Ofsted / CQC: SEND was bad before the pandemic, it’s worse now

Ofsted and the Care Quality Commission have published a joint report after a series of interim “listening and learning” visits to schools during autumn 2020 and Spring 2021. 

(Note: This is quite a long-ish article because it's a very, very long report, but at the end are some Ofsted videos from SEND specialist adviser Nick Whittaker, if that's more your thing)

The report looks further at the experiences of disabled children, young people and their families in the pandemic – which we already know about from both living it and from a number of research reports, including our own, and the earlier Ofsted reports. It also asks whether the SEND system has improved as a result of the 2014 reforms. 

The answer it seems is overall, not really... and it reminds us (not that we needed it) that even before the pandemic, SEND was largely a mess. But those families lucky enough to live in an area where the reforms have been taken seriously, fared better during the pandemic than those where the Children and Families Act has been treated like an annoying fly.

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Who did they speak to?

Inspectors made 10 visits in total, using a case-study approach to examine the experiences of support offered to children and young people with SEND during the pandemic. They spoke to parents and carers as well as practitioners and service leaders. Inspectors say they also invited children and young people to take part in interviews, but very few did. 

What does the report say?

The report gives a potted history of SEND from Ofsted’s perspective, from 2014 to today. However, we’re assuming you know much of this from reading SNJ, so we won’t cover that here. Plus, if you’ve read our coronavirus and education reports, you will already know much that is in the findings of this report. Therefore, for brevity, I’m not going to repeat it apart from some quotes, or this article will be as long as the report itself.

The importance of this report is that it underlines the findings of other SEND and Coronavirus reports by ourselves and other charities and organisations such as the Disabled Children’s Partnership, of which we are a part. And because these Ofsted visits also included professionals as well as families, it can compare and contrast between the two, as well as between different areas, and draw conclusions that policy-makers need to hear.

There's good but there's mostly bad...

The report really underlines how where you live affects your family’s experience of the SEND system, whether that is before Coronavirus or during. While every SEND learner was impacted, if you live in an area that thinks the law is optional, it is likely the impact on your child’s SEND education and support was more severe. 

“When support from health services ceased, this often had a serious impact. Many families told us that their children had received no health support or therapies during the first national lockdown. Where support had been provided, it was often in the form of advice to the family rather than direct work with the child or young person. Families told us that this caused problems. For example, some children and young people were left in pain, some lost the ability to walk or to communicate and others experienced severe dietary difficulties.”

“It is important to note that not all children and young people with SEND had wholly negative experiences during the first national lockdown. Our own evidence suggested that some of those who remained in education throughout had benefited from the experience. They flourished with smaller class sizes and more support. Others found learning at home rather than in a large class more enjoyable and made progress through the remote learning provided by the school.”

“At times, the effects of support being withdrawn were devastating. On more than one occasion, parents talked about reaching ‘crisis point’, where they felt totally unable to cope, even to the point of attempting suicide. In particular, some parents reported being unable to get help when their children were depressed, self-harming or becoming frequently distressed and aggressive.”

Pandemic attendance

Ofsted notes that issues with attendance were not all related to the pandemic, with the attendance of mainstream school pupils with SEND being long-standing. 

However, inspectors were told by school leaders in autumn 2020, that sporadic or non-attendance “seemed to be related to parents’ concerns about COVID-19, including worries about school transport”. This does seem to imply that schools are blaming the families for children not being in school, rather than looking into, for example, why a child’s transport was not in place or why parents said it wasn’t safe to use through lack of social distancing or provision of an escort.

Inspectors also found that lower attendance was sometimes because children were prevented from attending. As well as the issue of Aerosol Generating Procedures,  health practitioners weren’t coming into school to set up specialist medical equipment or to train staff to. This was because of “local directives” (not backed by national guidance), or because staff had been redeployed to other parts of the health service. The report notes that, “In others, the reasons were unclear. This issue began in the first national lockdown but in some places continued well into the autumn term. It caused great frustration for some children and young people and their families.”

Some leaders spoke of their distress in having to tell some families that their children could not return because they did not have the medical support to cater for them in school.”

The net result was of many SEND pupils missing learning, activities that were important for their physical health, or preparation for adult life.

“A report from Special Needs Jungle found that nearly two thirds of parents and carers of children and young people with EHC plans said that the provision outlined in their child’s plan had not been fully restored. Many parents and carers also said that NHS-delivered therapies such as speech and language therapy, occupational therapy and hydrotherapy were not taking place.”

Bad to worse...

Even more worrying is this:

“Some leaders of special schools and alternative provision settings were very concerned about some pupils having become more involved in criminal exploitation, including gang violence, and child sexual exploitation. Knife crime, drug use and becoming prey to grooming through social media were also mentioned...”

“Our evidence also indicated that some children and young people with SEND who experienced prolonged absence from education were exposed to increased levels of abuse and neglect while at home or in care, while they were ‘out of sight’. Some of these children had been living with domestic abuse, neglect and emotional abuse without practitioners being able to detect it.”

“For older young people, their social lives had been decimated. For some, this was not just because they were not attending college but also because they were shielding. This meant that they were not seeing any friends or attending any clubs, even when these briefly reopened. We heard from some young people that they had only left the house on a few occasions since the start of the first national lockdown, and then only for medical appointments. Some were able to spend time chatting with friends online. However, this was not possible for others, who are unable to communicate in this way.”

It’s always a postcode lottery

As Ofsted has already remarked, where schools and services had good working relationships with families before the pandemic, these held up under lockdown. And the opposite was also true with some families reporting having no contact from practitioners at all. 

Even in these ‘good’ areas, the relationship relied on the resilience of a parent who often had no support themselves:

“In some cases, for example, practitioners worked well together to meet the needs of the child or young person, but this was sometimes reliant on a parent taking on a ‘coordinating role’. This is a fragile way of working because if the parent does not (quite understandably) have the capacity to keep up the momentum, it can quickly fall apart. It was clear that the pandemic had highlighted rather than caused this issue.

We also found examples of where the good work of individual practitioners was undermined by problems with multi-agency working. Sometimes, for example, a lack of urgency from one partner undermined the effective work of another.”

In schools too, variability of response needs to be investigated both in school and for remote learning. 

“We heard about schools and colleges that had gone out of their way to provide what pupils needed in terms of a place in a school or good-quality, accessible remote education. However, others appeared not to have provided well at all for their pupils’ needs. At their most negative, parents’ evaluations of the educational provision for their children was that it was ‘patchy’, ‘spasmodic’ or ‘very poor’, and that children had been ‘forgotten about’. “

It is clear to me that the difference is leadership. Good leaders make the difference. They care about the most vulnerable and include them at the centre, because what’s good for this group of people is good for everyone. Also key are the quality of relationships:

“…we cannot underestimate the importance of these relationships in enabling children and young people’s needs to be met in all circumstances. Yet in many places, neither the relationships nor the systems that underpin them are strong enough.”

Some positives

As time progressed, CQC/Ofsted found evidence that practitioners had adjusted to the different ways of working and had upped their game: 

“In one area, for example, families were getting multiple calls from different professionals each week. Leaders recognised that this burden on families could have been reduced if communication between different services was better. The second and third national lockdowns were managed differently as a result. Professionals had reflected, felt better prepared and refined their practices to work more efficiently together.


“In our visits in 2021, we also found examples of where some excellent communication and collaboration between professionals had led to families’ needs being met during the pandemic from the outset. In each case, it was clear that the child or young person was placed at the centre of the decision-making. There were instances, too, where local areas had built on already strong co-production processes to improve even further the way in which they worked with families.”


“One clinical commissioning group, for example, had a dedicated SEND nurse resource team. This team had changed its ways of working during the pandemic, resulting in more contact between professionals and families and more efficient identification and assessment of needs.”

We hope the learning from these areas can be published and shared widely in a format that is easy to digest. 

Long-lasting impact

Ofsted found that even though it was many months since the start of the pandemic, children were still not receiving their usual therapies or support. There was a lack of specialist equipment at home, such as standing frames and communication aids and where they did have them there was sometimes no space to put them

“Again, this had a serious negative impact on children and young people. Even when health services were delivered in the home, leaders and families thought that this could not replicate the services that pupils with the most complex needs would receive at school.” 

Anyone without disabled children may be thinking, well, it’s a pandemic, everyone’s affected aren’t they? But this misses the point that the impact of loss of services on disabled people (of all ages) has a massively bigger impact. These aren’t “life-enhancing” they are life-supporting, and without them, progress, and quality of life, is lost. 

Lessons learned

The questions to be asked are: what now? How can we learn from this? It is good to see that some are asking the same question.

“In one local area, for example, this situation had raised questions about why they were sending children and young people across their local area to schools far away from where they live. They now plan to review this issue.”

“Practitioners reflected together on what worked well, and kept some of the best adaptations. Yet, this was not consistent across local areas.”

Such as this:

“My child has fallen out of the social care system all because of the pandemic and both my child and I feel abandoned when services should have been retained to support us.”

It’s not good enough to think of this as an exceptional situation. We do not know what’s coming down the road. Local authorities and national government must plan for the resilience of services for vulnerable people, whatever happens. Contingency plans need to be developed so they can immediately be put in place so should another crisis happen (or this one gets worse again) and disabled children, adults, and their families know that the things they rely on will not be snatched away again.

A huge pandemic impact on older pupils

Ofsted found that across their visits, young people missed out the most, with the pandemic hitting at crucial stages in their education such as exams, independent travel training, and work experience.

“I feel what I’ve learned has gone to waste and that I may not get a chance to prove what I can do as I may never be properly examined. I’m also not able to get any practical experience as work placement is cancelled. I can never demonstrate I have learned anything as no exams and no work placement. I feel if I do get a qualification, it won’t be worth the paper it’s written on.”

Young person with SEND

Missing identification means needs increase

Before the pandemic, it was common for an EHC needs assessment to take longer than the legal timescale. When the government parked the need for deadlines to be met, this only got worse. On top of this, with children not being in school, how could any emerging needs be identified or supported? And in all cases, needs may well have changed because of time passing and the impact of them missing out on education and services. 

Existing delays and difficulties have only got worse, as parent of children with complex medical needs explained:

“CAMHS support has been sporadic for the two younger ones and I have no support so am exhausted and burnt out, while statutory agencies have avoided offering options and the local authority caseworker refuses to attend the review planned for my middle child. Absolutely frustrating and very limiting for my children.”

Parent

“Delays to assessment processes in order for young people to be transferred from children’s to adult’s services also worried families. One parent, for example, spoke of their concern that their 18-year-old had not had an assessment of need until 4 months after turning 18. He did not receive the support he needed until a month after that. This had placed the family under great strain.”

Research and analysis, SEND: old issues, new issues, next steps, June 2021

Do parents still have to be SEND warriors?

I think we know the answer to that. The problem is, in lockdown, many parents felt they couldn’t ask for better. And if they did, the answer was, "The staff have been redeployed, very sorry, goodbye."

But even without a pandemic, Ofsted and the CQC don't think these issues identified by Brian Lamb in his 2009 report have improved enough.

  • inconsistencies in the identification of children and young people’s needs
  • poor evaluation by a range of public agencies of the quality of any additional support provided
  • a lack of coordinated support from education, health and social care services

Over time, we saw evidence through our area SEND inspections that, while some aspects were improving in some areas, in others the reforms were slow to be implemented. They were even slower to have an impact on children and young people with SEND and their families.

"Common weaknesses included a lack of joint commissioning, co-production that was absent or not working properly, poor-quality EHC plans and a lack of clarity in terms of who was being held accountable for services and provision in the local area.” 

The report notes that while the pandemic exacerbated difficulties, many problems were long. “In 2010, parents told inspectors that they felt the need to argue constantly to have their child’s needs recognised. In the area SEND inspections, we have heard similar comments on numerous occasions.”

The respective responsibilities of different professionals in providing for children with SEND are not understood well. If professionals do not understand them, then families have little chance of making sense of them or having a positive, joined-up experience. Worryingly, parents themselves often take the lead in joining the different parts of their child’s provision together…. 

..The need for a tightly coordinated, well-led set of changes across education, health and social care, with the aim of securing the very best provision and outcomes for children and young people with SEND, could not be clearer.

This report really underlines why Special Needs Jungle has had to continue for so long and why so many disabled children's charities are busier than ever.

What needs to happen next?

“Inequalities remain deep-seated. Inconsistencies in the local implementation of government policy and some poor education provision for pupils who are not achieving well in the curriculum have slowed progress.”

Research and analysis, SEND: old issues, new issues, next steps, June 2021

The Ofsted/ CQC joint report asks what's next. Clearly what's next is the SEND Review and another Green Paper. It's starting to feel like Groundhog Day.

There is a lot of talk of “recovery” and “catch-up” and yet the government’s funding for education shows where its priorities lie – and it ain’t with disabled children. Even the social care review so far seems to think they don’t matter. I do wonder how much money the government will be prepared to put into the upcoming Green Paper, after everything that was poured into the last one. If there had been no SEND reforms, would we be in a worse place now? How could that half a billion pounds have been better spent to support disabled children? It's certainly food for thought.

The 2014 reforms were, on the whole, good ones. Where they were lacking was in accountability. As seen in our post earlier this week, some local authorities feel they can ignore rulings from both the Ombudsman and the SEND Tribunal. 

“Clarity about who should provide what at a local level, greater coordination of services and clearer accountability for all partners, all leading to more effective multi-agency working, are key..."

“… the questions of what services are deemed essential, to whom and by whom... are ones that should be re-examined. Stronger cross-departmental working between relevant government departments is likely to be an important factor in making effective multi-agency working happen, particularly for children and young people with the most complex needs. It is not acceptable for parents to be the driving force in ensuring that agencies work together.””

Research and analysis, SEND: old issues, new issues, next steps, June 2021

It most certainly is not acceptable, because parents have enough to do already.

How will things improve?

So yes, the SEND Review is imminent – although we’re still waiting for the answers to your questions we sent to the DfE, which we hope are even more imminent – and nothing in this report will be a surprise to them. 

Perhaps this report will help concentrate minds as to how inconsistencies across the country can be ironed out. How do we ensure that good leaders of SEND departments and Children’s Services are supported by council CEOs and political leaders? How do we ensure that schools are led by people who understand SEND and believe in inclusion? How do we ensure that newly-qualified teachers walk into their first classroom with a deep understanding of SEN? How do we ensure that parents are supported from the very start of their children’s lives?

“The importance of the availability of good universal services to all children and young people with SEND across education, health and social care cannot be underestimated. The access to and effectiveness of these services can prevent a child or young person from needing something additional or different. As part of this, we must strengthen the quality of the curriculum and teaching in all education settings as the first step in meeting children and young people’s needs. This is particularly important in relation to the teaching of language and early reading. No child should be labelled as having SEND because of weak education provision.”

"The need for a tightly coordinated, well-led set of changes across education, health and social care, with the aim of securing the very best provision and outcomes for children and young people with SEND, could not be clearer.”

Research and analysis, SEND: old issues, new issues, next steps, June 2021

Read the report here

Care Quality Commission quote

“Throughout the pandemic, local areas have had to adapt their ways of working to continue to provide services for children and young people with SEND. We saw that the success with which they adapted appeared to be closely related to the ways they had implemented the 2014 reforms. This included whether they had created the necessary relationships, systems and structures to deliver well as partners. Some areas struggled to adapt, but even where systems seemed to be overwhelmed by the challenges of the pandemic, families expressed appreciation for the support and care given to them by individual professionals.

However, even in areas where the system worked together effectively, it is evident that children and young people with SEND are now even more vulnerable than they were before. Missing out on education as well as support for physical health, communication needs and mental health has had a seriously detrimental, and in some cases potentially permanent, impact. Some children and young people with SEND have also been out of sight of safeguarding professionals.

Victoria Watkins, Deputy Chief Inspector of Primary Medical Services and Integrated Care

HM Chief Inspector, Amanda Spielman quote

“Many local area leaders and practitioners have gone above and beyond to support children and young people with SEND and their families during this challenging time. However, our report shows that children and young people were not always getting the education and care they needed, even before the pandemic.

“As the damaging effects of the pandemic on children and young people with SEND become clear, so too does the need to ensure that we are all playing our role in supporting them. We will work closely with CQC to develop a new framework to support improvement in the way education, health and care services work together to get the best possible outcomes for children.”

From the commentary accompanying the report, HM Chief Inspector, Amanda Spielman
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Video commentary from Nick Whittaker, Ofsted SEND Specialist Adviser

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