Setting

Area SEND inspection of Hertfordshire Local Area Partnership

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Inspection dates: 10 to 14 July 2023 Dates of previous inspection: 4 to 8 July 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 reinspection will be within approximately 3 years.

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Inspection outcome

As a result of this inspection, 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

Hertfordshire County Council and the NHS Hertfordshire and West Essex Integrated Care Board (ICB) are responsible for planning and commissioning services to meet the needs of children and young people with SEND in Hertfordshire, as part of the Hertfordshire Local Area Partnership. The Hertfordshire Local Area Partnership oversees the commissioning of local education, social care and health provision for children and young people with SEND.

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Information about the local area partnership

There have been some quite recent changes to some leadership posts at Hertfordshire local authority. These include the appointment of a new Director for Children’s Services in September 2021, and new Service Directors for Inclusion and Skills and Specialist Services and Commissioning, who were appointed to the local authority in September 2022.

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Information about the local area partnership

The commissioning of health services changed across England in 2022. On 1 July 2022, the responsibility for health services in Hertfordshire passed from the NHS East and North Hertfordshire Clinical Commissioning Group (CCG) and the NHS Herts Valleys Clinical Commissioning Group to the NHS Hertfordshire and West Essex ICB. Area SEND inspection report: Hertfordshire Local Area Partnership 10 to 14 July 2023

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The Hertfordshire local area partnership commissions a range of alternative provision. Alternative provision provides education for children or young people, including those who cannot attend schools due to social, emotional and mental health and medical needs, or for those who have been or are at risk of being permanently excluded from school. Area SEND inspection report: Hertfordshire Local Area Partnership 10 to 14 July 2023

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

Too many children and young people with SEND have to wait too long for their needs to be assessed and for suitable provision to be put in place to meet their needs. This means that the time taken to put appropriate provision in place impacts significantly on the outcomes and experiences of children and young people and limits their chance of success. Too many parents and carers experience poor communication in relation to education, health and care needs assessments and education health and care planning and review. Too many parents and carers have to resort to formal routes to try to secure suitable provision for their child. This results in frustrations and additional pressures on families in trying to meet the needs of their child.

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

Children and young people who are undergoing an education, health and care needs assessment too frequently experience significant delays in receiving their final plan. Those who are in receipt of education, health and care (EHC) plans experience similarly lengthy delays when plans are reviewed. This means that actions and amendments are not in place to ensure children and young people’s needs are met within timescales that ensure they are wholly successful.

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

Too many EHC plans are of a poor quality. Parents and practitioners are frustrated when errors that have been pointed out at the draft planning stage are not corrected in the final report. Plans do not set out clearly enough the provision that will enable each child or young person to be successful. Plans lack precision and clarity. This impacts negatively on the experiences of too many children and young people in accessing the right support at the right time.

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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 do not experience a holistic approach to understanding their individual needs. EHC plans do not typically capture the voice or experience of the child or young person from their point of view. Too many children and young people with SEND in Hertfordshire do not feel that they are listened to or asked about the help they need. Leaders acknowledge there is work to do to ensure that the voice of children and young people with SEND and their families is heard and understood.

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

While many parents and carers value the support they receive from the school’s special educational needs coordinator (SENCo), and children and young people with SEND are positive about what they receive in school, too many children and young people who are waiting for a specialist placement are not accessing full-time education or school provision that meets their needs well. SENCos often work closely with parents to accurately identify children and young people’s needs. However, significant delays in accessing suitable provision impacts on children’s and young people’s experiences and limits their chance of success.

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

The rate of exclusions for children and young people with EHC plans is a concern. A significant number of parents feel they have no alternative but to educate their child at Area SEND inspection report: Hertfordshire Local Area Partnership 10 to 14 July 2023

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home while they are waiting for a place in a special school to become available. Partnership leaders have recognised that there is a shortage of specialist education in Hertfordshire and have taken action to commission, and plan for, additional special school places through the building of new schools and specialist provisions. At the point of the inspection, however, a substantial proportion of these additional places are not available.

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Young people are positive about the help they can access in school to support their mental health and well-being. In Hertfordshire, the children and young people mental health specialist service is predominantly meeting all waiting time standards, though some children across the county are still waiting too long. Providers have ‘waiting well’ policies in place to ensure that all children on waiting lists have appropriate support measures in place to identify any changes of risk or presentation. While there are many positive outcomes for those children and young people with SEND who are able to access mental health support, there may be potentially serious consequences for children and young people with SEND if they need to wait for services to become available to them.

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A significant number of children and young people who are accessing alternative provision have specific needs that should have been identified, assessed and met at an earlier stage. As a result, these children and young people have not had access to the suitable adjustments or specialist support that would have given them a greater chance of success in their education and avoided the need for alternative provision. While there remain too many children whose needs are not being identified or met before entering alternative provision, the recent experience of some children and young people once they access alternative provision is more positive. Recent developments in alternative provision in Hertfordshire mean that some children and young people who access alternative provision benefit from the support of a multi-agency team throughout their placement. This is helping these children and young people reintegrate successfully back

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For some children and young people who have clearly identified and more complex medical needs and/or disabilities, practitioners in health, education and social care work effectively in order meet those needs through their specific services. These children and young people often receive more appropriate and timely interventions, for example through occupational therapy services. Children with disabilities are provided with specialist adaptive equipment in a timely way.

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Parents and carers appreciate the short breaks that are available to support children and young people with SEND and their families. However, a substantial number of parents and carers also report that there is not enough short-break provision to meet the needs of families in the local area. This means that numbers of families and children and young people with SEND are not able to access enough of the support to which they are entitled.

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Young people with SEND are offered appropriate guidance and support that helps them plan and prepare for their future in further education, training and employment when they leave school. This includes coaching support to develop the skills that help young people overcome social and emotional barriers to achievement. Some young people Area SEND inspection report: Hertfordshire Local Area Partnership 10 to 14 July 2023

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access additional support to develop their confidence, resilience and determination to raise their aspirations of what they can achieve. This helps to increase their likelihood of success.

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What is the area partnership doing that is effective?

◼ Area leaders have correctly identified the challenges facing the provision for SEND in Hertfordshire. Leaders’ strategy sets out what needs to be done and how they intend to do it. ◼ There are new governance structures in place. Leaders across the local area partnership intend for these to provide strengthened systems of oversight of services across the partnership and SEND partnership working. When fully established, these should provide the necessary rigour to hold leaders to account. ◼ The local area partnership has improved the information that is available to support practitioners in education, health and social care to provide relevant advice and guidance to families of children and young people with SEND. This includes resources such as the ‘Ask SALI’ SEND advice line, the education and neurodiversity hubs, ‘Delivering Specialist Provision Locally’, the dynamic support register and a range of outreach and support services that are promoted through

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What is the area partnership doing that is effective?

the local offer. ◼ The local area partnership works closely with the Hertfordshire Parent Carer Involvement (HPCI, the Hertfordshire parent carer forum) to co-produce, review and develop the local area SEND strategy. The HPCI takes an active role in representing the views and experiences of the families of children and young people with SEND. The HPCI engages widely with voluntary organisations to support their work. The HPCI represents parents and carers at a strategic level and is informing the local area partnership’s work to improve the outcomes and experiences of children and young people with SEND across Hertfordshire. ◼ Transformation in mental health services and therapies has been co-designed with children and young people and their families. This work is still developing and the intended impact on the experiences and outcomes of children and young people with SEND is not fully realised. ◼ The local area’s provision for careers advice and guidance and preparation for

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What is the area partnership doing that is effective?

adulthood is a strength, so that young people needing additional support are identified early. Systems and approaches are well established and lead to high levels of engagement for young people with SEND in further education, training and supported employment. Leaders are proactive in creating links with employers that help young people with SEND to access work experience and opportunities to develop their knowledge, skills and experience that is relevant to their needs and aspirations. ◼ Once children and young people with SEND and their families meet the threshold for support from the intensive family support and social care teams, the support from these teams is of a high quality. Practitioners from these teams have a sound understanding of children’s and young people’s specific needs and abilities. Area SEND inspection report: Hertfordshire Local Area Partnership 10 to 14 July 2023

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Support is tailored well to meet the individual needs of the child or young person. Practitioners work with families to devise action plans that support the needs of the children and young people with SEND and their families. ◼ Multi-agency monitoring and oversight of children and young people who attend residential special schools is effective. The commissioning team regularly reviews placements to ensure that the support is appropriate and of a sufficient standard. The Virtual School supports the work of the partnership well. The Virtual School also supports the monitoring of children and young people with SEND who are in residential placements through regular and effective reviews of personal education plans (PEPs) which are specific to the child’s or young person’s needs. PEPs review strengths and progress and effectively capture the voice of the child or young person. The specific targets that are set as part of the PEP review process ensure

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that appropriate steps are put in place to support each individual child or young person’s progress. ◼ The commissioning of alternative provision is enabling schools to intervene more quickly to help children and young people with SEND and reduce the risk of permanent exclusion. The partnership’s strategy for alternative provision is at an early stage of development and the impact of this work on the experiences of children and young people with SEND across the local area is not fully realised. ◼ The public health nursing team works closely with families to understand and meet the needs of children and young people with SEND. This is impacting positively on the accurate identification of individual needs and improving the experiences of families of children and young people with SEND. ◼ The impact of the work of the ‘0-25 Together’ service on children and young people with disabilities is a strength of the partnership, as is the work of Special

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Educational Needs and Disabilities Information Advice and Support Services (SENDIASS) in supporting families.

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What does the area partnership need to do better?

◼ Partnership leaders have not acted with the necessary urgency to address long- standing, systemic and significant weaknesses in the systems and processes to improve the provision for children and young people with SEND and support for their families. ◼ Leaders have identified through their current strategy the main issues that need to be tackled, and new governance structures are in place to improve provision. However, their evaluation of the situation across Hertfordshire underestimates the scale of the significant weaknesses that exist and the impact this is having on children and young people with SEND and their families, often over a prolonged period of time. This means that leaders are not able to prioritise actions that will lead to sustainable improvement. This leads to problems being ‘patched’ rather than dealing with the underlying and systemic issues. This also limits the partnership’s capacity to plan effectively for the future.

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What does the area partnership need to do better?

Area SEND inspection report: Hertfordshire Local Area Partnership 10 to 14 July 2023

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◼ Leaders have taken steps to address this situation by their recent introduction of the SEND ‘Data Dashboard’. As a new development, it is yet to realise its potential and have its intended impact. ◼ Health representation as part of the joint strategic needs assessment (JSNA) has been limited. There are plans for health leaders to become more involved in the JSNA process, but this has not happened. Leaders are not doing enough to understand the lived experience of children and young people with SEND and their families. ◼ Leaders acknowledge that there has often been a lack of appropriate, clear and accurate responses, and timely follow up, to questions and enquiries to the LA SEND team. This is frustrating both for families and for schools who spend time following up delays or errors in EHC plan paperwork or in the issuing of EHC plans. ◼ Leaders’ actions to ensure that the concerns of parents and carers are addressed

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at an early stage, to reduce the need for issues to escalate, such as the recently introduced Resolution and Reconciliation Team, have not been effective enough. More families are requesting support through SENDIASS. A significant number of complaints that are made to the Local Government Ombudsman are upheld. Families often feel that their issues should have been resolved at an earlier stage through effective communication and a shared understanding of SEND needs. Some parents and carers feel that they are left with no option but to pursue legal routes. The local area partnership’s own data shows that the number of complaints is increasing overall. This includes an increase in the number of complaints that relate to issues of communication. To address this, leaders have recently secured substantial additional funding to support the delivery of their ‘Making SEND Everyone’s Business’ strategy. ◼ Many children and young people who access alternative provision have specific

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needs that should have been identified, assessed and met at an earlier stage. ◼ Families and early years practitioners often rely on the local knowledge of health professionals and established relationships between health and education practitioners for guidance, advice and support for early years placements where children with special educational and/or health needs are known to professionals. ◼ There is significant variation in the timeliness of health assessment processes for children and young people with SEND. This impacts particularly on children and young people who are waiting for autism spectrum disorder ASD and attention deficit hyperactivity disorder ADHD assessment. In some cases, this is exacerbated when during ASD assessment it is recognised that a child or young person also requires an assessment for ADHD. In these circumstances, families are often having to wait a further 15 months or more depending on which part of the

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county they live in. There is also significant variation between geographic areas within Hertfordshire. The local area partnership has recognised that there are issues in wait times for ADHD diagnosis and have made recent investments to review services with an improved pathway. The impact of this investment is yet to be felt by families and practitioners. Area SEND inspection report: Hertfordshire Local Area Partnership 10 to 14 July 2023

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◼ Audiology services have experienced an increase in referrals into the service of children and young people who are neurodiverse. Additional funding has been agreed but challenges remain in recruiting suitably qualified staff to undertake these assessments. The impact of this is further delays in assessment for children and young people with SEND. ◼ There are long wait times for children and young people to access speech and language services. Although a new service design is in place to improve this, the impact of this is not being felt by families. The partnership has been working with schools and early years settings to provide training for staff in education to support early intervention for children with speech and language needs. This work is at an early stage. ◼ Some children and young people with EHC plans are waiting for a placement in a special school. A significant proportion of these pupils have attended mainstream

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school part-time for an extended period of time. Although additional resource is allocated to schools to enhance the support for these children, partnership leaders do not monitor this provision sufficiently closely so that they can be reassured that the arrangements are having a positive impact on the experiences and outcomes of children and young people with SEND. ◼ Some children and young people with SEND struggle to remain in settings that are sometimes not the most appropriate to meet their needs. Some parents feel they have no alternative but to educate their child or young person at home until suitable provision is available. A significant proportion of children and young people with SEND whose parents have elected to educate them at home are currently undergoing EHC needs assessments. Some parents have to leave paid employment to support their child or young person at home. ◼ The local area partnership is in the process of commissioning additional special

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school places. However, these are not becoming available quickly enough for children and young people who have already been identified as requiring specialist provision or to meet the area’s growing need for specialist provision. ◼ The work to improve the systems and processes to support more effective EHC planning and review has been too slow. Too many parents wait too long for draft EHC plans to be finalised. When plans are issued, too often they contain errors and inaccuracies that do not reflect the discussions that have taken place, or do not take account of the responses from parents and carers and/or practitioners to improve the accuracy of the draft plan. ◼ Too many EHC plans do not specify clearly enough children’s education, health and care needs. EHC plans do not routinely capture the input from the range of professionals from education, health and social care, even when they are directly

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involved in the processes of EHC planning and review. Consequently, practitioners in schools do not have clear guidance for the provision that needs to be in place to meet a child or young person’s education, health and care needs effectively. This makes it hard for practitioners to evaluate the impact of the plan, creates additional work, and can delay children and young people’s transition to a new school. Recent work to improve the quality assurance of EHC plans is not yet Area SEND inspection report: Hertfordshire Local Area Partnership 10 to 14 July 2023

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making enough of a difference to ensure that EHC plans are fit for purpose and are completed in a timely way.

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Responsible body Areas for priority action

Hertfordshire County Council and NHS Hertfordshire and West Essex Integrated Care Board Leaders should act with urgency to accelerate their data dashboard work so that they have a shared, accurate understanding of the exact provision for SEND in Hertfordshire, and of its quality, so that they can target coherent activity where it is needed most. Hertfordshire County Council and NHS Hertfordshire and West Essex Integrated Care Board Leaders should work more collaboratively and in partnership across all of SEND provision, with secure governance and quality assurance arrangements in place, and with a particular urgent focus on addressing the areas leaders have identified in their strategy for SEND.

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Areas for improvement

Leaders across the partnership should address the variability in children and young people’s access to health services that exists in different areas within the local area so that all children and young people with SEND in Hertfordshire have an equal opportunity to access appropriate provision and support that meets their needs. Leaders across the partnership should act to improve the quality of new and existing EHC plans and ensure that plans meaningfully capture the voice and experience of children and young people with SEND and their families. Leaders should take action to ensure that pupils with EHC plans are attending the provision as stated on their plans, that the provision is effective in meeting needs, and that the use of part-time timetables is appropriate and is carefully managed and monitored. Leaders should further address the gaps and delays in service provision to meet the full range of needs of children and young people with SEND. This includes services for

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Areas for improvement

ASD, ADHD, mental health, audiology and speech and language. The local area partnership should act to address parents’ and carers’ concerns at an early stage to reduce dissatisfaction and eliminate the need for parents and carers to have to follow formal routes. Area SEND inspection report: Hertfordshire Local Area Partnership 10 to 14 July 2023

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Local Authority Integrated Care Board

Hertfordshire County Council Hertfordshire and West Essex NHS Integrated Care Board Jo Fisher, Director of Children’s Services Jane Halpin, Chief Executive Officer www.hertfordshire.gov.uk www.hertsandwestessex.icb.nhs.uk Hertfordshire County Council County Hall Pegs Lane Hertford SG13 8DQ Hertfordshire and West Essex NHS ICB Charter House Parkway Welwyn Garden City Hertfordshire AL8 6JL

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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 HMIs from education and social care, a lead Children’s Services Inspector from Care Quality Commission (CQC); and another Children’s Services Inspector from the CQC.

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Ofsted Care Quality Commission

Katherine Douglas, Ofsted HMI, lead inspector Daniel Carrick, CQC lead inspector Margaret Burke, Ofsted HMI Lesley Perry, CQC inspector Charlie Fordham, Ofsted HMI Area SEND inspection report: Hertfordshire Local Area Partnership 10 to 14 July 2023

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