Commission

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