Surrey County Council: Area SEND full inspection
Local Area Partnership report
Area SEND inspection of Surrey Local Area Partnership
Inspection dates: 25 to 29 September 2023
Dates of previous inspection: 18 to 21 March 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 3 years. Ofsted and 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
Surrey County Council, NHS Surrey Heartlands Integrated Care Board (Icb) and NHS Frimley Icb are jointly responsible for the planning and commissioning of services for children and young people with SEND in Surrey.
There have been changes to some leadership posts across the local area partnership since the previous inspection. These include new appointments and changes to the governance structure. The commissioning of health services changed across England in 2022. At this time, the responsibility for health services in Surrey passed to Surrey Heartlands and Frimley ICBs.
Surrey County Council commissions a range of alternative provision in Surrey. This is to provide education for children and young people, including those who cannot attend school due to social, emotional and mental health (Semh), and medical needs, or for those who have been, or are at risk of permanent exclusion. The local authority maintains a list of registered and unregistered alternative providers that it has approved following checks on safeguarding arrangements.
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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 have variable experiences in Surrey. Leaders have identified the areas that they need to improve. They have put in place important actions that are starting to make a difference. However, the overall pace is too slow and not yet improving outcomes for many children and young people.
The Local Offer provides information about a wide range of opportunities and activities in the community. Some children and young people are encouraged and supported to take part in activities such as skiing or horse riding for the disabled, football or pursuing a personal interest. When this happens, the impact is positive and helps children and young people achieve strong outcomes.
Too often, children and young people with SEND and their families do not feel valued or visible in their communities. Many children and young people are unable to access mainstream after-school and holiday clubs, and these are not routinely adapted to their needs. Children and young people on waiting lists for Short Breaks programmes wait too long to access the provision they want. Children and young people in older age groups feel there is a lack of support and suitable opportunities for them, such as safe spaces or groups outside of education.
There are shining beacons among this landscape: the Atlas (Accept, Teach, Listen, Access, Support) participation group of children and young people in Surrey has co- produced many of the recent positive changes across the local area, for example the All Age Autism Strategy. Members of Atlas are helping partnership leaders to understand and respond well to the current situation of inconsistency. Members value the group for the friendships and opportunities it has given them. They feel that they have been actively listened to and their views respected.
Increasing numbers of younger children and those preparing to move into adult services benefit from improved early identification of their needs. This comes from strengthened multi-agency working, particularly in health and social care. However, for too many, identification and assessment of their education, health and social care needs still take too long. Consequently, some children, young people and their families experience unnecessary escalation of their needs. Some families report that this delay impacts adversely on their whole family’s well-being.
Many children and young people with SEND and their families wait too long for neurodevelopmental (Nd) assessments, as do some children and young people waiting for speech and language therapy, physiotherapy and occupational therapy. Families can access online resources and group clinics to support them while waiting for these therapies. Those who are waiting for Nd assessments benefit from practical and well-considered actions, including a helpline which provides resources such as coping strategies, and short-term interventions such as family support courses. However, although this information has been shared with them, too few parents and carers who spoke to inspectors have felt the impact
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of this work.
Children and young people with SEND who attend the maintained alternative provision benefit from a high level of support and effective multi-agency working. Together, professionals identify these children and young people’s needs carefully. As a result, many of these children and young people return to full-time education, where their needs can be met and they are successful. However, this provision is too often put in place when a child or young person’s needs have not been assessed or met in a timely way, which means they have reached a crisis point.
Some parents and carers told inspectors that they feel they are left with no other option than to remove their child or young person with SEND from education settings because they feel that their education and health needs are not identified or met effectively. In these situations, children and young people often spend extended periods of time out of education while waiting for their needs to be identified. While education and health professionals are now addressing this issue, there are often further delays in arranging and agreeing provision which is suitable to meet these needs. Often, this is of limited duration and scope. Consequently, these children and young people spend too long out of education and so are not well prepared for their next steps. Some families feel that their views are not fully appreciated when decisions are made.
Parents and carers have access to information, support and guidance provided by the parent and carer forum, Family Voice Surrey (Fvs) and SEND Advice Surrey and published online. Fvs are involved in key strategic decision-making, such as the All Age Autism Strategy. However, some parents and carers do not know about these services so lack the support they need to understand and navigate the complex system with its very many projects and schemes. This is particularly the case for parents and carers from marginalised groups.
What is the area partnership doing that is effective?
◼ There is ambition for children and young people with SEND in Surrey. Early
indications from the recently renewed SEND strategy and the new SEND partnership governance model are promising. Some children and young people with SEND and their families report that their experience of using services and of practitioners supporting them has improved. These parents and carers feel listened to and say that professionals work with them well.
◼ Joint commissioning is improving. Partners work together effectively in order to
make innovative improvements. They identify need well through a refreshed joint strategic needs assessment. They have listened to feedback from children, young people and their families to inform commissioning. The work to provide additional specialist school places and increased spaces in post-16 settings is on track to meet the projected education needs.
◼ Across education, health and care, practitioners work increasingly well together.
Effective communication between practitioners helps to put support in place promptly. For example, multi-agency meetings are held when a child or young
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person on the dynamic support register is identified as needing more support to prevent escalation of need and possible admission to hospital. Additionally, the key- worker health project which was co-produced with the involvement of Surrey Youth Focus is supporting positive outcomes. Professionals feel there has been a positive change across the local area partnership and that their expertise is listened to. This is starting to help join up the whole system more effectively and particularly at transition points.
◼ The Transitions team has well-understood referral pathways for young people
needing support in adulthood. Assessments and support packages are timely, and most young people receive the right service at the right time. Those with Adhd benefit from an appropriate clinical handover so that they have no gaps in their healthcare. As a result, these young people progress well and increasing numbers achieve sustained employment.
◼ Where families have built trusted relationships with professionals, they feel more
involved in and understand decisions better. Leaders have improved the access to and timeliness of decisions about education, health and care needs assessments (Ehcna). They have recently introduced a multi-agency triage where decisions are made quickly, and families are supported well to understand them.
◼ Early years settings value the support from the Early Years Graduated Response
Team and the Early Intervention Fund. Alongside younger children and their families, practitioners benefit from helpful information and signposting to relevant support services. This effective multi-agency working provides useful support and enables settings and families to meet the needs of the child quickly.
◼ The Youth Justice Service works closely with partners such as the Engage Service.
Together, they respond swiftly to support young people at risk of offending.
◼ The Children with Disabilities team ensures that children and young people with
complex needs benefit from appropriate pathway plans reflecting their capabilities and aspirations. These are prepared in good time and make good use of the range of effective support available, such as the Hope project, which provides a multi- agency service for 11- to 18-year-olds who are experiencing complex Semh challenges.
◼ Practitioners use Early Help, in particular family centres, the One Stop health referral
portal and the speech and language and occupational therapy links in schools effectively. These services enable them to support the needs of children and young people who are referred to them. Additionally, there are a range of early help services located in communities to support families. In therapy services, there is effective implementation of a system to support speech, language and communication needs. This means families and practitioners can access support, advice, training and guidance before a specialist assessment.
What does the area partnership need to do better?
◼ There is a wide range of projects and interventions, such as the early intervention
fund and the team around schools project, to address the weaknesses that leaders
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have rightly identified across the partnership. However, many parents, carers and children and young people with SEND have not yet felt the impact of these improvements.
◼ Leaders use many small-scale individual service evaluations to inform their strategic
plan. The overall evaluation of the impact of projects and plans on the whole system is underdeveloped. Leaders do not routinely consider the overall impact on children and young people’s outcomes. Consequently, system improvement is still too slow and unwieldy.
◼ Many parents and carers gave powerful examples of not feeling listened to and
feeling cut out of how decisions are made about their child or young person. Some processes do not support the ‘tell it once’ ambition. Communication with parents and carers is often poor. Additionally, some children and young people receive time- limited services, particularly in health, and frequent changes of personnel in social care. As a result, some parents and carers feel ‘bounced about’ and confused about how different services can help them. In this context, many parents and carers find it hard to build trusting relationships with professionals. To them, services appear disjointed and uncaring.
◼ Similarly, some professionals particularly in social care feel that, in more complex
cases, their expertise is not fully taken into account. There is often a lack of clarity about who is leading each aspect of support or who is responsible for each child or young person’s support. This can make the system hard to understand or navigate for families and professionals alike. This can also result in unnecessary distress for children and young people.
◼ The timeliness of EHC needs assessment remains poor for most children and young
people aged 11 to 16 years with SEND, despite recent improvements. Too many children and young people wait too long to have their needs assessed and met. When they are completed, contributions to Ehcna and EHC plans do not reliably incorporate social care information that would lead to an accurate understanding of these needs for all children and young people. The plans to remedy this have not yet had the impact that leaders intend.
◼ There is also poor completion of annual reviews. While many annual review
meetings are held, they are not always recorded, responded to or acted on quickly. Many lack high-quality contributions from all professional voices in order to ensure that children and young people’s ongoing needs and aspirations are identified and included. Some schools report difficulty in getting the appropriate professionals to attend annual review meetings in order to identify and assess ongoing need, particularly at times of transition.
◼ Support for children and young people’s transitions between phases, geographical
locations or placements is inconsistent, particularly for children and young people with social care needs. It is of particular concern for those with more complex difficulties or who experience multiple placement moves where there are often delays in receiving required support.
◼ Although leaders are in the process of evaluating and improving the alternative
provision offer, they do not have secure knowledge of the quality of provisions used
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and offered to children and young people with SEND who need education other than at school. Additionally, too many children and young people are offered a handful of hours for weeks and even months at a time. This is not the equivalent of the full- time education to which children and young people are entitled. As a result, parents, carers and children and young people can struggle to find provision that will meet their needs well. School leaders and parents and carers do not feel that they have been suitably involved in the decisions that have been made about these alternative provisions or on the impact they have had on their children and young people.
◼ Recent projects, particularly in health, are not yet showing the impact that leaders
intend. The system-wide Nd transformation plan is beginning to have an impact, leading to meeting needs without a diagnosis. However, it is too early to see the impact of this culture shift for children, young people and their families. Similarly, leaders have been creative in addressing the rising mental health needs of children and young people in Surrey through the innovative Mindworks Alliance model. Concerningly, the demand is already outstripping capacity, leading to longer waits.
Areas for improvement
Areas for improvement The partnership board should further develop their strategic evaluation of all partnership projects and interventions in order to improve their ability to monitor at a systemic level the impact of these projects and interventions and their outcomes on children and young people.
Leaders across the partnership should improve communications from SEN case officers and practitioners to parents and carers so that all stakeholders are supported to understand the system and decision-making, and feel fully involved in the journey with their child or young person.
Leaders across health, social care and education should ensure that improvements continue in line with their recovery plan in respect of:
− reducing waiting times for health assessments;
− increasing timeliness and quality of needs assessments; and
− increasing timeliness and quality of EHCPs and annual reviews.
Leaders in education should continue to review the breadth and offer of alternative provision in order to inform commissioning so that alternative provision meets children and young people’s needs and improves their outcomes.
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Local area partnership details
Local Authority Integrated Care Boards Surrey County Council Surrey Heartlands Icb and Frimley Icb
Rachael Wardell Executive Director of Children, Families and Lifelong Learning
Karen McDowell Acting Ceo Surrey Heartlands Integrated Care Board Fiona Edwards Ceo NHS Frimley Integrated Care Board
www.surreycc.gov.uk www.frimley.icb.nhs.uk
www.surreyheartlands.org
Surrey County Council 11 Cockshot Hill Woodhatch Reigate RH2 8EF
Surrey Heartlands Integrated Care Board Block C, 1st Floor Dukes Court Duke Street Woking Surrey GU21 5BH NHS Frimley Integrated Care Board King Edward Vii Hospital St Leonard’s Road Windsor SL4 3DP
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: four Hm’Is/Ofsted Inspectors from education and social care; a lead Children’s Services Inspector from Care Quality Commission (CQC); and two Children’s Services Inspectors from CQC.
Inspection team
Ofsted Care Quality Commission Emma Leavey, Ofsted Lead Inspector Tessa Valpy, CQC Lead Inspector Claire Prince, Ofsted Inspector Geraldine Bates, CQC Inspector
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Russel Breyer, Ofsted HMI, Social Care Maire Atherton, Ofsted HMI, Social Care Elizabeth Fox, CQC Inspector
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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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