Setting

Partnership

Inspection dates: 30 January 2023 to 3 February 2023 Date of previous inspection: 20 to 24 June 2016

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Inspection outcome

There are widespread and/or systemic failings leading to significant concerns about the experiences and outcomes of children and young people with special educational needs and/or disabilities (SEND) which the local area partnership must address urgently.

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Inspection outcome

A monitoring inspection will be carried out within approximately 18 months. The next full area SEND inspection will take place within approximately 3 years.

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Inspection outcome

HMCI requires the local area partnership to prepare and submit a priority action plan (area SEND) to address the identified areas for priority action.

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Information about the local area partnership

Nottinghamshire County Council and NHS Nottingham and Nottinghamshire Integrated Care Board (ICB) are responsible for commissioning and planning the services for children and young people with SEND in Nottinghamshire.

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Information about the local area partnership

There have been recent changes to some leadership posts in the local authority’s services for children and families. New Service Directors for Education, Learning and Inclusion and Help, Protection and Care have been appointed in the local authority in September 2022. The commissioning of health services changed across England in 2022. On 1 July 2022, the Nottingham and Nottinghamshire ICB took over the commissioning of health services from the Nottingham and Nottinghamshire Clinical Commissioning Group (CCG) and Bassetlaw CCG.

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Information about the local area partnership

Nottinghamshire County Council commissions a range of alternative provision. This provides education for children or young people, including 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. Small numbers of children and young people with SEND reside in placements outside Nottinghamshire. Area SEND inspection report: Nottinghamshire Local Area Partnership 30 January 2023 to 3 February 2023

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

Children and young people wait too long to have their needs accurately assessed. This includes accessing assessment and therapy services for children and young people who are receiving SEN support and those children and young people applying for education, health, and care plans (EHC plans). As a result, their needs are not being met in a timely way. Leaders’ plans and actions have not resulted in noticeable or sustained improvements to this situation.

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

Too many children and young people with SEND wait too long to access some health services such as speech and language therapy and neuro-developmental pathways. In addition, there are gaps in service provision, for example in occupational therapy and some specialist equipment provision. This results in ongoing frustration for children, young people and families.

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

For those children and young people with the most complex needs, EHC plans do not identify health and social care needs, outcomes, or services well enough. This means children and young people are not consistently getting the help they need at the right time. This is compounded by a lack of health and social care input at annual reviews for these children.

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

For too many young people, their experiences of transition to adult health services are dependent on their diagnosis, or the service they access, rather than their need. Additionally, some young people’s access to some health services stops abruptly and it is unclear to them how their needs will be met as an adult. While there is some work to address this through transition roles, the ICB currently lacks the commitment from health providers to address some of the shortfalls. Currently, there is a reliance on the adult practitioners’ experience and interest in improving young people’s transition to adult services.

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

Some children in mainstream provision with SEND do not receive clear advice to prepare for moving to their next stages of education. This means that families and children and young people do not always get the support they require in a timely fashion. Many young people with SEND receive effective support in securing employment, education, training and independent living as they become adults in Nottinghamshire. The proportion of Nottinghamshire children and young people with SEND who are not in education, employment, or training is decreasing. However, many parents and carers lack confidence in how well their children or young people are being prepared for adult life because they do not know what support is available.

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

Children and young people are positive about how their views and aspirations are reflected in their individual EHC plans and the support they receive. However, many parents and carers feel less informed and involved in decision-making for their children. They feel they must fight to get the support their children need to make progress towards their EHC plan outcomes. Area SEND inspection report: Nottinghamshire Local Area Partnership 30 January 2023 to 3 February 2023

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Pre-school aged children with clearly identifiable needs are well supported by education, health, and care services. Where a child or young person’s special educational needs emerge over time, the effectiveness of identification and assessment to meet education and any health or social care needs is variable. Leaders do not have clear plans to improve the experiences of these children and young people. This means support is reliant on the variable knowledge of school staff and special educational needs coordinators.

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Most children and young people awaiting a specialist placement receive suitable education in a timely manner. However, leaders recognise that there is a shortage of specialist education in Nottinghamshire and are commissioning additional places.

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For many children and young people with SEND, alternative provision is a positive experience. It supports them to remain in education and prepares them for their next steps.

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Young people with SEND who receive support from the Preparation for Adulthood Team (PfAT) transition effectively between social care for children and adult social care. Leaders have developed the Maximising Independence Service (MIS) to support young people who do not meet the threshold for support from the PfAT. After initial contact is made, most young people and their families are positive about the support provided from the MIS.

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Many of Nottinghamshire’s children and young people with SEND are reliant on schools and families for social activities and to make friends. This is because they do not know what is available for them. This can leave some children and young people isolated. Where children and young people with SEND receive travel training, it supports them well to participate independently in their communities. Groups like ‘The Pioneers’ youth forum are ensuring that the voices of children and young people with SEND in Nottinghamshire are increasingly heard. However, partnership leaders have more work to do to gather and act on the voices of children and young people with SEND.

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What is the area partnership doing that is effective?

◼ Partnership leaders have agreed an appropriate set of priorities to improve their SEND arrangements, following consultation with children and young people, parents and carers, professionals in education, health and care and wider stakeholders. It is too early to see the impact of these newly formed plans on the experiences and outcomes for children and young people with SEND. ◼ Leaders have increased their engagement with children and young people with SEND to gather their views about services. Some of this work is in its early stages. Leaders have increased opportunities for co-production (a way of working where children, families and those that provide the services work together to create a decision or a service). Examples include the Youth Zone hosted on the Ask Us (Nottinghamshire’s independent advice and support service) website that was co- Area SEND inspection report: Nottinghamshire Local Area Partnership

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produced with the Young Person’s Forum. ◼ The Nottinghamshire Parent Carer Forum (NPCF) take an active role in representing the families of children and young people with SEND. NPCF is represented on the SEND accountability board. Members of the forum use their own and their members’ experiences to challenge partnership leaders when services and provision are not good enough. NPCF is involved in the partnership’s planning to improve services and provision. However, they are rightly concerned that leaders’ planning is reactive rather than forward looking. ◼ Leaders have provided training for professionals in education, health and care, including social care, to increase their understanding of their roles and responsibilities for children and young people with SEND. There are some examples of individual practitioners working together with individual children and young people with SEND effectively in order to jointly commission bespoke

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packages of support. ◼ The Ask Us service is well regarded by those who use it. More families are seeking its support due to increased dissatisfaction with arrangements for SEND in Nottinghamshire. Ask Us ensures that partnership leaders hear the concerns that families raise. The service is currently meeting demand to provide support to parents and carers. There are plans to jointly increase its capacity to meet higher levels of requests for advice and provide wider work, such as attending parent and carer engagement events, that it has carried out previously. ◼ All partnership leaders and professionals want the best for children and young people with SEND in Nottinghamshire. Partnership leaders have agreed a set of priorities for SEND following consultation with children and young people, parents and carers, professionals in education, health and care and wider stakeholders. The ICB has identified clearly its priorities for children and young people with

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SEND in its statement of intent. ◼ Local partnerships and families of schools provide effective support for some children and young people with SEND. Those children and young people with SEND who benefit from a key worker are well supported.

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What does the area partnership need to do better?

◼ Partnership leaders do not work together effectively in order to meet their statutory requirements for joint commissioning fully. Leaders’ use of information and data from across the partnership to establish, advance and monitor priorities and outcomes is underdeveloped. Leaders’ plans have not led to the improvements they wanted to achieve. For example, at the time of the inspection, opportunities to improve some services to meet current need, such as speech and language therapy and access to some specialist equipment, had not been progressed. Commissioned services currently do not always meet the needs of Nottinghamshire’s children and young people with SEND. ◼ Partnership leaders do not have a strong enough strategic oversight of the Area SEND inspection report: Nottinghamshire Local Area Partnership 30 January 2023 to 3 February 2023

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partnership’s SEND priorities and the actions being taken to bring about improvement. The current accountability and outcomes framework does not include the information that partnership leaders need to evaluate how effectively education, health and care services are working together. Consequently, leaders are unclear about the challenges that children and young people with SEND and their families face in Nottinghamshire. ◼ The lack of meaningful data and information is an issue particularly for the ICB. ICB leaders are candid that some information is not collected and/or shared by health partners. Partnership leaders are setting up new processes to improve data-sharing across the partnership. However, this work is at an early stage and there is no evidence of improved data-sharing and co-working. Where there is a variety of data and information, such as in education, leaders are not always using this as well as they should to inform and support their strategic oversight.

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Partnership leaders cannot effectively challenge and support one another at present. ◼ Leaders across the partnership do not review the effectiveness of support for children and young people with SEND. They do not yet use information from EHC plans, SEN support and from the views of children and young people and their families to identify areas of need and inform joint commissioning. ◼ Leaders are not evaluating thoroughly the effectiveness of their actions. This does not support the local area partnership to understand and prioritise challenges. This, in turn, risks leaders’ work to provide services and support for children and young people with SEND not having the necessary impact. For example, leaders have improved processes for health partners to notify when a child has SEND. However, leaders do not know if these processes are making a positive difference. Multi-agency quality assurance arrangements for EHC plans are not yet

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embedded. EHC plans do not reflect the needs of children and young people well enough. ◼ The current leadership and governance structures and systems do not support effective multi-agency working. The ICB has started some work to develop SEND risks and assurances processes with health providers. However, this work is in its infancy. There are links between structures in the ICB, such as the ICB SEND Assurance Board and the partnership’s SEND Accountability Board. However, leaders recognise that these need to be strengthened to provide effective oversight and to support joint working.

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Responsible body Areas for priority action

Nottinghamshire County Council and NHS Nottingham and Leaders, NHS Nottingham and Nottinghamshire Integrated Care Board and education, health, and care providers should cooperate to urgently identify, assess and provide for the needs of children and young people Area SEND inspection report: Nottinghamshire Local Area Partnership 30 January 2023 to 3 February 2023

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Nottinghamshire Integrated Care Board with SEND. This includes assessment of needs, timely issuing of EHC plans and holistic oversight of these plans through annual reviews. NHS Nottingham and Nottinghamshire Integrated Care Board Leaders, including commissioners and providers, should act urgently to identify and address the delays and gaps in access to some health services, particularly speech and language therapy, neuro-developmental pathways and equipment services. They should also ensure that they use available performance data to identify where gaps exist and whether actions taken to address these are effective.

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Areas for improvement

Leaders across the partnership should continue their work to gather a wider range of views of children and young people with SEND and their families so that they can use these views to inform their planning for, and evaluation of, SEND services. Leaders across the partnership should establish effective processes for the quality assurance of EHC plans and use these to improve the quality of new and existing plans. Leaders across the partnership should use performance data and information effectively to inform their evaluation and joint commissioning of SEND services. Leaders across the partnership should put in place the appropriate governance arrangements to deliver their SEND plans both individually and across the wider partnership. ◼ Area SEND inspection report: Nottinghamshire Local Area Partnership 30 January 2023 to 3 February 2023

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Local Authority Integrated Care Board

Nottinghamshire County Council Nottingham and Nottinghamshire ICB Colin Pettigrew, Corporate Director Children, Young People and Schools Rosa Waddingham, Executive lead for SEND www.nottinghamshire.gov.uk https://notts.icb.nhs.uk Nottinghamshire County Hall Loughborough Road Nottingham NG2 7QP Sir John Robinson House Sir John Robinson Way Arnold Nottingham NG5 6DA

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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/Ofsted Inspectors from education and social care; a lead Children’s Services Inspector from Care Quality Commission (CQC); and another Children’s Services Inspector from CQC.

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Ofsted Care Quality Commission

Paul Wilson, Ofsted HMI Lead inspector Alison Smale, Ofsted HMI Lucy Harte, CQC lead inspector Lyndsey McGeary, CQC Inspector Patricia Head, Ofsted HMI Area SEND inspection report: Nottinghamshire Local Area Partnership 30 January 2023 to 3 February 2023

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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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