Medway Council: Area SEND full inspection
Local Area Partnership report
Area SEND inspection of Medway Local Area Partnership
Inspection dates: 5 to 9 February 2024
Dates of previous inspection: 9 to 11 December 2019
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. The next full area SEND inspection will be within approximately three years. Ofsted and the Care Quality Commission (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
Medway Council and the Kent and Medway Integrated Care Board (Icb) are responsible for commissioning and planning the services for children and young people with SEND in Medway.
Since the last inspection of the Area SEND arrangements, in 2019, there have been changes to the leadership structure in both organisations which have added to the delays in improving services for children, young people and their families. These changes include the appointment of senior leaders in education, health and care and, more recently, changes to the political administration of the local authority.
Medway Council reprocured the commissioned range of alternative provisions (AP) following a review and consultations completed in April 2023. The offer now includes the provision of assessment centres, outreach support provision, reintegration placements and full-time AP for children and young people who cannot otherwise access education. The local authority maintains a list of registered APs and has oversight of these provisions and their safeguarding arrangements.
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What is it like to be a child or young person with SEND in this area?
For most children and young people with SEND and their families, receiving timely identification of their needs has long been a challenge. The local area partnership is addressing this and their actions have improved experiences for some children and young people. For example, children and young people who have complex and high-risk mental health needs receive strong multi-disciplinary support promptly. However, experiences overall are inconsistent.
Infants and younger children are starting to have improved experiences and outcomes, particularly in health and social care. They and their families receive well-managed and increased support from the health visiting team. This team ensures earlier identification of their needs and quicker onward referrals, which helps to identify any support that children need in order to start school successfully.
Parents of children in early years settings value the support provided by ‘Small Steps’. This has enabled them to implement strategies that help their children self-regulate when at home. However, as with so much in this local area, this strong pocket of practice has limited scope and is not fully developed. Here, the early years settings these children attend do not feel supported to ensure that they are equipped with the right knowledge and skills to build on this work.
When professionals work with families whose children or young people do not attend full- time school or are not in education, employment or training, they provide well-considered support. Most of these children and young people successfully return to education or find employment opportunities if it is appropriate for them. However, challenges to staffing continue to hamper the support that the partnership aims to provide.
The most vulnerable children and young people with complex needs have their views sought and considered by the professionals who work with them. These children and young people contribute to decision-making and are supported to understand choices about their current interventions and pathways. Their families access timely assessment and support for their health, social care and education needs. For example, children and young people placed in specialist settings, and who are known to social care, receive the right information, advice, guidance and support at the right time.
Many children and young people who are referred to commissioned AP settings have positive experiences. Their needs are identified quickly at assessment centres. They receive useful support to successfully reintegrate into permanent school places.
However, most children and young people continue to wait too long for their SEND to be assessed. This often results in an escalation of their needs and inability to manage at school. Some families feel their child or young person reaches crisis point before their needs are identified. Waiting lists for neurodevelopmental pathways, speech and language assessments, occupational therapy assessments and educational psychologists are too long.
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The local area has developed a programme to support families awaiting assessment, but few families know about it and it has not had the desired reach. However, families waiting for support for their children’s speech and language needs can access early language programmes, such as ‘Tiny Talkers’. Additionally, families can access short specific training to develop parenting strategies and understand their child’s or young person’s needs.
Children, young people and their families value the warm, inviting space that ‘family hubs’ offer, alongside the information, advice and guidance provided. Family hubs help families to navigate systems and reach the right information more quickly. They also enable practitioners to ensure that families do not unnecessarily join waiting lists for assessment where other more appropriate support can be put in place.
However, many parents and carers still struggle to find the right support to identify their children’s and young people’s needs. The local offer continues to be weak and most parents, carers and young people do not know how to find it. There is a lack of up-to- date information, including limited accessible opportunities for children and young people outside of education.
Too much communication is unclear and can be confusing. There are multiple routes to access SEND assessment and too much still depends on a child, young person or family finding someone to help them to navigate the very complex system. There is not enough consideration of individual families’ situations to make communication and information accessible for all. As a result, there is inequity for families across Medway.
What is the area partnership doing that is effective?
◼ Leaders have an accurate understanding of the needs of children and young people
with SEND. They know the areas for future development and improvement and have recently made progress with some of the ambitious actions in their strategic plan. These actions have had recent and positive results, which have had an impact on a minority of children and young people with SEND.
◼ Leaders have reviewed the majority of services, processes and provisions and made
changes that are firmly focused on the needs of the children, young people and their families. Where this has happened, more children and young people get the right help and support in an increasingly timely fashion.
◼ There is a strong relationship with the passionate, confident and experienced Medway
Parents and Carers Forum (Pcf). This has improved in recent years into a positive, constructive relationship. The Pcf is involved in co-production and commissioning at all levels of service development. They represent parents and carers through gathering views in a range of accessible ways.
◼ Leaders commission effective services to build capacity and ensure that quality and
efficiency of process is always focused on how these will benefit children and young people with SEND. For example, they have focused their commissioning in health on
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the early identification and reduction in escalation of need. There is a strong universal health offer for children and young people up to 19 years.
◼ Leaders have commissioned AP using their knowledge about the needs of children
and young people. There is a range of suitable mental health support within schools to support the rising numbers of children and young people with social, emotional and mental health needs. This includes signposting to additional services. However, many families are not aware of this support so are not able to access it, particularly if they do not attend school full-time.
◼ There are effective systems and processes to ensure effective oversight of
experiences and outcomes for children and young people in care who live at a distance from the local area. This includes the most vulnerable children and young people.
◼ There are some positive examples of thoughtful, inclusive co-production in all areas of
the partnership. This includes lived experience work in mental health and engagement in forums, including ‘Takeover Tuesdays’. Leaders have co-produced training to support school professionals to identify and support children’s and young people’s mental health needs.
◼ The use of young people’s lived experiences to inform the Dynamic Support Database
is a strength. As a result, fewer children and young people reach crisis point and need admission to hospital. Health practitioners have received training in SEND to improve their understanding. This has made processes and support smoother for children, young people and their families.
◼ Children and young people with SEND receive a good service from the ‘early help
hubs’. Clear partnership networks are effective in providing a wide range of timely practical support as well as parenting programmes that make a positive difference to children’s, young people’s and families’ lives. Targeted early help is well informed through detailed assessments of need. Practitioners create plans of support collaboratively with families and children.
◼ The recent changes to the fair access protocols and the implementation of
assessment centres have positive and prompt impacts for children and young people who are permanently excluded or do not have school placements. More are now placed in appropriate full-time education in a timely manner.
What does the area partnership need to do better?
◼ Leaders have not developed key performance indicators at governance level. This
prevents them from being able to jointly evaluate the progress and impact of services and provision across the partnership. Leaders have aimed to work on this for some years now. While the monitoring inspection in 2019 found that lines of accountability were strengthening, it also noted continued lack of joint strategic leadership across the area. While leaders express high ambition for children and young people with SEND and have recently developed strategic actions, this lack of key performance indicators means this ambition is not able to be assessed or measured.
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◼ Leaders know that across the partnership communication is not effective. Parents and
carers often have difficulties and delays in communications with the SEND team. Communications with parents and carers who are waiting for assessments are often confusing, creating barriers to ensuring that children and young people are supported effectively and at the right time.
◼ Recent changes have not been communicated clearly to education professionals in
order to help them to navigate systems and advocate for the families with whom they work. Leaders are still unpicking historical barriers. For example, until recently, some professionals did not have access to education, health and care (EHC) plans or SEND information. Families have had to repeat information that should have already been shared. This hinders the process of helping children and young people in a timely fashion.
◼ Although some pieces of work are well commissioned to support families, there has
not been sufficient consideration of how these services will be coordinated. As a result, services can overlap and cause confusion. For example, in health, some practitioners have ‘social prescribers’ to support families to access the right information. However, there is a lack of coordination so that there is no clear lead practitioner for families, which can lead to a fragmented approach.
◼ Leaders have a measurable plan to ensure that places are made available to meet the
emerging future needs of children and young people with SEND, for example increasing spaces in AP settings. However, these are limited and school leaders are concerned that the demand will overwhelm this service quickly. Additionally, there is a lack of suitable provision to meet the needs of young people aged over 16 years, other than level 3 qualifications.
◼ The strategic partnership’s work to prepare children and young people for adulthood
has not had the impact that children and young people need. Too often, plans for adulthood are not considered early enough. However, where plans have been implemented, children’s and young people’s experiences have improved. For example, those known to social care and health have more effective support to transition into adult services.
◼ The quality, impact and timeliness of EHC plans is too variable. Leaders have taken
recent action, which has started to have a positive impact, but there are still too many processes which delay and cause barriers to the implementation of support for children’s and young people’s needs. There is a lack of detail in social care contributions and inconsistencies in how children’s and young people’s health needs are reflected. Frequently, outcomes are not specific, appropriate or time bound. The development of children’s and young people’s plans is also hindered by the inconsistent attendance of practitioners at meetings.
◼ Similarly, annual reviews are not always attended by the practitioners who know the
child or young person. There are delays in updating plans following annual reviews. These have a negative impact on the support provided to the child or young person.
◼ There is a lack of identification and support for the health needs of children and
young people who are not attending full-time education. There is little consideration of the changing needs for these children and young people.
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◼ Leaders have strengthened the knowledge, skills and understanding of staff in the
children’s disabilities service, specifically around safeguarding. However, the partnership has not maintained its register of children with disabilities in line with statutory requirements. Leaders have started to address this.
◼ Leaders have put in place processes that enable families to directly commission ‘short
breaks’ to meet their children’s and young people’s needs. However, more is needed to ensure that there is sufficient variety in appropriate services. Currently, there is a six-month delay in reviewing these, and some families have struggled to find and purchase support.
Areas for improvement
Areas for improvement Leaders across the partnership should ensure that they swiftly identify key performance indicators that represent all stakeholders and enable evaluation of the impact of the partnership as a whole. Leaders across the partnership should improve communication to:
- improve equity for all children, young people and families across the area; - remove barriers to information and provide clear, consistent and accessible information about processes so that families can access the right support at the right time; and - ensure that all professionals have appropriate access to information they need to support children and young people with SEND. Leaders across the partnership should continue to sustain the pace in completing the actions to:
- improve the oversight, quality and timeliness of EHC plans and annual reviews; and - reduce waiting times for health assessments and educational psychologists. Leaders across the partnership should continue to improve co-production specifically to ensure that children’s and young people’s voices are heard and used to inform improvements and developments. Leaders across the partnership should continue to improve the transitions from child to adult services in health, education and care for all children and young people with SEND. Leaders should ensure that they improve children’s and young people’s access to experiences outside of education by:
- improving and maintaining the quality and content of information on the local offer so that is it up to date and helps families find appropriate, accessible activities; and - developing more partnership working so that barriers to services are lifted.
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Local area partnership details
Local Authority Integrated Care Board Medway Council Kent and Medway Icb Lee-Anne Farach, Director of Children’s Services
Paul Bentley, Chief Executive Officer
www.medway.gov.uk www.kentandmedway.icb.nhs.uk Dock Road Chatham ME4 4TR
2nd Floor Gail House Lower Stone Street Maidstone ME15 6NB 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.
The inspection was led by one of His Majesty’s Inspectors (HMI) from Ofsted, with a team of inspectors, including: two of HMIs from education and social care; and a lead Children’s Services Inspector from the Care Quality Commission (CQC) and another Children’s Services Inspector from the CQC.
Inspection team
Ofsted Care Quality Commission Emma Leavey, Ofsted HMI Lead inspector Tessa Valpy, CQC Lead inspector Amanda Maxwell, Ofsted HMI Lesley Perry, CQC inspector Keith Tysoe, Ofsted Inspector
Area SEND inspection report: Medway Local Area Partnership, 5 to 9 February 2024 8
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