London Borough of Enfield: Area SEND full inspection

Local Area Partnership report

Area SEND inspection of Enfield Local Area Partnership

Inspection dates: 20 March 2023 to 24 March 2023 Date of previous inspection: 27 June to 1 July 2016

Inspection outcome

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

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

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

Information about the local area partnership

The London Borough of Enfield and the North Central London Integrated Care Board are jointly responsible for the planning and commissioning of services for children and young people with SEND in Enfield.

The commissioning of health services changed across England in 2022. On 1 July 2022, the North London Integrated Care Board (Icb) became responsible for the commissioning of health services in Enfield.

The local authority commission a single provider to provide alternative provision for chil- dren or young people who are at risk of or have been permanently excluded.

Inspection report: Enfield Local Area Partnership 20 March 2023 to 24 March 2023 2

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

Children and young people with special educational needs and/or disabilities (SEND) have varied experiences in Enfield. In recent years, leaders have stepped up the pace of improvement, but parent and carer representatives have mixed views about how much impact leaders’ improvements have had so far.

Children, young people and their families are involved in the redesign and improvement of services. This is because leaders have encouraged providers to listen to their ideas. For example, ‘peer parents’ now work with families to support them in using the neuro diverse diagnostic pathway before and after diagnosis. Leaders have been innovative in finding effective ways to encourage children and young people with SEND to have a voice in forums such as the youth council.

Children and young people who have education, health and care (EHC) plans have mixed experiences. Leaders make sure that decisions about whether a child or young person needs an EHC plan are made on time and these are completed within the 20 week timescale required. Leaders have improved the quality of more recently agreed EHC plans and are ambitious to bring others up to this standard. This means that children and young people who have a recent EHC plan have their needs identified and the provision they require specified in a timely and accurate way. However, too many children and young people continue to rely on out-of-date EHC plans which do not reflect their current needs. Some children and young people are therefore disadvantaged when an annual review identifies that their EHC plan requires amending and this does not happen quickly enough. While leaders have asked schools to implement requested changes and seek additional support if required, this still means that professionals have gaps in the information they need to support the child or young person effectively. This is particularly important when the child or young person is moving from one phase of education to another.

Sometimes children, young people and their families experience delays in or disruption to their needs being met as a result of insufficient or inefficient information sharing between professionals. At times, families are relied on to bring important information from professionals to the attention of other agencies, or to ensure that long-term therapy needs are brought to the attention of adult health services.

Children and young people who are at risk of exclusion, or who are excluded, access alternative education commissioned by the local authority. Leaders make sure that other services work closely with the alternative provision so that, where this is appropriate, pupils return to mainstream schools as soon as possible. The number of exclusions has reduced significantly as a result of this close working. However, some children and young people with SEND experience late identification of their needs with this taking place only after they are placed in alternative provision.

Some children and young people with SEND are well prepared for their next steps in

Inspection report: Enfield Local Area Partnership 20 March 2023 to 24 March 2023 3

education and for transfer to adult services when required. This includes some strong provision for supported internships and movement from children to adult social care services. However, others are not as well prepared and express anxiety about the transition to adult life. For example, although we are aware the local area has two experienced careers advisors whose sole focus is SEND, many young people, parents and carers are not aware of this service.

There is a broad range of activities for children and young people to try in Enfield. Some children and young people with SEND take part in ambitious theatrical productions. Others say they enjoy meeting their friends in youth clubs.

However, some children and young people with SEND and their families are not always made aware of available activities. Leaders are listening to this and planning to improve access to popular events such as the Summer University. Parents of some young people with the most complex needs are also concerned that options to take part in activities such as youth clubs narrow as young people get older.

What is the area partnership doing that is effective?

▪ Leaders across the partnership are ambitious to improve outcomes for children and young people with SEND. They are focused on developing a greater shared understanding of children’s and young people’s needs across services. For example, a team of specialist health professionals work solely with children and young people with SEND who are looked after. This reduces their waiting time for any health needs to be identified and met.

▪ Since 2020 leaders have accelerated their work to improve the quality of EHC plans. Partners from education, health and social care share their expertise. This means they know what is typically effective in plans and recognise weaker features which need to improve further. Children and young people with recent EHC plans have their needs identified and met in a timely way.

▪ The designated social care officer (DSCO) is implementing training for professionals in social care so they better understand the needs of children and young people with SEND. For example, social workers are being trained in a range of communication methods to better support children and young people who cannot use words to communicate. This training is starting to have a positive impact for children and young people who have an allocated social worker. ▪ Some children and young people with very complex needs benefit from a range of services developed together by practitioners. An integrated team of social workers, therapists and psychologists makes sure that all of a child or young person’s needs are accurately assessed and understood. They then ensure that appropriate services, such as independent living and positive behaviour support are provided. This service helps children and young people identify and achieve their aspirations as they move into adulthood.

Inspection report: Enfield Local Area Partnership 20 March 2023 to 24 March 2023 4

▪ The needs of children and young people with SEND are typically identified promptly. For example, the Enfield Communication Advisory Support Service (Ecass) provides school settings with a whole school communication approach to aid early intervention and train education staff. This ensures that children’s speech, language and communication needs are identified and met in a timely way.

▪ There is a well-established and well-regarded range of services to support pupils whose behaviour puts them at risk of exclusion. Nurture groups in mainstream schools offer effective help. The fair access panel in Enfield delivers a transparent and collaborative process to decide if a move between providers is in the best interests of a child or young person. The panel work effectively to support reintegration of some children into mainstream schools after successful placement in alternative provision.

▪ The youth justice service is a strong, well-resourced team. They are working with the police to ensure the physical environment of custody suites is better adapted to reflect the needs of children and young people with SEND.

▪ Young people with SEND who do not have an EHC plan and may be at risk of missing out on progressing to a suitable placement after school are identified early and offered advice. This means that they typically remain in education, employment or training after leaving school.

What does the area partnership need to do better?

▪ There are inconsistencies across education, health and social care in the way leaders share and use information about children and young people with SEND. Information about the curriculum offer that is included in the commissioning agreement for alternative provision is not well-defined. Also, sometimes information from health professionals’ work with children and young people with SEND is not made available to multi-agency partners. It is up to parents and carers to bring this new information about a child or young person’s needs to annual reviews of EHC plans.

▪ Some professionals who help children and young people with EHC plans are left without access to the most current information about their needs. This is because of delays in updating plans after annual reviews. Leaders are aware of this and have plans to strengthen systems to ensure better timeliness and quality of re- views. However, this is yet to have an impact on ensuring the needs of some chil- dren and young people are being met. For example, college staff are trying to support some young people as they move into post 19 education or employment while using plans which still include secondary school objectives. Local area lead- ers rely on practitioners in schools to formulate their own plans to meet the needs

Inspection report: Enfield Local Area Partnership 20 March 2023 to 24 March 2023 5

of children and young people who attend their settings while waiting for updated EHC plans.

▪ Young people with SEND who require community therapy services as they move into adulthood sometimes do not experience a smooth transition from children’s to adult services. For example, young people who require ongoing physiotherapy after they are 18 years old do not directly transfer to adult physiotherapy services. It is up to the parent, carer or young person to ensure that their case is referred to the adult team by their Gp. ▪ Waiting times for some community health services such as speech and language therapy and children and adolescent mental health services (CAMHS) are too long. This means there are variations in how promptly children and young people get the right help. Workforce capacity has negatively impacted on long waits. Icb leaders have recognised this and have prioritised recovery action plans where necessary to promote the ability to continue to deliver core health services. However, there is still too much variation in how promptly children and young people get the right help.

▪ Parents and carers are typically not consulted by speech and language therapists when they are commissioned to complete a statutory assessment of a child or young person’s needs. This limits the information available when making decisions about how speech and language needs of children and young people with SEND can best be met.

▪ The information and advice service in Enfield is recovering from a lack of capacity and several changes in management. Parent representatives say they have needed to fill this gap until recently. Over time, the information and advice service has not done enough to make its offer of advice known to children and young people with SEND.

▪ Currently, there is very limited residential respite care providing overnight stays to those families needing a high level of support. Leaders have recognised this, and development of a residential short breaks provision is in the early stages of planning. Areas for improvement

Areas for improvement Leaders should ensure that information sharing across education, health and care ser- vices leads to a more consistent understanding of current needs and supports transition for children and young people as they move from one provider to another. The partnership should ensure that EHC plans consistently reflect current needs in the prescribed outcomes for children and young people. They should ensure that the annual review process leads to EHC plans being updated in a timely way. Leaders should ensure that children and young people with SEND who move from chil- dren to adult health services experience a smooth and effective transition.

Inspection report: Enfield Local Area Partnership 20 March 2023 to 24 March 2023 6

Local area partnership details

Local Authority Integrated Care Board London Borough of Enfield NHS North Central London Integrated Care Board Tony Theodoulou Frances O’Callaghan Executive Director, People Services Chief Executive Officer at NHS North Cen- tral London Integrated Care Board. www.enfield.gov.uk https://nclhealthandcare.org.uk/icb/north- central-london-integrated-care-board Information about this inspection

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

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 Ser- vices Inspector from the Care Quality Commission (CQC); and another Children’s Services Inspector from CQC.

Inspection team

Ofsted Care Quality Commission Andrew Wright HMI, Ofsted Lead inspector Claire Mason, CQC lead inspector

Sam Hainey HMI, Ofsted Lesley Perry, CQC Inspector

Janet Fraser HMI, Ofsted

Inspection report: Enfield Local Area Partnership 20 March 2023 to 24 March 2023 7

If you are not happy with the inspection or the report, you can complain to Ofsted.

The Office for Standards in Education, Children's Services and Skills (Ofsted) regulates and 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 children looked after, safeguarding and child protection.

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