1

March 2019

Self-evaluation of the local areas’ effectiveness in

identifying and meeting the needs of children and

young people who have special educational needs

and/or disabilities

2

Table of Contents

Foreword ................................................................................................................................. 3

Executive Summary .................................................................................................................. 4

Contextual Headlines ............................................................................................................... 6

Question A: How effectively does the local area identify children and young people who have

special educational needs and/or disabilities? ........................................................................... 9

Question B: How effectively does the local area assess and meet the needs of children and young

people who have special education needs and/or disabilities? ................................................. 16

Question C: How effectively does the local area improve outcomes for children and young people

who have special educational needs and / or disabilities? ....................................................... 23

3

Foreword

We work in partnership to ensure that children and young people with Special Educational

Needs and Disabilities (SEND), and their families, receive the support and access to

services that they need, in a timely manner; with co-production as the driving principle

throughout.

Services in Cumbria are committed to inclusion. This is a commitment which has been

sustained over many years, and within a national context of increasing numbers and

complexity of demand, and of reducing resource. The local authority, educational settings

and Clinical Commissioning Groups (CCGs) have embraced the opportunity for change and

development presented by the reformed model of SEND support.

Need in Cumbria is changing. More children are being diagnosed with Autistic Spectrum

Conditions, and proportionally fewer require support to access the curriculum as a result of

physical disability or sensory impairment, in this changing environment Cumbria is delivering

reforms significantly more successfully than our statistical neighbours.

Governance for SEND has been established through the Children’s Trust Board (CTB) and

Health and Wellbeing Board. A ‘Children with Disabilities’ sub group of the CTB provides

multi-agency strategic leadership, with an independent chair. The portfolio holder for Schools

and Learning receives performance information and provides added challenge and direction.

A peer review of Local Area SEND provision was commissioned in 2016 and took place in

March 2017. The review team, organised through the Local Government Association (LGA)

network saw a multidisciplinary team, led by the Director of Children’s Services (DCS) for

Durham, carry out a review of the Cumbria Local Area system, to provide support and

challenge around our partnership approach.

The findings of this review, referenced at various points in this self-evaluation, were captured

in a Peer Review Action plan, which is governed by the sub-group. The group was set up

specifically to oversee the implementation of the recommendations from the peer review.

Remaining actions are captured by the Improvement Plan, which is appended to this Self

Evaluation.

John Macilwraith

Executive Director – People (Deputy Chief Executive)

Sue Sanderson

Elected Member – Portfolio Holder for Schools and Learning

4

Executive Summary

The Cumbrian local area is a partnership across the local authority, health system, schools,

settings, third sector, Parent Carer Forum and other partners. This partnership centring

around children and families, seeks to work together to improve identification, assessment

and outcomes for children and young people with SEND.

This partnership is maturing, there are many areas where our joint working has been

successful and has improved the lived experience of our children and families. There are still

areas in which the partnership needs to improve.

We have divided our self-assessment into three main areas, according to the joint inspection

schedule.

Question A: How effectively does the local area identify children and young people

who have special educational needs and/or disabilities?

Our strengths Our priorities for improvement

S1. SEND Early Help Process

S2. Collaborative working

S3. Support and advice for

professionals and parents to support

early identification

S4. EHCP timescales

P1. Collaboration in complex cases

P2. Identification and assessment of social

care needs

P3. Understanding of how well SEN

support children are identified and

supported

P4. Use of data

P5. The local offer

Question B: How effectively does the local area assess and meet the needs of

children and young people who have special education needs and/or disabilities?

Our strengths

Our priorities for improvement

S1 Positive examples of co-

production and engagement

S2 The quality of impartial information

advice and support

S3 Meeting the needs of CLA

P1 Strategic approach to engagement and

co-production

P2 Joint commissioning

P3 Further developing the quality of EHCPs

P4 Personal Budgets

Question C: How effectively does the local area improve outcomes for children and

young people who have special educational needs and / or disabilities?

Our strengths Our priorities for improvement

S1 Outcomes (Education, Health,

Social)

S2 Quality of existing provision

S3 Commitment to Inclusion

P1 Emotional Wellbeing

P2 Expanding the range of provision

P3 Transition planning

5

Question A – Identification

We know that we have good and improving systems for identifying children and

young people with SEND at every stage.

Cumbria responded swiftly to the SEND reforms and since their implementation have

remained well above national average and statistical neighbour rate for timely

completion of EHCPs.

Our knowledge of children and young people whose needs are below the level for an

EHCP is less good.

Quality of advice to support in the identification of children and young people’s needs

in the system, is good.

Availability of this expertise can be limited at the early help stage because of the

impact on capacity due to increasing demand for statutory assessment.

We are developing the way we use data from multiple sources

Question B – Assessment

Families are positively engaged in co-production both in terms of their own EHCPs

and also in the design of service delivery.

There is more work to do in engaging families in co-production at a strategic level.

Our peer review in 2017 highlighted joint commissioning as a priority for

development.

Significant progress has been made against this priority but more developments are

needed in order to improve the agility of our system in responding to our families’

needs.

Whilst our EHCP timescales are good, quality is variable. The system has invested

significant resource in developing a multi-agency quality assurance model to highlight

thematic areas for improvement.

Independent advice and support for families receives positive feedback and is highly

valued.

The system is good at meeting the needs of Children Looked After (CLA) with SEND

Question C – Outcomes

Educational attainment for children with an EHCP in Cumbria is comparatively high.

For SEN support children levels of attainment are improving in relation to national

figures.

Our Cumbrian special schools and short breaks provision are of high quality.

There is a longstanding commitment to inclusion in Cumbria.

The existing provision model does not match with the rapidly changing needs of the

population. There is a commitment across all stakeholders in the system to expand

the range of provision in Cumbria.

Children and young people’s emotional wellbeing is a priority for children and

families, and for the system.

Families tell us the transition from children’s to Adult services is not a smooth

process for them. A multi-agency strategic group, including parent carer

representation is actively working to address this key priority.

6

Contextual Headlines

127,443 children and young people aged 0-25 (up to 25th birthday) live in Cumbria: This

equates to the 0-25 age group being around 25.6% of the total population in the county1.

As a proportion of the 0-25 age population in Cumbria, 2.5% have an Education, Health and

Care Plan (EHCP).

The proportion of school age pupils with EHCPs has increased in Cumbria since 2014.

The proportion of school age pupils with Special Educational Needs (SEN) Support, but

without an EHCP, has fallen in Cumbria and in statistical neighbours and the country as a

whole since 2010. The proportion in Cumbria in 2018 was equivalent to the national.

(Source for EHCPs/Statements and SEN support pupil school proportions - DfE Statistical

First Release Special Educational Needs in England January 2018)

Educational Settings

There are currently 5 (day placement) Special Schools in Cumbria. There are also 3 Pupil

Referral Units which also oversee the Home and Hospital Tuition Service.

There are 5 Further Education colleges in Cumbria that are able to provide for young people

with SEND from the age of 16. In addition, there are Cumbrian young people placed in 8

Independent Specialist Colleges. One of these also delivers locally at sites in Barrow-in-

Furness and Carlisle, enabling young people to access a specialist further education

opportunity without having to leave their home area. There is also an independent sixth form

college, and a University Technical College (UTC).

Some Cumbrian children and young people who are currently supported by the Local

Authority attend independent educational placements with specialist providers, either in the

county or elsewhere. There are 322 state funded schools (including 3 Pupil Referral Units, 5

special schools, 6 nursery schools, 39 secondary schools (including 23 academies), 269

primary schools (including 53 academies and 2 Free Schools) in Cumbria providing support

to pupils/students with SEND. These include 29 schools with additional funding allocated to

offer resourced provision, with students able to access a resourced unit within these

establishments as well as being integrated into the mainstream learning environment.

These schools have a team of specialist staff to support pupils and staff in other schools.

There are 6 Local Authority (LA) maintained nursery schools, 178 Private, Voluntary and

Independent (PVI) settings, 21 are academies and 5 are independent schools all with

separately registered childcare provision. There are 28 Children’s Centres of which 5

provide their own childcare (included in the PVI numbers above) and 172 childminders.

Specialist provision is in place throughout the County but Cumbria retains a significantly

higher proportion of SEN learners with EHCPs in mainstream settings than the national

average (55.2% of pupils with an EHCP compared with 40.1%) This is both the result of

agreed policy and is the most appropriate approach to meeting need in a large rural County

with a dispersed population. (Source – SEN2 Jan 2018 published data)

1 According to ONS data, (mid 2017)

7

Pupils by SEN need and school phase

There is a varied picture between school phase and type of SEN need comparing Cumbria

to the country as a whole.

In special schools, the proportion of pupils is substantially lower than the national for

social, emotional and mental health (SEMH), Autistic Spectrum Disorder (ASD),

Moderate Learning Difficulties (MLD) and Speech, Language and Communication

Needs (SLCN).

However, proportions are well above national in special schools for Severe Learning

Difficulties (SLD) and Profound and Multiple Learning Difficulties (PMLD).

In both primary and secondary schools, proportions are below national for SEMH,

MLD and SLCN. Both primary and secondary schools have slightly higher

proportions of pupils with ASD, SLD, PMLD, and much higher than national for

SPLD.

• There has been a substantial increase, (66%) from January 2012 (4.3%) to January

2018 (8.9%) in the number of school age pupils with an EHCP or SEN support with a

diagnosis of autism. The Cumbria rate has remained lower than national, but has

been increasing at the same rate. The Inclusion Team is working with schools to

develop a new system of Hub and Spoke Resourced Provision to meet these needs.

SEND and Social Care

As at 11th March 2019, there were 3205 children subject to an Education and Health Care

Plan (EHCP) in Cumbria. Of these, 530 were open to Children’s Social Care

.

Of these:

7.6% were on a Child in Need Plan,

1.0% had a Child Protection plan,

5.2% were Looked After

2.4% were a Care Leaver with a pathways

plan.

9.9% recorded in ICS as Children with

Disabilities.

8

Performance Indicators

9

Question A: How effectively does the local area identify children and young people

who have special educational needs and/or disabilities?

Our strengths Our priorities for improvement

S1. SEND Early Help Process

S2. Collaborative working

S3. Support and advice for professionals

and parents to support early

identification

S4. EHCP timescales

P1. Collaboration in complex cases

P2. Identification and assessment of

social care needs

P3. Understanding of how well SEN

support children are identified and

supported

P4. Use of data

P5. The local offer

Our strengths

S1. SEND Early Help Process

There is a single pathway and process for assessment for EHC Plans and SEND

Early Help assessments, which gives access to a range of specialist support from all

agencies, including the option of statutory assessment. Settings also have access to

a range of specialist support from all agencies throughout the process.

Consequently, there has been an increase in early identification of need through the

Early Help process, leading to earlier identification of children and young people with

SEND.

Members of the Access and Inclusion Team regularly contribute to the Early Help

process by drawing in relevant SEND support, such as Early Years Area Special

Educational Needs Coordinators (SENCOs) for the child where appropriate, resulting

in appropriate support for the child, the school/setting and the parents at the earliest

possible point.

An increasing number of early help assessments ensure that a team is established

around the child to identify support and appropriate next steps. The emphasis of this

is on following the process of ‘assess, plan, do, review cycles’ looking at all aspects

of the child’s needs. This process enables those working to support the child or

young person to move through the ‘Graduated Response’ as outlined in the Code of

Practice. Parents are fully involved throughout the process. Consequently

appropriate levels of support are in place where this approach is used.

The close professional relationships allow for prompt involvement enabling plans for

future learning and next steps to be identified to improve outcomes. For children who

have an identified need, an Early Years SEN support plan or Individual Education

Plan (IEP) is developed including SMART targets (Specific, Measurable, Achievable,

Realistic & Timeframes) reflecting the child’s individual needs and abilities. This is

10

having a positive impact on the achievement of individual children within settings and

on transition.

S.2. Collaborative working

Health services work closely with SEND professionals – for example, specialist

advisory teachers are alerted to children and young people who are blind or Vision

Impaired and/or Deaf and Hearing Impaired (BVI/DHI). These colleagues form part of

the team around the child (TAC) from the point of identification onwards as required.

This allows for additional support to be provided to the child and family from a very

early age and also ensures that early planning to meet need is in place to support

educational provision.

Positive operational relationships between the Local Authority and health colleagues

have led to collaboration on developing effective gathering and sharing of information

contributing to reduced delay for children and families.

Joint working through the Multi Agency Autism Team (MAAT) has significantly

reduced the waiting time for a diagnosis leading to a better service and outcomes for

these children. Educational psychologists continue to be available to offer school

based support and advice as needed, whether or not the MAAT gives a diagnosis of

autism.

Early Years Area SENCOs work closely with Health Visitors and Children’s

Community Nurses which ensures families and settings identify SEND at the earliest

stage in a child’s life and work together to develop individual SEN support plans,

supported, if necessary, by Area SENCOs, with request for statutory assessment.

This results in earlier identification of SEND.

Clear information, advice and guidance is provided by the Early Years team on how

best to support children with SEND which is also accessible on the Local Offer.

Where needs are identified in the Early Years there are appropriate systems to

signpost families to relevant services provided by the Children’s Centres. The Area

SENCOs are highly trained early years qualified teachers who offer appropriate

advice, support and guidance to the Early Years sector. This is provided through

termly SENCO briefings, cluster working and bespoke training for Early Years

providers. The impact of this is evident through the effective early identification and

intervention put in place by the early years providers. The Area SENCOs work in

close collaboration with the SEND Teaching Support Team so that the most effective

and consistent support is in place for individual children in Cumbria.

Children’s Centres in Cumbria work with children from pre-birth to 12 years, and their

families. They consult with local families in order to shape the services that they

provide in each area. Children’s Centres provide a range of services to support

children with additional needs which includes portage, activities for children and their

families to enjoy together (socialisation, sensory play, swimming and soft play) and

short break sessions after school or in the holidays if parents request this; the

specific services in each area vary according to local consultation and need. This

bespoke service results in positive impacts for individuals and families as evidenced

in consultations.

Between the ages of 24 – 36 months the Early Years two year old review is

completed. In Cumbria a joint review alongside a health visitor for the most

vulnerable children is carried out where possible. For those children where a joint

review is not able to take place the Early Years provider is able to include the ages

11

and stages summary from the child’s Red Book into the two year old review.

Following consultation with the sector and health colleagues the process has been

reviewed, and a summary sheet of the child’s two year old progress check has been

introduced to the Red Book to further enhance partnership working and also to

identify any emerging needs at the earliest point. Alongside this, practitioners

develop appropriate Early Years SEN support plans to meet a child’s individual

needs involving relevant professionals as appropriate. This ensures that provision is

fully able to meet the child’s needs and ensures their parents are well supported at

what may be a very challenging and emotional time.

Health Visitors see children for core contacts from handover from the midwife after

birth, 6-8 weeks, 12 months and 2.5 years, undertaking assessments at each stage

to identify need. They are always available to support families from the antenatal

period through to the child starting school through clinics and one-to-one

appointments and are instrumental in referring or signposting to other appropriate

supporting agencies or services. As a result, families are supported early, and needs

are identified at an early point.

The Virtual School officers work very closely with the Inclusion Team and as a result

have high awareness of the number of children who are both looked after and have

SEND, leading to early identification of, and improved experiences, for CLA with

SEND

There is a joint working agreement in place between Cumbria Youth Offending

Service and the SEND Team. This agreement ensures that we are in compliance

with the legal framework for children and young people with SEND in youth custody.

Consequently, close working, in line with the agreement, ensures that the SEND

team are aware of all young people detained in custody who have a SEN or EHCP.

At the start of a custodial sentence all relevant information is made available to the

secure estate to ensure good sentence planning and appropriate provision for all

detained children and young people.

The appropriate pathway is in place to ensure children and young people in custody

are considered for assessment, where additional learning needs have been

identified. This ensures that appropriate provision is in place, during the custodial

element of a sentence and upon release.

S.3. Support and advice for professionals and parents to support early identification

Settings and schools have access to high quality specialist advice even at the early

help stage which is highly valued. This is evidenced by the service user feedback

reports from schools and settings on the work of the Area SENCO, the Specialist

Advisory Teaching Service and the County Psychological Service which indicates a

significant positive impact on teaching and learning and identifies the value of their

contribution to the review process. In a relatively small number of instances parents

are not happy with the service they receive for a number of reasons; in these

instances we have a complaints process which is followed and we seek to work with

families to expedite a resolution.

There are identified Post 16 LDD officers who work closely with Inspira and post 16

settings to ensure young people with additional needs are identified and appropriately

supported. The officers work in close collaboration with colleges and they alert young

people to us who they identify as needing support. Each college has a named

12

person who effectively takes on the SENCO role. Termly FE Network meetings are

held as well as regular meetings with Inspira to ensure effective sharing of

information so that young people who may have SEND can be identified. The officers

also work closely with Adult Social Care and attend local area transition meetings.

We have a comprehensive SEND Handbook, and associated training delivered to

key staff, with positive feedback received. Furthermore, guidance has been provided

for settings on how to make a request for statutory assessment, as well as when a

request is appropriate and what information needs to be provided to expedite the

decision making process, resulting in an improved understanding of the referral and

support process.

Information on making a parental request for statutory assessment is published on

the Local Offer, as is our Short Break statement which was produced in partnership

with parents/carers, contributing to improved awareness of SEND referral processes

amongst parents and carers.

The SENDIAS team provide high quality information, advice and support to parents

across Cumbria with regard to the whole process including identification. This

enables parents to hold schools and the LA to account for statutory duties.

Children’s Centres provide activities for children aged 0 – 12 years who have

additional needs, and this includes children who are below the threshold for an

EHCP. Each Children’s Centre is linked to a member of the Early Year’s Team and/or

an Area SENCO who can provide advice and support regarding early identification

when required. Children’s Centres are also invited to the termly INCO clusters

provided by the Early Years Team for ongoing updates and professional

development. This joint working leads to early identification and referral of children to

the appropriate service.

S4. EHCP timescales

At the end of March 2018, Cumbria had a conversion rate (statements to EHCPs) of

99.7%, compared to the national rate of 98.4%. This means that all children and

young people who are eligible for an EHCP in Cumbria have had the opportunity to

experience the new process and benefit from a meeting between themselves, their

family and involved professionals to plan for their future.

Performance in EHCPs being issued within timescale has shown a decline in

performance since January 2018. The annual rate of EHCPs completed in 20 weeks

was higher than statistical neighbours and national average (61.3%) in Cumbria

during 2017 (79.7%). We recognise continued focus is required to maintain positive

performance particularly in the South of the county where there have been staffing

challenges.

Our priorities for improvement

P.1 Collaboration in complex cases

Where, due to highly complex needs, a Children’s Continuing Care assessment is

required this can sometimes lead to delays in the assessment process. More work is

needed to improve collaboration between the Local Authority and Health colleagues

in these cases to avoid unnecessary delay, particularly for young people in transition.

13

The change to having two CCGs in the County means some systems to plan and

deliver support have required revision, for example the Complex Needs Panel.

We now have active Complex Needs Panels in both north and south Cumbria.

Where appropriate, individual cases will be agreed outside of panel to minimise

potential delays in arranging care.

North Cumbria CCG has reviewed their Children’s Continuing Care policy and written

a Standard Operating Procedure (SOP). This includes aligning them with the Adult’s

Continuing Healthcare panel arrangements in order to facilitate transition processes.

Morecambe Bay CCG is currently reviewing policy and process for agreeing

Children’s Continuing Care and other funding streams.

North Cumbria CCG have employed additional staff whose remit is specifically

around support for the Continuing Health Care process for those adults with a

learning disability and those transitioning from Children’s Services.

Morecambe Bay CCG is working with their Commissioning Support Unit to align

processes for EHCPs and Care Education and Treatment Reviews and individual

funding.

Specific training workshops have been arranged for all partners to attend ensuring

that a collaborative approach is adopted throughout Cumbria in the delivery of

continuing care.

P.2 Identification and assessment of social care needs

We recognise the need to improve social care screening in some cases for children

and young people with SEND as part of the assessment process. Our EHCP audit

process indicates the quality of social care input is currently variable. As a result, the

template for social care colleagues to provide information for statutory assessment

and reviews has been revised and was launched at district events in September

2018. We have a named contact in Social Care to provide support in ensuring the

input from social care colleagues is understood and prioritised. It is too early to

evidence the impact of this which is being reviewed through the audit process.

The Ofsted inspection of children and families services under the single inspection

framework in November 2017 highlighted a key priority area to “improve consistency

in the quality of social work practice for disabled children including assessments and

care plans” A number of actions are now in place to address this and these are

monitored through the Ofsted improvement plan.

A key part of our practice improvement in relation to social care is the implementation

of the Signs of Safety practice model which is being adopted across Cumbria and

which our SEND/Inclusion staff are centrally engaged in.

P3 Understanding of how well SEN support children are identified and supported

We recognise there is a gap in our understanding of how well the needs of those at

SEN support level are met. Six roadshows took place during 2018 in all areas of the

county to engage with children and families and gain an insight into their

experiences. The roadshows were drop-in events and included a range of

information, advice and support that families, children and young people (0-25 years)

with SEND would find useful. Cumbria County Council shared with parents and

14

carers the Cumbria Graduated Approach for Special Educational Needs. This

graduated approach sets out how schools can support children and young people

with SEND and what different types of support are available to match differing levels

of need and how they can be accessed. There were opportunities for families to

feedback about services. Feedback clearly indicated that greater support is needed

for secondary schools around identifying and supporting pupils with SEND and that

all schools needed support to recognise the possible impact of SEND on behaviour.

A working group has been established to develop a behaviour ladder and sources of

support and information for schools. Plans are being developed as a result of this to

address training needs for school staff utilising the skills and knowledge of

Educational Psychologists and Specialist Advisory Teachers.

Historically, SEN support pupils have not achieved as well at school as their peers

nationally, although 2018 results provide a more positive picture for this pupil group.

Work continues to be needed across the partnership in schools to continue to

improve the offer to this cohort. The feedback from roadshows has provided valuable

information about the areas to focus on. The Inclusion Strategy identifies the need to

use existing resources to build capacity across the county and this was also reflected

in the recent Inclusion Summit.

The Learning Improvement Service has developed a process for school’s

self-evaluation, including how well they support pupils at SEN support level. This

information will be collated and used to support LASLs to identify schools needing

support for SEND issues, and to broker that support. It is too early to evaluate the

impact of this.

Further examples of collaboration between colleagues in the Inclusion Service and

The Learning Improvement Service are the creation of working groups to support

schools, to manage behavioural issues and to develop a SEND toolkit for schools.

Clusters of schools are actively getting together to support children at SEND support.

One joint event has taken place with a SENCO cluster to ensure they are up to date

with knowledge of what support is available and how to access it.

Future developments to build on this effective joint working include communication

with SENCO networks through LASL during this academic year to create and build a

network to support key priority areas such as transitions.

Attendance of the Area Service Manager at the LASL meetings could further embed

the working partnership and sharing of information.

P4 Use of data to support early identification

Within health, tactical use of information to align resources to need and forward plan

services is under developed. On-going work to improve data reports will provide

additional oversight and enable more effective use of information to plan services.

While we now have a comprehensive monthly data report, we recognise that we

need to further develop specific targets and measures as well as progressing work to

develop a joint Health and Local Authority dashboard.

Work has been undertaken recently to look at the SEN support for children

transitioning between primary and secondary school and to address some

inconsistencies in the classification that schools have when children go to secondary.

15

A joint SEND Dashboard is currently under development within all organisations.

The aim of the dashboard is to link together all CYP with an EHCP and receiving

health interventions to identify themes, trends, and hotspots enabling organisations

to tailor input accordingly.

P5 The local offer

A priority area for us following the SEND Peer Review in 2016 was to further develop

the Local Offer to become more ‘user friendly’ for young people, parents and

professionals. This redevelopment has now been completed (in collaboration with

health colleagues and the Parent Carer Forum) and will enable parents and

professionals to identify and access sources of support at all levels. We are currently

in the process of promoting these developments and engaging stakeholders. A plan

is in place to ensure identified key individuals within the local authority keep specified

sections up to date, so users can rely on information provided.

The health system has confidence that families who are known to children’s health

services, regardless of whether there is an EHCP in place, are signposted to the

Local Offer. Links to the Local Offer and to Weston’s Welcome, Cumbria

Partnership’s “introduction to services” website are included in all patient facing

documentation and letters.

Raising awareness of the Local Offer has been undertaken, for example: weekly

adverts through the CCC Communications Team and the County Council’s Facebook

page; promotion via the Early Years briefings and to early PVI providers and teams

within Early Years; presentations at local meetings and workshop and parent/carer

forum information days and signposted and discussed through the Cumbria

SENDIAS service at their parents meetings and advertised through their web pages.

A co-produced business card has been created and will be available to share widely

with families and relevant partners to increase awareness and use of the Local Offer.

The leaflet has also been circulated to all GP surgeries via the Cumbria Partnership

Trust. A joint Health and Local Authority business card has been developed to

publicise/advertise the Local Offer and Parent Carer Forum in Cumbria. Business

cards are to be given out to CYP and Families by health, education and social care

professionals.

Following the launch, we recognise the need to ensure feedback is sought regarding

areas for improvement and development. Parent workshops have been held in a

variety of locations across the county to facilitate the navigation of the Local Offer

and auditing of the relevance of information and its accessibility.

An audit has taken place through the Cumbria Partnership Trust to provide feedback

on its effectiveness and accessibility for service users.

Regular performance feedback is collated to continually improve and develop the

Local Offer.

As a result of the above work the website received 21,077 ‘hits’ in December 2018

compared to 11,694 in December 2017.

16

Question B: How effectively does the local area assess and meet the needs of

children and young people who have special education needs and/or disabilities?

Our strengths

Our priorities for improvement

S1 Positive examples of co-production

and engagement

S2 The quality of impartial information

advice and support

S3 Meeting the needs of CLA

P1 Strategic approach to engagement and

co-production

P2 Joint commissioning

P3 Further developing the quality of

EHCPs

P4 Personal Budgets

Our strengths

S1 Positive examples of co-production and engagement

There is evidence of positive engagement of parents and children in the development

of EHCPs. Parental satisfaction is improving, and feedback from schools is positive

around the suitability of EHCPs, leading to increasing numbers of children and young

people having their needs met appropriately in their education, and attaining

improved outcomes.

Short Breaks Services were highlighted in the LGA Peer Review as a positive

example of co-production with parents. There has been positive parental feedback

around the process of commissioning out of Short Breaks. Advisory Boards have

been created with significant parental involvement to ensure family involvement in

the shaping of provision. We are now working with the Boards and with the Parent

Carer Forum to ensure they work in partnership to provide clear and effective

representation for all families. There is a new range of ways in which Short Breaks

can be provided, including Direct Payments, many of which can be accessed without

a full social care assessment. This change was in response to family feedback and is

strongly supported by families, and leads to improvements in the lived experience

and all outcomes of children and families with SEND.

As a result of feedback from the Parent Carer Forum (PCF), the Assistant Director

and Senior Manager for Inclusion now alternate attendance at PCF meetings to

respond to queries, share information and gather views to enable the local area to be

more responsive and to lead improvement together. Health Senior Managers are

also in attendance at all Parent Carer Forum meetings. An example of this is around

SEND transport. As a response to parent carer feedback, the school transport team

is setting up a pilot to bring some routes ‘in house’. As a result, the voice of parents

and carers is increasingly ‘heard’, and where appropriate, queries responded to.

Further examples of co-production include the public-facing version of the transitions

protocol which has been co-produced with members of the Parent Carer Forum and

is published on the Local Offer, leading to a better understanding by parents and

17

carers of the Local Area commitments to improving transition, and of what families

can expect from partners.

In October 2018 a co-production workshop was undertaken to develop a strategic

plan/approach for future review/re-design of service provision for Children, Young

People (CYP) and adults with a learning disability and/or autism. This secured senior

leadership agreement and commitment to co-produce work with all CYP and adults,

partners and stakeholders across Cumbria. Information obtained from the workshop

will now be combined with a Health Watch co-production event that has the aim of

producing principles of working and a co-production charter for Cumbria. A date has

been set in June 2019 for an event around the key issue of transition to ensure

families have access to all the relevant information. This is being developed jointly by

the LA, both CCGs and the CPCF with the CPCF taking a lead role in identifying

what families feel would be useful. The event will lead to significant improvements in

communication in relation to transition, and families being better prepared. Additional

administrative support has been provided to support them the PCF with this.

North Cumbria CCG is working with the Charlie Waller memorial trust to develop a

parent/carer peer support network for people in receipt of mental health services. The

primary purpose of this group is to provide parents and carers with the support they

need however it will be supported by mental health professionals and as issues with

services are identified it will provide a valuable source of information to enable the

development of services.

Although the group is not aimed exclusively at parents/carers of children and young

people with SEND, this group of CYP make up a significant proportion of those who

need support from mental health services, therefore the Cumbria Parent Carer

Forum are members of the group planning the development of this network, and are

engaged in the planning for future arrangements.

North Cumbria CCG has undertaken a number of engagement/co-production

workshops with CYP, including sessions with CYP with autism, learning disabilities

and Children Looked After, specifically looking at what service redesign is required to

be made in relation to service delivery across Cumbria.

North Cumbria CCG has also produced two information films and eBooks for health

professionals and schools highlighting the reasonable adjustments that should be in

place when working with CYP with autism. Findings from focus groups informed

production of these films, and will lead to improved differentiation for CYP with autism

in schools and settings.

Current engagement work is being undertaken to work with CYP who are non-verbal

to ascertain their needs/wishes. Work revolves around emancipatory learning for

teaching staff and artefact creation (arts based therapies) for students. The

interpretation of the work (art) will hopefully indicate specific areas of need that can

further developed.

S2 The quality of impartial information advice and support

The Service User Feedback Report for the SENDIAS Service to the year May 2018,

reported that 86% of parents and carers said the information and advice they had

received from the service was very helpful, 86% reported that they thought the

service was neutral and unbiased and 93% said they had found it very

18

confidential. 75% of people said they had found the service had made a great

difference to them and some said the difference was “huge” and some “amazing” and

other said it was “invaluable”.

On staff behaviours: 93% of parents and carers reported they were happy with how

they had been treated by SENDIAS Co-ordinators; 89% said their needs had been

met by the SENDIAS service; 89.5% said they would recommend the service to other

parents.

Parents said that help and support from the SENDIAS service reduced their anxiety,

gave them confidence, helped them find their way through the SEND processes and

explained the law and their rights to them.

One parent stated “My Co-ordinator was fantastic in helping diagnose and help our

son. I often contacted her out of the blue and she was able to pick up where we left

off. My calls and e-mails where answered very promptly. I felt she went well out of

her way to help and support my family”. This quote demonstrates how the service

often helps with the early identification of a child’s special need.

Another quote from a parent which shows how empowered she now feels after

working with the SENDIAS team is: “I now feel heard. I often feel like a pushy or

annoying parent when I point out my child’s needs and ask how they might be met.

My co-ordinator’s support helped to make it less personal, looking at my child’s rights

and helped everyone to find solutions.”

We work effectively with vulnerable groups, for example a request was made to the

SENDIAS Service from the Adoption Team to raise awareness of the support that

can be provided to foster carers and adoptive parents of children with SEND.

Following a presentation by SENDIAS staff to the Adoption Social Care Team, there

has been a rise in the number of carers of adopted or fostered children making

contact with SENDIAS for support. The service has been involved in supporting

children who have trauma and attachment disorders coupled with a range of

disabilities and learning difficulties that impact on their learning. The Virtual School

recognise the value of this additional input for families and will be providing training

around some key issues to support staff develop their skills.

The County Psychological Service (CPS) is a team of Educational Psychologists

(EPs) and Behaviour and Emotional Wellbeing Officers (BEWOs) who give advice to

settings and families, both at Early Help, and as part of EHCP assessments.

Although employed directly by the County Council, the EPs are bound by HCPC

registration requirements, and also follow the British Psychological Society Code of

Conduct. This means that they look in an unbiased way at children’s situations and

needs, and the advice and recommendations which they give have the child at the

centre. The EPs work at a variety of levels, from consultative advice through to direct

work with children. In the Service User Feedback Report on the EP service to

August 2018, 88% of settings rated the EP service as Very Effective, Effective or

Sometimes Effective; 39% rated it as Very Effective. Areas for improvement noted

by the settings were around reducing waiting times and providing a higher level of

support and training around the needs of pupils with less severe difficulties.

19

S3 Meeting the needs of CLA with SEND

The Virtual School team work in partnership with schools, carers, social workers and

alternative providers to ensure the needs of CLA with SEND are met. The CLA

Achievement Teachers quality assure all the PEPs for the CLA in their allocated

schools. If there are concerns or issues the CLA Achievement Teachers contact the

Designated Teacher in school and the SENCO to discuss strategies and attend

Team Around the Child (TAC) meetings, leading to improvements in meeting the

needs of CLA with SEND. An example of this is in case study “S” where the CLA

Achievement Teacher worked with the educational psychologist, the carers and the

school through regular TAC meetings. Working in partnership with the school, carers

and others agencies meant that S stayed with the peer group and engaged in

mainstream education for Year 3.

A member of the Virtual School team attends the first PEP meeting when a child is

new into care. If a child comes into care with undiagnosed Special Educational

Needs these are addressed through the PEP and the SEND framework. The Virtual

School Head is responsible for managing Pupil Premium Plus funding for all children

and young people who are looked after by Cumbria County Council wherever they

live. The allocation of Pupil Premium Plus, outlines needs to be addressed

immediately with the use of additional Pupil Premium Plus, leading to the allocation

of further resource to support CLA with SEND in accessing education and attaining

better outcomes.

An example of this is in case study “M”, where Pupil Premium Plus was used to

provide additional full time 1:1 support for M so that they could manage the school

day. Due to their physical delay, M needed support for basic tasks such as toileting

and making their wishes, feelings and needs known as their speech was significantly

delayed. The additional full time 1:1 support was needed whilst the statutory

assessment took place.

North Cumbria CCG and Local Authority colleagues carried out two engagement

events with Children Looked After (Primary and Secondary school age groups) and

produced an easy read report identifying the needs and wishes of the CYP, creating

a mechanism for CYP views to be taken into account when designing services.

Our priorities for improvement

P1 Strategic approach to engagement and co-production

We recognise that this is a key area for development, further reinforced by the

findings of the Parent Carer Forum (PCF) survey (May 2018).

The AD Education and Skills is leading on the development of a Cumbria Co-

Production Charter the first workshop took place in October. This will involve

colleagues from the LA, CCGs, CCC Commissioning, Cumbria Parent Carer Forum,

and Healthwatch. The initial purpose of this charter will be the co-production of

services and packages for families with children who have SEND as this will be

strongly oriented towards improved service-user experience and outcomes.

20

A Co-Production Toolkit has been developed and implemented for all partner

organisations to use. This will ensure that CYP and Families are all working together

to deliver effective and efficient services for all.

A Co-Production Pledge developed and agreed by all partner organisations. Pledge

outlines key statements that will deliver collaborative working with all.

The chair of the PCF represents parents at the Children’s Trust Board Children with

Disability sub group and senior representatives from the LA, North Cumbria CCG and

CPFT attend the PCF meetings. North Cumbria CCG (and more recently

Morecambe Bay CCG as well) meet with the PCF Chair to discuss any issues and

future provision.

Parental Advisory Groups have been established in each area and these provide an

opportunity for parents not only to provide valuable feedback on services but also be

actively involved in the planning and development of services in the local area.

Parental involvement has been actively encouraged and these groups are now well

established in all areas and it is encouraging that there is evidence that parents are

now actively shaping service delivery.

In order to improve engagement with children and young people, and ensure the

voice of the child is at the heart of the EHCP process, a named EHCP keyworker will

work with child and family throughout the process.

Obtaining regular feedback from children and families in order to improve our

services and support is a key priority. Considerable work has been done to improve

how feedback is captured and plans are in place to send regular questionnaires to

families open to CWD and to complete a survey on current direct payment

arrangements, and we will produce quarterly reports detailing feedback from our

short break overnight respite units and commissioned short breaks activities.

In CPFT, parents/carers and children are encouraged to provide feedback through a

variety of methods in outpatient settings such as child development centres and

clinics. Compliments and complaints are reported on via the Patient Experience

Team on a monthly basis and are acted upon accordingly and staff groups are made

aware of the themes of the compliments and complaints received in their monthly

team meetings so that they can be acted upon accordingly. The Health system

acknowledges that it is difficult to pull out feedback specifically for people with SEND.

Health providers are looking at how they can extract and use this information.

A children and young person led Inclusion Board has been established, co-produced

with schools, the local authority, health system and the advocacy service. The board

will seek to recognise the importance of the voices of children and young people

informing and steering our service improvement and developments. Consequently

children and young people’s voices are increasingly heard by the system and used in

informing planning.

A Children’s and Young Person’s forum has been set up to engage directly with

experts by experience. Six meetings are scheduled per year, one in each locality

(Allerdale, Copeland, Eden, Carlisle, Barrow-in-Furness and South Lakes). The

young people have named this group ‘All of Us’.

21

P2 Joint Commissioning

There are currently inconsistent approaches to joint commissioning across Cumbria,

and as a result the offer of services to children and young people is not consistent.

Through the Complex Needs Panel the Local Authority and the CCGs are starting to

jointly identify those needs that are currently not met through commissioned services

and how best to commission and fund. This will include formal funding

arrangements to ensure parity over funding of services.

Schools, in particular special schools, have identified that sufficient access to

therapies is an issue for children with SEND. A range of possible solutions is being

considered; these will be identified and planned for through the SEND Improvement

Plan.

CPFT have a new Learning Disability and Behaviour Support Service, developed in

partnership and is serving as a model to support the development of joint

commissioning as we recognise this is insufficiently developed.

North Cumbria CCG, Morecambe Bay CCG and the Local Authority are actively

exploring more integrated approaches to joint commissioning.

The Children’s Learning Disability service within CPFT has been redesigned resulting

in a more equitable service across the Cumbrian Health Economy.

CPFT have launched a Children’s Therapy Toolkit on the CPFT website giving

information pre-referral. This is available for referrers and families and is intended to

provide information on self -help and normal development to ensure that referrals into

the specialist services are appropriate. This benefits the efficiency of the therapy

teams so that their input can be focused where they can make the most impact on

children’s lives. Links to the website are incorporated into the Local Offer.

https://www.cumbriapartnership.nhs.uk/our-services/children-families/our-children-

and-families-services/childrens-therapy/childrens-therapy-toolkit

Running of Integrated Care Communities (ICC) Multi-Disciplinary Meetings (MDT)

pilot with Paediatricians, GPs and other professionals. This is a small scale pilot and

will be evaluated and if effective, rolled out as required.

P3 Further develop the quality of EHCPs

Since April 2018 we have had a comprehensive monthly audit process in place to

assess and monitor the quality of EHCP. This auditing involves a range of

professionals across the service, and includes a moderation and reflection stage for

senior and service managers. Of 38 audits completed of EHCPs between April and

July 2018, 9 were graded as Good, 24 as Compliant and 5 as Non-compliant (13%)

Findings, learning and actions as a result of the audits are reported back to

managers and discussed at DMT quarterly performance review meetings.

As a result of the audits we have been able to identify areas for improvement and

taken action to address these for example it was identified that there were training

needs for EHCP report authors and as a result a training session with the DfE lead

has been delivered on how to write reports in a way that supports clear user friendly

EHCPs. Further development work on this is taking place in the autumn term to

develop guidance and processes. A working group is developing a new template for

SATS and Educational Psychologists to ensure advice is clear and accessible and

22

can be readily recorded in EHCPs and to provide clarity and understanding for

parents, carers, children and young people.

We have now reviewed the process to enable easier access to the moderated audits

to be used as a learning tool. We have refined the reflection tool so that Health and

Social Care colleagues can input and use the findings to impact on performance in

their own areas. A full quality assurance process is in development and all agencies

are engaging in this

Workshops will be held with key social care staff to develop understanding in relation

to social care input to the EHCPs. Dates have been identified and these are being

run jointly with the Virtual School to enhance our work with all vulnerable children

A template and supporting guidance for health professionals has been produced so

that the most current and accurate information is provided at the point of statutory

assessment and at reviews.

The Designated Clinical Officer will receive details of all cases being audited each

month to allow her to review health input to the EHCPs. This has led to a need for a

system re-design to include quality assurance in the process of responding to health

requests and for one collated health response to be returned to the LA. The system

re-design is commencing in March 2019 and will lead to a significantly more robust

health response which will in turn improve the quality of the EHCPs being produced.

P4 Personal Budgets

There is a policy for personal budgets and a parental fact sheet in place. Personal

budgets are discussed with, and offered to parents/carers during the EHCP process.

Information regarding personal budgets is available on the Local Offer.

NCCCG introduced the provision of personal wheelchair budgets for children and

young people. This increases the choice they have over the specific wheelchairs that

they use. This is evidenced by written policy.

Continuing Care policy has been reviewed and re-written to ensure more effective

delivery of care for CYP in Cumbria. A Standard Operating Procedure has also been

developed to accompany the policy.

There is recognition that the understanding of the Continuing Care and Personal

Health Budget (PHB) process is currently lacking, this has triggered North Cumbria

CCG to arrange PHB training for all Health, Social Care and Education colleagues.

Continuing Care eligibility panel has been instigated, in combination with an eligibility

tracker data base to monitor all referrals for continuing care.

Case Study 1: helped a severely autistic young man to develop confidence through

physical activities

Case Study 2: enabled a severely disabled youngster to access a family hobby which

enabled them to have quality time together and also built his confidence and sense of

being part of the family unit and the wider community.

Direct payments and other forms of short breaks provision – we are working with

providers to record activities undertaken with children which demonstrate progress

towards achieving outcomes, for examples where providers work with children to

develop independence skills to ensure this is recorded so progress can be reviewed

at the annual review.

23

Question C: How effectively does the local area improve outcomes for children and

young people who have special educational needs and / or disabilities?

Our strengths Our priorities for improvement

S1 Outcomes (Education, Health & Social)

S2 Quality of existing provision

S3 Commitment to Inclusion

P1 Emotional Wellbeing

P2 Expanding the range of provision

P3Transition planning

Our strengths

S1 Outcomes (Education, Health & Social)

Children with EHCPs generally do well in school in comparison with their peers

nationally as a result of the quality of support received. Development work is

underway through the delivery of the Inclusion Strategy, which aims to provide a

wider range of learning environments for children with SEND.

We have also worked alongside the Cumbria Academy for Autism Free School which

has resulted in 56 specialist school places for children with autism in area of the

county with a demonstrable need for these places and a lack of local provision.

Following a dip in end of Key Stage performance for all pupils in 2016, The Cumbria

Alliance of System Leaders and The Learning Improvement Service refocused a key

focus on pupil outcomes for all pupil groups. This has been reinforced through plans,

strategic improvement meetings in identified schools, peer review guidance and in

presentations to Headteachers. This, in addition to quality first teaching in schools,

has impacted on pupil outcomes.

A good range of data allows the LA to have a good understanding of different cohorts

and how they perform against expectations. Identified Areas of strength include:

KS2 pupils with EHCPs attainment in RWM combined (with an improvement

for SEN support pupils) (2018)

KS2 pupils with EHCPs and SEN support progress in Reading (2018)

KS2 pupils with EHCPs and SEN support progress in Writing (2018)

KS2 pupils with EHCPs progress in Maths (2018)

KS4 Pupils with EHCPs and SEN support achieving grade 9-4 (standard

pass) in English and Maths (2018)

KS4 Pupils with EHCPs and SEN support achieving grades 5-9 (strong pass)

in English and Maths (2018)

KS4 Pupils with EHCPs and SEN support Progress 8 score, where Cumbria

pupils with an EHCP have improved again in 2018, and are well above their

national peers. SEN support pupils are broadly in line with national, although

there has been a decline compared to 2017 (2018 Overall absence in

relation to the number of pupils with EHCPs and SEN support (AY 16/17)

Persistent absence in relation to the number of pupils with EHCPs and SEN

support (AY 16/17)

24

Destination outcomes relating to Cumbrian children and young people with

SEND in Education, Employment or Training (EET) are positive in

comparison with national figures. SEND performance report

Low numbers of young people with SEND who are NEET in comparison to

the national average.

Areas of concern where performance has improved over the last 12 months:

KS2 pupils with SEN Support achieving at least the Expected Standard in

Reading, Writing and Maths (2018) – performance on this indicator is

improving, with the gap between Cumbria and national closing.

Exclusions for pupils with EHCPs

KS1 pupils with SEND achieving expected standard in Reading, Writing and Maths (2018):

Reading - publication 2018 figures show a slight drop for pupils with EHCPs compared to 2017, but are above their national peers. SEN support pupils have also improved and are now marginally higher than their national peers.

Writing - publication 2018 figures show an improvement for pupils with EHCPs compared to 2017, and are above their national peers. SEN support pupils have also improved and are now broadly in line with their national peers.

Maths - publication 2018 figures show an improvement for pupils with EHCPs compared to 2017, and are above their national peers. SEN support pupils have also improved and are now higher than their national peers.

2018 EYFS data shows an improvement for both SEND pupil groups compared to

2017 National data shows that Cumbria has performed better than national for both

SEND groups.

SEN pupils with ECHPs achieving L2 by age 19 performed well above the national in

2017 (Cumbria 24.1%, national 14.9%). Those with SEN Support saw improvement

and performed marginally below national but above statistical neighbours (Cumbria

35.8%, National 37%, SN 34.8%)

Through close monitoring and tracking Virtual School ensures educational outcomes

for CLA improve from their starting points. The progress of CLA with SEND is

recorded in their PEPs in the form of data, text and photographs.

Improving life chances for a CLA with SEND is also important as shown in the case

study for E, who now has the opportunity to gain qualifications and a pathway to

College and further education. Case study E

Strong partnership working improves outcomes for CLA with SEND as shown in the

case study for A.

The majority of parents responding to the PCF survey in May 2018 said their child

was making educational progress because of the support they received, and felt they

were involved in setting outcomes for their children around education. This was also

reflected in the feedback received from families attending the SEND Support

roadshows

This is supported by the most recent SENDIAS service user feedback survey where

65% of respondents believed their child was now better supported.

Identified outcomes are regularly reviewed and met by the majority of children and

young people. Families participate in this process in the majority of cases.

25

Tribunal cases are few in number, below the level of both national figures and those

of statistical neighbours, indicating that families are generally satisfied and that,

where issues arise, positive working relationships enable these to be resolved. The

SENDIAS Service works hard with parents and carers throughout Cumbria to bring

agencies and parents together to broker local solutions so parents no longer want or

need to go to tribunal to secure the provision they want or need for their child with

SEND.

Directorate Quarterly performance meetings chaired by the Executive Director of

People are in place, and focus on the contribution of the service to improving

outcomes for children and young people, and provide constructive challenge where

this is not evidenced. This has widened the range of people involved in scrutinising

the service and performance and offering useful insight in to how to bring about

improvements

Therapy services prepare CYP by helping to understand and deal with their

conditions whilst not creating a dependency to the service. The Care Aims process

was introduced and is being embedded. It ensures that an outcome based approach

is adopted. Care Aims is a needs-led concept which avoids over-medicalisation of

children and focuses therapy on the aspirations of the child whilst discouraging

dependency on medical services. It focuses on clinical impact and works towards

jointly agreed outcome between the CYP, parents/carers and the therapist.

NHS England is piloting a three-fold approach to improving the resilience of families

to manage challenging behaviour in Cumbria. There are programs for children below

school age (EPATS), children of school age (PBS) and direct training is offered to

both families and professionals who work with children who have a learning disability.

Early Intervention Challenging Behaviour Service has been set up to provide families

with coping strategies to reduce challenging behaviours, as CYP approach

adolescence. The services aims to increase the quality of life for CYP and families

by maintaining the CYP in their family home, continued attendance at

mainstream/special school, remain in the family home, continued interactions with

peers and to reduce the need for out of area placements. Current service provision

has been commended by the Challenging Behaviour Foundation (CBF) for its

innovative style of working.

The independent evaluation is not complete yet but findings that have been reported

from qualitative interviews include:

Parents happy to be invited in and enjoyed the involvement, strategic work,

EPAtS training and delivery;

More coordination/ knowledge of each other and of VCS in area;

More links e.g. LD team and PCF and MENCAP;

Very satisfying for agencies to be able to offer a programme like EPAtS to

families (as so little out there generally);

Some staff are now trained in EPAtS;

Both PCF and Mencap Carlisle reported getting some new and younger

members;

Parents were observed to enjoy EPAtS.

26

S2 Quality of existing provision

Special schools are generally of high quality, two are outstanding, two are good and

one requires improvement on an upward trajectory, leading to improved outcomes for

CYP with SEND.

Short breaks homes are highly regarded by Ofsted and service users and their

families. Ways of using short breaks to help achieve identified outcomes are being

developed. We recognise that positive outcomes are not just about academic

success and the short break provision is well placed to support outcomes around the

development of skills needed for adulthood. Providers are beginning to record

progress towards these outcomes on the Early Help module on ICS and this is

feeding into reviews to facilitate effective planning.

Social care involvement is required for access to overnight short break homes – 2 of

these are rated by Ofsted as outstanding and the remaining two as good.

The re-organisation of short breaks services includes using those situations to

support outcomes around independence. In the Short break homes children have

keyworkers who plan to help them achieve outcomes around practical independent

living.

S3 Commitment to Inclusion

In Cumbria we are committed to Inclusion. An inclusion summit was held on

17 April 2018, which had excellent engagement from special school head teachers

and chairs of governors. At this summit a discussion around special school funding

bands was held leading to a fairer allocation of funding.

We have carried out some modelling exercises using the new funding allocation

process and met special school heads again in October to follow up and seek to

implement changes. A new model has been agreed and is scheduled to go to the

schools forum in March 2019 for implementation in September 2019. Resulting in

fairer funding and better outcomes where local area special schools are better able to

meet needs

Our inclusion strategy was written through a thorough engagement process. The

Strategy aims to build upon this to develop provision for current and future needs.

The inclusion strategy has identified a number areas of need relating to provision of

available settings including alternative provision, resourced provision and special

schools. This will lead to an improved ability for the system as a whole to meet need.

There is an agreement from cabinet to progress work in relation to each of these

targets as well as a review of our PRU provision. The PRU review has been

completed and a number of recommendations identified. In particular a funding

review which is scheduled for summer 2019 which will result in the PRU system

being better able to meet the needs of its cohort. (Evidence PRU Review)

We have identified two local authority buildings and are investing circa £3,000,000

capital funding to develop two x 40 place AP settings, which will result in an

additional 80 AP places across the county by 2020.

27

Our priorities for improvement

P1 Emotional wellbeing

Promoting and supporting the emotional and mental wellbeing of children and young

people is identified as one of the key challenges for Cumbria. In surveys children and

young people across Cumbria consistently report that this is the most important issue

for them. This year 50% of the youth population (15,846) across 73% of schools

took part in the ‘Make Your Mark’ consultation to vote on their top ten issues. ‘Mental

Health’ came out top overall, with 3006 votes.

In terms of young people with SEND we know that they are more likely than the

general population to have emotional health and wellbeing needs and that they are

more likely to struggle to access services.

Cumbria has strong partnership arrangements in place to deliver transformation of

the emotional wellbeing and mental health system in order to deliver the vision

outlined in the Mental Health Five Year Forward View. The Transformation

Programme Plan refreshed in November 2018 (attached) strengthened the

commitment to increase the focus on children and young people with additional

vulnerabilities including those with disabilities. For children and young people with

SEND, as well as the wider population, our focus must be on both effective early

intervention and prevention, as well as ensuring that when urgent support is required

our provision is timely and sufficient.

We know that there are a number of challenges in terms of children and young

people with SEND being able to access the services they need:

There are significant challenges in terms of how the system works for the

whole population of children and young people, with increased impact on

those with SEND. The number of children and young people with emotional

wellbeing and mental health needs are increasing, this is evident in the

increases in referrals into CAMHS services and, in particular, referrals for

young people in crisis which are currently around 54 per month. There are

complex reasons for the increasing emotional and mental health needs of

young people and this is a national trend. The latest Official Statistics from

NHS Digital (Nov 18) highlight that over a third of those aged 5 – 16yrs with a

mental health disorder had special educational needs compared with 6.1% of

the population. The numbers of referrals to specialist services and for young

people in crisis clearly indicate that needs are not met early enough and that

there is insufficient support.

Specialist CAMHS services in Cumbria are provided by Cumbria Partnership

NHS Foundation Trust (CPFT) and by Barnardos My Time. The system faces

a number of challenges in delivering these services including the increases in

referrals, the numbers presenting in crisis, difficulties in recruiting to specialist

posts, having the right skill-mix and increasing the range of therapeutic

approaches available. CPFT currently has a recovery plan in place with

additional supported having been draughted in from Northumberland, Tyne

and Wear NHS Foundation Trust.

For children and young people with SEND there is a particular challenge in

ensuring that services are accessible and that professionals are able to adapt

their approach to meet the needs off the individual. Within the current system,

28

we know that children and young people with autism and/or learning

disabilities are sometimes excluded from services because professionals feel

unable to meet their needs effectively.

Families tell us that our system feels fragmented and that they struggle to

access the services they need. This is particularly an issue for young people

who have SEND who are most likely to have enduring needs and be

accessing a wide range of services. In particular, young people with a range

of needs currently frequently escalate into crisis, this is particularly an issue

for young people with autism and looked after and adopted children.

The Emotional Wellbeing and Mental Health Transformation work is aiming to

redesign the system in line with the THRIVE model. The model will help us to focus

on the needs of the young person more effectively than the previous tiered model

and is aligned with the commissioning of 0-19 services which is also using the

THRIVE model. In particular the THRIVE model specifically identifies those needing

“Risk support” – those young people currently unable to benefit from or access

evidence-based interventions. A number complaints from families and in the PCF

survey cite difficulties in accessing support because of the inability of their children

and young people to engage, often because of levels of anxiety.

The Transformation Programme includes a wide-ranging programme of work to

improve the whole system for children and young people with emotional wellbeing

and mental health needs, including:

• Improving support for children and young people, e.g. Kooth telephone/online

support which is currently seeing around 200 new registrations per month and

Barnardo’s My Time

• Improving support to families, for example co-producing peer support for

parents, early intervention support for families at pre-school stage, early

intervention for children with challenging behaviours

• Improving support to schools, including School Trailblazer bids, improved

advice & consultation for schools, training for SENCOs, improving 3rd sector

support for schools and Mental Health First Aid training which has now been

delivered to over 400 front line professionals across Cumbria

• Improving support for young people with the most complex needs and those

in crisis – e.g. improving support in acute hospitals such as improving the

hospital environment for young people in crisis, health passports, Dynamic

Support Register & CETRs.

• Improving specialist services e.g. improvements in the ADHD pathway and in

transition to adult ADHD services, reduction in waiting times for ASD

diagnosis.

From an educational perspective, there is a rising number of children and young

people with SEMH needs – these children can have particular difficulty accessing

education. The usual specialist options are often not appropriate for them as their

academic ability may be good. For some children and young people, their anxiety

levels are so high, they are unable to attend any provision. BEWOs and Educational

Psychologists offer support to those in school or college but capacity is limited and it

is difficult for them to support those who are unable to attend school or college. Initial

discussions have taken place with NISAI to develop bespoke packages of support for

these young people with the aim of helping them back into a setting. The Inclusion

29

Strategy includes options which will support some of those children and young

people.

P2 Expanding the range of provision

We recognise the need to develop the range of provision we have in Cumbria for

children with SEN.

A comprehensive countywide needs analysis has been completed as a result we

know about that SEMH and ASC are our priority need areas (Evidence needs

analysis).

We are developing improved Alternative Provision (AP) throughout the county – there

is a multi-stranded approach which includes the building of new provision which will

amount to 80 additional places (as referenced in S2 Commitment to Inclusion). FE

colleges are currently developing a “Cumbrian entitlement” which will be a single

costed 14-16 offer across the county.

A review of Resource Provision (RP) is underway and a timeline is being developed

for conversion of existing provision into a locality hub model which will improve

efficiency and agility providing provision at the point of need. A consultation will be

live by the end of March 2019. This long term project will result in improved access to

local settings for children and families.

The LA recognises a significant deficit in Special School provision and will look to use

this needs analysis to develop options to develop options around the development of

new special schools.

A further concern is access to CAMHS provision (as raised in the PCF survey). It is

recognised across the partnership that we need to develop better access to mental

health services for vulnerable young people. There is a Local Transformation Plan to

improve this and two members of Carlisle Youth Council with additional were part of

a group that reviewed the Easy Read version. In addition CPFT are able to identify

children with an EHCP in electronic health records enabling them to contribute to the

assessment process more effectively. Children and Young People on an EHCP will

be prioritised on CAMHS and My Time waiting lists in line with CLA.

Online service KOOTH is now available (for 11 to 18yrs) and provides early access

to services. Young people using Kooth with additional needs report that they like to

use online support as a way of getting help. As a result children and young people

with Social, Emotional Mental Health (SEMH) have increased access to mental

health.

Schools, in particular Special Schools, have identified that sufficient access to

therapies is an issue for children with SEND. A range of possible solutions are being

considered. There is active work between Health and special schools to identify the

gaps and reach a clear understanding of what can be provided. Therapy guidelines

are provided for all children with SEND who are accessing therapy services; this can

be found on the electronic patient record RIO.

The SEND Health group has been established to address concerns about the SEND

health process and a system wide action plan is currently being developed.

Work is underway to improve health transition processes and this is reflected in the

health action plan. In CPFT, CAMHS have worked with children and young people to

develop a pathway for transition to AMHS most recently and the use of Ready

30

Steady Go is continually reviewed to ensure the biopsychosocial needs of young

people are met at this time.

P3 Transition planning

We need to ensure better transition planning for young people at key transition points

including for those approaching adulthood and identification of the most appropriate

provision for post-16 considering Pathways for Life and to employment. While a range

of agencies work well together around educational outcomes, progress towards

planning for adulthood in other key areas such as independent living, is insufficiently

developed. However work is ongoing to improve this including:-

Introduction of ‘An Additional Needs Commissioning Framework to enable the

commissioning of new services to support young people with high needs in

independent accommodation

Regular meetings taking place with CLA team, SEND team and Transition

Workers to facilitate better communication and more effective planning

Information leaflets for young people in transition to adult services have been

produced and will soon to be available distribution to young people, their

families and schools (Evidence information leaflets)

A standardised Database of people in transition is now held in countywide s-

drive identifying key information and is populated by Transition Workers.

A Transition questionnaire is produced and sent out to individuals/families by

Transition Workers to capture their experience and to identify areas for

improvement

Letters are sent out to SENCOS re referral pathways which is ensuring a

consistent approach

An improved Information, Advice and Guidance section of the CC website is

being developed but has not yet published by adult social care

Quarterly Countywide Transition/Team Manager meetings are held in adults

(People) to share knowledge, best practice and to ensure a consistent

approach.

Transition Workers record details at key points on the Integrated Childrens

System (ICS) as well as on Integrated Adults System (IAS).

Established links with adult commissioning to ensure ongoing need is met.

The focus of adult commissioned support is built around the concept of

citizenship ensuring that progression is at the heart of commissioned support.

There is an agreed process for transfer to secondary education which supports a

smooth transition at this point. In the review the year before transition, the preferred

secondary school will be invited to the review, however in some areas this is not

happening consistently, in response a programme of support and training is being

developed for SENCOs which will include transition.

Following the move to a People directorate initial work has started on how different

elements across children’s, adults and health services can be restructured to work

more effectively with regard to transition including the possibility of a pooled budget

to promote a smoother and more seamless process.

There is a significant degree of complexity for some young people, particularly

around the transition from children’s to adult services – across all agencies. There

31

have been significant changes to legislation for services and we have not yet

sufficiently developed a response that facilitates smooth transition for young people.

A Transition Steering Group has been established to develop a Transitions Protocol

and mechanisms have been developed to seek feedback from young people and

families specifically in relation to transition, as well as the development of case file

auditing processes. The transition protocol has been ratified by all parties and is

published on the local offer in a parents and carer friendly format. This is resulting in

greater clarity for parents and carers on what they can expect from the partnership.

The group continues to meet on a monthly basis and is developing proposals around

an all age service which will improve the lived experience of young people going

through transition.

In addition to the countywide Transition Steering Group, Locality Transition Groups

are held on a regular basis in each area. In addition, a monthly meeting including

CWD and CLA colleagues, with the transition social workers has been introduced to

monitor and review progress on individual children from their 17th birthday, is

currently being piloted in the Carlisle and Eden area.

A Transition event will take place in spring 2019. This will include a range of key note

speakers and a provider ‘market place’. All key stakeholders, including children,

parents, carers and professionals will be invited.

CPFT have adopted Ready Steady Go as the preferred transition programme.

However, this is being scrutinised regularly for its effectiveness and popularity

amongst our stakeholders.

A transition tracker is under development to support reporting on the health electronic

patient record (RiO). Mental health services have worked with service users to

develop a robust pathway for transition of young people from CAMHS to AMHS.

A Well Child Specialist Transition nurse has recently been appointed within CPFT

and she is working with the ICCs to embed transition of CYP with complex needs.

This has allowed the voice of the families to be heard and acknowledged and their

feedback is being used to inform transition planning strategically and locally.

32

Acronym Guide

ASD Autistic Spectrum Disorder

BVI/HI Blind, visually impaired/hearing impaired

CAMHS Child Adolescent Mental Health Service

CASL Cumbria Alliance of System Leaders

CCG Clinical Commissioning Group

CETR Care Education and Treatment Review

CLA Children Looked After

CPD Continuous Professional Development

CPFT Cumbria Partnership Foundation Trust

CTB Children’s Trust Board

CWD Children with disabilities

CYP Children and young people

DfE Department for Education

EET Education, Employment and Training

EHCP Education, Health and Care Plan

ICC Integrated Care Communities

IEP Individual Education Plan

KPI Key Performance Indicator

LA Local Authority

LASL Local Area System Leaders

LDD Learning Disability & Difficulties

LGA Local Government Association

LIS Learning & Improvement Service

MAAT Multi Agency Autism Team

MDT Multi-disciplinary meetings

MLD Moderate learning difficulties

NCCCG North Cumbria Clinical Commissioning group

NEET Not in Education, Employment or Training

PCF Parent Carer Forum

PEP Personal Education Plan

PMLD Profound & multiple learning difficulties

PVI Private, voluntary and independent

RWM Reading, Writing, Maths

SEMH Social, emotional and mental health

SEN Special Educational Needs

SENCO Special Educational Needs Coordinator

SEND Special Educational Needs and Disabilities

SENDIAS Special Educational Needs Information & Advice Service

SLCN Speech, language and Communication needs

SLD Severe learning difficulties

SMART Specific, Measurable, Achievable, Realistic & Timeframes

SW Social Workers

TAC Team around the child

UTC University Technical College