Arrest and conviction of a 13-year-old boy for a serious violent crime. Learning includes: children and young people with special educational needs and disabilities (SEND) need to be understood, and local capacity improved so that these specialist needs can be met; the quality of information sharing when a child or young person with an education health and care plan (EHCP) changes schools is crucial; new pathways are required for young people with complex needs if exclusions from school are to be reduced; there is a need to develop a culture of safeguarding within front line staff to improve the service offered to young people by Thames Valley Police. Recommendations include: develop new procedures for the early review of EHCPs when a child or young person moves local authority area at the same time as transitioning from primary to secondary school; develop new information sharing procedures when students with an EHCP change schools, including professional meetings attended by the relevant schools, the agencies working with the young person, and the parents/ guardians; Thames Valley Police should produce new policy and guidance in relation to children and young people who are identified as suspects in a criminal investigation and develop a culture of safeguarding and partnership working, with training delivered to all police officers and police community support officers; update policy and guidance for the review of referrals and contacts that involve children and young people with SEND.
      
 Title:  Local child safeguarding practice review (Wokingham): ‘Harry’. LSCB: Berkshire West Safeguarding Children Partnership Author: Mark Power Date of publication: 2022  This case review report was deposited by the publishing LSCB(s) with the national SCR repository, a partnership between the Association of Independent LSCB Chairs and the NSPCC.  This report is available online via the NSPCC Library Catalogue. Copyright of this report remains with the publishing LSCB(s) listed above.                            1       Local Child Safeguarding Practice Review  (Wokingham)   ‘Harry’                  Commissioned By: Berkshire West Safeguarding Children Partnership Lead Reviewer and Author: Mark Power (Mark Power Safeguarding) Date of Publication: 13th December 2022         2CONTENTS    Section   Page  1. Introduction and Methodology    3 2. Case Summary and Key Events     4    3. Views Of Harry’s Family and the Wider Context     8 4. Critical Analysis and Learning   9  a) Finding 1: The Provision of Services for Children and Young People with Special Educational Needs (SEND). 9  b) Finding 2: Educational Establishments – Information Sharing and Planning 11  c) Finding 3: The Police Response to Young People and Suspected Criminality 13  d) Finding 4: Children’s Services – Response to Safeguarding Concerns 13  e) Finding 5:- Early Help Services for Children and Young People with SEND Needs    14 5. Conclusion and Summary of Recommendations     17            31. INTRODUCTION AND METHODOLOGY Background  In February 2021, the Berkshire West Safeguarding Children Partnership (BWSCP) considered the case of Harry, a young person who had been arrested, and later convicted, for a serious violent crime.  Harry had been known to a number of services over a lengthy period and at the time of the incident was being supported by the Wokingham Integrated Early Help Service1.  The safeguarding partnership recognised the potential to improve the way agencies worked together to safeguard young people and commissioned this Local Child Safeguarding Practice Review (LCSPR)2.    The review aimed to use the experiences of Harry and his family, to identify learning and to continually improve the way that agencies work together to safeguard children and young people.  A wide number of agencies from the safeguarding partnership took part and five key findings were identified.  These are outlined in this report as follows: a) The Provision of Services for Children and Young People with Special Educational Needs and Disabilities (SEND).   b) Educational Establishments – Information Sharing and Planning.  c) The Police Response to Young People and Suspected Criminality.  d) Children’s Services – Response to Safeguarding Concerns.  e) Early Help Services for Children and Young People with SEND Needs.  Methodology An independent lead reviewer was appointed to undertake the review, working alongside a panel of local professionals.  Terms of reference were provided, identifying the key date parameters as July 2018 to January 2021.  Chronologies and single organisation reviews were provided by each agency, analysing events and considering how changes to practice may deliver future improvement.    The independent reviewer met with Harry’s family on a number of occasions to ensure that their views were fully considered, and that Harry’s voice could be captured.  The BWSCP is very grateful for their participation and valuable contribution.    Practitioners and senior representatives from each agency met for a further analysis of events and to identify the systemic reasons as to why better outcomes were not achieved.  All were then involved in identifying potential improvements for consideration by the safeguarding partnership.  This overview report summarising the analysis and findings of the review panel was then prepared, having passed the BWSCPs quality assurance process.    About This Report This report outlines the recommendations in a concise format.  It is written with the intention of publication and as such does not contain information which may identify those involved.  The document aims to be as succinct and practical as possible and therefore does not contain a detailed chronology of events, or the ‘working out’ process for the review findings.  The detailed analysis of events and the evidence underpinning this report are held in additional documents retained by the BWSCP.        1 Integrated Early Help and Youth Offending services.  Now restructured into two separate services.   2 https://www.berkshirewestsafeguardingchildrenpartnership.org.uk/scp/professionals/child-safeguarding-practice-reviews      42. CASE SUMMARY AND KEY EVENTS Harry – An Overview   At the age of 13, Harry was involved in the commission of a serious violent crime, in which he used a knife in the assault of another young person.  He was subsequently convicted of the offence and was sentenced to a lengthy period of youth detention.  Prior to his arrest he had been living in the Wokingham area with his mother and younger sibling.  Whilst his parents are estranged, he regularly saw his father who remained active in the children’s lives.    During his early childhood Harry was diagnosed with a developmental disability.  This condition affected his understanding of what behaviour was socially acceptable, his understanding of consequences, and his assessment of risk.  Despite this Harry was determined to be treated the same as his friends and felt a strong need to ‘fit in’, both at school and with his peers.  To support his academic ambitions, Harry was supported by the local authority with an Education and Health Care Plan (EHCP)3.   Despite Harry’s enjoyment of education and his desire to do well, his schools found it difficult to manage his behaviour and this led to a number of exclusions.  This caused considerable distress to Harry, increasing feelings that he was different and that he could not be accommodated in school.  The exclusions led to him spending considerable time outside of full-time education, during which he became vulnerable to criminal exploitation.    Criminal exploitation may take many forms4 and in Harry’s case this risk came from peer groups, with whom due to his developmental disability he felt a need to fit in.  This risk of exploitation was identified a number of times and was demonstrated by his involvement with different groups of young people.  All were older than him and had been suspected of crime and disorder before his association with them began.   Whilst involved with these groups Harry went on to become involved in criminality, which became more serious as time went by.  During 2020, concerns about exploitation continued to increase and Harry became involved in a number of incidents which were reported to the police.  Despite being supported by a number of agencies his involvement in criminal incidents escalated, culminating in the offence leading to this safeguarding review.    Key Events 1) For the majority of his time at primary school, Harry was living in Reading and his EHCP was supported by Reading Borough Council.  His school describe how they found it extremely difficult to support his needs and how there was a need to provide one to one supervision.  They felt that Harry would struggle to succeed in a mainstream secondary school and expressed these views to the local authority.  In February 2018, Harry was required to select his secondary school in accordance with the school admission calendar.  He was keen to attend the same school as his friends and selected a mainstream school near to his home.   2) In March 2018, Harry and his family moved to Wokingham, at which time Wokingham Borough Council assumed ownership of his EHCP.  As the secondary school had already been selected, and in accordance with procedures, there was no family engagement at this time and the EHCP was not reviewed.  Future reviews were inconsistent in their timing and quality.   3) In July 2018, Harry’s primary school made a child safeguarding referral to Reading Children’s Services, after Harry’s sibling had disclosed that he had threatened to harm them with a knife.  Following an assessment, early help5 support was offered to the family.  The early help service did  3 https://educationadvocacy.co.uk/what-is-a-ehcp/ 4 https://www.nspcc.org.uk/what-is-child-abuse/types-of-abuse/gangs-criminal-exploitation/#criminalexploitation 5 https://learning.nspcc.org.uk/safeguarding-child-protection/early-help-early-intervention    5not succeed in engaging the family and it was recorded that Harry’s mother declined any support.  The case was closed.   4) In late July 2018, the school made a second referral to children’s services following an incident at school.  Harry had threatened another pupil with a cutlery knife and the school became concerned about Harry and his risk to others.  A referral was also submitted to the Child and Adolescent Mental Health Services (CAMHS) who had previously worked with Harry.  CAMHS determined that this was not a mental health issue and referred it to children’s services.   5) Both referrals6 were received by Wokingham Children’s Services and reviewed by the Referral and Assessment Team, a department providing the single point of access to children’s services for all referrals and contacts7.  This review considered the previous involvement of Reading Children’s Services but did not involve any discussions with the referring agencies.  Whilst it was assessed as proportionate to offer early help services, this was recorded as being declined by Harry’s mother as she had found previous offers ineffective.  The case was closed.  6) In September 2018, Harry started at his secondary school where concerns about him quickly developed with frequent episodes of disruptive behaviour.  Attempts to support Harry did not result in any improvement and the school, along with Harry’s mother, concluded that it may not be possible to support his needs in a mainstream school.  The school made attempts to discuss these concerns with the Wokingham Specialist Education Needs (SEN) service8, however they did not receive any reply to correspondence.  7) On 26th November 2018, Harry’s secondary school submitted a safeguarding referral to Wokingham Children’s Services, following information that he had been making bombs at home and was threatening to hurt his sibling.  At this time Harry’s behaviour had escalated to assaulting other pupils and making threats to injure others with a pair of scissors.  A child and family assessment9 was completed, which resulted in a recommendation that the family should be supported by the provision of early help ‘family coach’ services.  An early help visit to the family did not take place until March 2019, at which time it was recorded that Harry refused to engage and that his mother declined any support.  The case was closed.   8) On 9th January 2019, Harry received a fixed term exclusion from school, the first of eight short term exclusions between January and July 2019.  Whilst these did little to support Harry, the head teacher felt they had little option as there was a need to safeguard other pupils.   9) During March 2019, both the school and Harry’s mother raised concerns about the provision of his schooling with the SEN service and requested an emergency review of his EHCP.  Despite delays in responding to these requests, the SEN service did attend two emergency reviews during April and May.  Representations were made that a specialist school placement was required, however this was not facilitated by the local authority. Further specialist services were provided to the school to help in supporting Harry, however this had little effect in improving his situation and the exclusions from school continued.   10) On 18th May 2019, Harry’s school submitted a referral to the PREVENT10 scheme as concerns about Harry escalated.  This was received by Thames Valley Police, who shared the information with children’s services.  Following a review of this contact it was determined that a multi-agency strategy discussion to share information was not required and that an offer of early help would be proportionate.  It was recorded that Harry’s mother declined any support and the case was closed.    6 Working Together 2018 (Para17) outlines that any person, or agency, may make a safeguarding referral and that the local authority should have published measures in place to receive and manage referrals.   7 ‘Contacts’ – A term used by Children’s Services to describe information passed to them by other agencies concerning child safeguarding concerns.  Often described as a referral by the agencies passing the information.   8 Provided by the Wokingham Borough Council 9 Under the provisions of Section 17 Children’s Act 1989 10 https://www.thamesvalley.police.uk/advice/advice-and-information/t/prevent/prevent/    611) On 5th July 2019, a further emergency review of Harry’s EHCP took place.  The SEN service was represented at the meeting and whilst they agreed that a specialist placement was now required, it was explained that this may not be possible as such placements were not readily available.  The school was offered additional financial resources to meet Harry’s needs, although when challenged by the school the local authority was not clear as to how this would help.   12) On 15th July 2019, the SEN team received a letter from the head teacher requesting that a new school placement was found for the September term and two days later Harry was permanently excluded from school.  It was explained that staff were no longer able to manage his behaviour and that the head teacher did not believe his needs could not be delivered in a mainstream school.  The SEND panel11 subsequently met to consider the provision of a new school placement, concluding that Harry’s educational needs had not changed since starting at his previous school and that with a better use of resources they could be met in a mainstream setting.  As a result the request for a specialist school was not approved.   13) In September 2019, Harry started a temporary placement at a specialist pupil referral unit which aimed to help young people re-engage with education.  This was a temporary arrangement whilst a permanent school placement was sought, and Harry was only offered a part time timetable (mornings) with a limited curriculum.  Whilst at the college Harry’s behaviour improved with the provision of clear routines and boundaries.  It was however noted that Harry felt a need to be accepted by others and at times would respond to encouragement to behave in an inappropriate way.  It was recognised that his educational and health needs made him at risk of exploitation.  14) In December 2019, Harry started at a new secondary school.  The school had originally declined to offer a placement as they didn’t believe that they could meet Harry’s needs, however one was subsequently provided following encouragement by the local authority.  Concerns quickly emerged about Harry’s behaviour towards staff and other pupils and upon later receiving his education records, which were incomplete, the school identified that they had not been fully informed of Harry’s needs and the previous concerns in relation to him.  Both the school and Harry’s mother quickly formed the opinion that he was unable to manage in a mainstream school and that a specialist provision was required.   15) During February and early March 2020, Harry was identified by Thames Valley Police as being involved in two crimes.  Whilst it was policy to submit a safeguarding referral for a young person involved in crime, this was not done.   16) On 10th March 2020, Harry’s mother contacted children’s services to express concerns that Harry was the subject of criminal exploitation and to seek support in managing his behaviour.  Harry’s mother explained to the review that this was the moment that she had become extremely worried for Harry and also for the safety of her family.  In her words this was a cry for help.  The outcome of this contact was to make a further offer of early help, however upon them contacting Harry’s mother she was recorded as saying that she no longer needed assistance.  The case was closed.   17) On 16th March 202012, due to the worsening COVID-19 pandemic, the UK government issued public guidance to stop all unnecessary personal contact and to avoid unnecessary travel.  On 23rd March the first ‘lockdown’ period commenced.  Public sector organisations continued to provide services, which included face to face contact where necessary and the introduction of mobile and remote working practices for non-essential services.  The lockdown period also involved a reduced attendance at schools, with a move to remote learning for most students other than those who were vulnerable or children of key workers.  Due to Harry’s vulnerability and his mother’s occupation, he was entitled to continue attending school and on a number of occasions was invited to attend by the school.    11 A panel of experts who meet to support the local authority’s decision making in respect of EHCP and the resourcing of educational need.   12 UK Govt COVID-19 Timeline - https://www.instituteforgovernment.org.uk/sites/default/files/timeline-lockdown-web.pd    718) On 1st April 2020, an emergency review of Harry’s EHCP took place with the SEN service at the request of his school.  It was agreed that his needs could not be met in a mainstream school and the process to commission a specialist placement commenced.   19) On 1st June 2020, having made her own enquiries to find Harry a specialist school placement for the new September term, Harry’s mother received a provisional offer from a nearby school subject to completion of the commissioning process.  The school was located in an adjoining local authority area, it specialised in supporting young people with special educational needs.  This was not approved by the SEN service which continued to seek a school within the Wokingham area, eventually securing a placement in October 2020.  Harry was not attending any educational setting between the start of the September term and him starting at the new school in November.  This gap in education was not reported to the SEN service, nor was it identified by them despite it being highlighted to children’s services in a subsequent safeguarding referral.   20) On 14th July 2020, the police submitted a safeguarding referral to children’s services following an incident involving Harry.  The referral outlined that his mother was unable to cope with his behaviour, that she was concerned about increasing risks of criminal exploitation, and that he had no schooling provision for the September term.  She had asked the police to submit the referral as she had been unable to receive any support with his schooling.  Following review an offer of early help was made, which was recorded as being declined as previous offers had not delivered positive outcomes.  The case was closed. 21) On 28th September 2020, Harry’s mother contacted children’s services after finding cannabis in his room.  She expressed concerns about exploitation, his escalating behaviour, and the fact that she was struggling to cope.  She also explained that Harry was being verbally aggressive to her and to his younger sibling.  She was advised to contact the police to report her concerns and an offer of early help was made.  An exploitation screening tool was completed, which concluded that whilst some indicators of exploitation existed there was not any evidence of it actually happening.    22) On 29th September 2020, Harry’s mother contacted the police to express concerns that Harry was being exploited by a County Lines criminal drugs network13.  The police shared this information with children’s services.  No further action was taken in respect of this contact, as children’s services felt that his had already been addressed with Harry’s mother when she had contacted them herself.   23) On 7th October 2020, the police made a second safeguarding referral and requested a multi-agency strategy discussion.  A meeting was held on 9th October, with a decision that the Section 47 threshold to determine if Harry was suffering or likely to suffer significant harm had not been met.  It was determined that a single agency response by children’s services was appropriate, with a rationale that Harry’s mother was protective, and little could be gained from multi-agency involvement.  This was not a unanimous decision, with the meeting participants equally split as to whether a more robust child protection response was required.  A child and family assessment commenced.     24) During September and October 2020, Harry was involved in the commission of three violent crimes against other young people.  Each case was investigated by a different police officer, and each involved a significant delay between him being identified as a suspect and being interviewed.  During the period of delay, neither Harry’s mother nor children’s services were informed of his involvement in the crimes.  Information was not shared with children’s services until February 2021 when the investigation concluded.    25) During September and October 2020, a number of incidents were also reported to the police, where Harry had threatened to stab other young people.  These were not investigated as crimes but treated as reports of potential disorder.  Information was not shared with children’s services and his mother was not informed of the incidents.    13 https://www.nationalcrimeagency.gov.uk/what-we-do/crime-threats/drug-trafficking/county-lines    826) On 3rd November 2020, Harry started at his new school which specialised in supporting young people with complex needs.  When the school later received his school records it was evident that they had not been fully informed about the concerns for Harry.  They were unaware of concerns relating to criminal exploitation, an involvement with gangs, and his involvement in knife crime.  During the safeguarding review, it also became apparent that Harry’s previous educational establishments were unaware of the extent of these concerns and there was a pattern of information not being effectively shared with the schools.   27) On 11th November 2020, the child and family assessment was completed and a decision was made to allocate the case to the Integrated Early Help Service, which encompassed both early help and youth offending services (YOS).  A YOS worker was appointed to conduct prevention and intervention work. 28) On 30th November 2020, Harry’s new school submitted a safeguarding referral about his suspected involvement in violent crime, threats to kill others with a knife, and Harry claiming to have associates with access to weapons and a firearm.  As Harry was now being supported by YOS, a decision was made that no further action was required.  A multi-agency strategy discussion was therefore not held.  29) On 3rd December 2020, the YOS intervention work commenced, and Harry was described as engaging well and making a positive contribution.  Incidents of Harry threatening to harm others with knives continued and this was reported to his YOS worker by Harry’s mother.  A decision was made to discuss this with Harry at the next intervention session on 15th December, however during this session Harry disengaged and no further work was completed.   30) In early 2021, Harry was involved in a violent crime when he assaulted another young person with a knife.  He was subsequently convicted for this offence and sentenced to a period of youth detention.    3. VIEWS OF HARRY’S FAMILY AND THE WIDER CONTEXT Views of Harry’s Mother Harry’s mother actively contributed to the review and presented views as to why she felt that better outcomes were not achieved for Harry.  Her key issues and views are summarised as follows:  1. At the time of Harry transitioning to secondary school, she did not have an understanding of what his educational needs were and that they may not be met in a mainstream school.  She feels that at the time of selecting the school greater support from the SEN service and an informed discussion about options would have made a difference.   2. When it became apparent that a specialist placement was needed, she felt that the SEN service would not listen to her views.  Things went wrong quickly after the permanent exclusion, and had a specialist placement been commissioned at this time, she feels that outcomes would have been very different.  Harry spent a considerable time outside of full-time schooling and on a limited curriculum.  He felt that he was not wanted in school, and this pushed him away from supportive figures to ones who were able to exploit him.  Whilst outside of full-time schooling, he drifted into criminality.  3. During the assessments of safeguarding concerns she felt that the focus was placed upon her and not Harry’s needs.  She felt that she was seen as a fellow professional by children’s services staff, who were often overly optimistic about her ability to support and meet Harry’s needs (especially his educational needs), rather than being seen as a mother of a child in need of additional support.   4. She felt that the early help pathways were ineffective, and that the worker was not aware of what support could be offered, placing the onus on her to suggest what she would like.  When she was unable to outline what she needed, the cases were closed.  At no time did she withdraw consent for early help services or say that she did not need support.      95. She was not aware of the extent of information known to the police and the concerns about Harry’s involvement in disorder whilst away from home.  This affected her ability to protect Harry.  Further Local Child Safeguarding Practice Reviews During 2021, the BWSCP considered learning that had been obtained from a case unrelated to Harry’s.  Whilst not connected, it provides useful context as a number of similar learning themes were also found in Harry’s review.  These include: a) The family did not feel that they were listened to and did not feel that agencies were able to provide practical and emotional support.   b) A focus on repeated early help offers and not escalating to section 47 child protection.  c) Professionals not understanding criminal exploitation and a lack of pathways to provide effective outcomes.  This included the lack of mechanisms for cross border working.   d) Police information and intelligence was not shared with other agencies.   During 2022 the issues of exploitation and violent crime will be explored through wider work commissioned by the BWSCP, which will include how capabilities may be developed to reduce crime and protect young people.  To avoid duplication, Harry’s safeguarding review does not explore the wider issues of violent crime and exploitation.   COVID 19-Pandemic The time period for this safeguarding review included a significant period during 2020 when services in England were affected by the COVID-19 pandemic.  It was important for the review to consider how this may have impacted upon Harry and how this may have affected the ability of professionals to support him.  Whilst the pandemic will have impacted upon the way key services were delivered across the country, it was not a relevant issue in Harry’s case.  The ability to provide him a suitable educational provision was an issue that pre-dated the pandemic and due to his EHCP he was still able to attend school even when they were closed to many other young people.  None of the key events that affected Harry took place in the lockdown periods and there was no evidence to say that he was at greater risk of exploitation during them.  The lengthy period of time he spent outside of education during 2020 was between September to November and was not COVID related.      4. CRITICAL ANALYSIS AND LEARNING Finding 1:  The Provision of Services for Children and Young People with Special Educational Needs  Learning:   There is a requirement for the local authority to develop new ways of working to ensure that children and young people with special educational needs and disabilities are understood.  There is also a requirement to improve local capacity so that these specialist needs may be met.  The issue that would have made most difference to Harry, providing the opportunity for improved outcomes, would have been the early involvement and intervention of the local authority in his education provision.  This did not happen as his needs were not understood by the SEN service and due to the lack of provision in Wokingham to support children with specialist needs.    Shortly before transitioning from primary to secondary school, the governance of Harry’s EHCP transferred to Wokingham as his family moved home.  As it is not policy to review education plans when a young person moves between authorities, the SEN service did not hear the concerns of Harry’s primary school and did not have an understanding that his needs may not be met in a mainstream secondary school.  It also meant that Harry’s mother did not benefit from an informed discussion to    10understand his schooling needs and to properly consider their options.  Had a review taken place, a school able to support his needs may have been selected and a different course followed by Harry.  The transition from primary to secondary school is a significant adjustment in a young person’s life, with a very different method of education and a less intensive level of supervision.  Whilst it may not be practicable to review every EHCP when a young person moves local authority area, there would be great benefit in doing so when it also involves transition from primary to secondary education.  This was highlighted as good practice by the SEN service at the review panel and as such this change of process forms one of the recommendations in this review.    The quality of education plans and the support provided to schools by the SEN service, were also identified as key issues during this review.  Harry’s written plan was not updated within statutory time frames and when it was done it did not reflect the changes in his life.  Of significant concern was the fact that multi-agency information and child protection concerns were not included in the plan.  When concerns about Harry were raised by the schools, there was a lack of response by the SEN service which did not have the capacity to reply or to attend review meetings.  This lack of capacity meant that they were unable to provide any quality assurance as to how the school planned to deliver Harry’s needs.  When a specialist school placement was eventually authorised, the lack of provision in Wokingham caused a significant delay in providing Harry a school and meant that he was outside of education for a number of months.  By the time he started at this new school, he had been exposed to exploitation and had become involved in the commission of serious crime.  At this stage it was simply too late for the new school to make a difference.    In April 2019, OFSTED conducted an inspection of SEND provision in Wokingham and identified a number of areas for improvement, including all of the themes highlighted in this review.  In response the local authority has developed an ambitious strategy14, with a focus on early intervention and engagement with young people and their families.  Since 2020 an improvement board has been in place to oversee progress of the improvement plan, supported by an implementation team commissioned until the end of 2022.  Whilst improvements have been made, those working within the system explain that there is still much to achieve, a view supported by performance documentation considered in the review.    Due to the extent of the improvements required the difficulty in delivering this new strategy should not be underestimated.  It is therefore recommended that the local authority develops arrangements with the Children’s Safeguarding Partnership, to provide ongoing assurances that the improvement board is effective in the delivery of change and that it is able to evidence how improvements are delivering better outcomes for children and young people.     Recommendation 1: The local authority should develop new procedure for the early review of EHCPs when a child or young person moves local authority area at the same time as transitioning from primary to secondary school.    Recommendation 2: The Local Authority should develop arrangements with the BWSCP, to provide ongoing assurances that the improvement board is effective in the delivery of change and that it is able to evidence how improvements are delivering better outcomes for children and young people.        14 Wokingham SEND Strategy 2021-2025    11Finding 2:  Educational Establishments – Information Sharing and Planning  Learning:   There is a need to improve the quality of information sharing when a child or young person with an EHCP changes educational establishments.  If exclusions from school are to be reduced, then new pathways are required for young people with complex needs.     When a young person changes school, the established process for sharing information is confined to the exchange of written records.   The information is often received and reviewed after the student has joined the new school and does not include the richness of information which may be presented by a previous member of staff who knew the young person well.  Whilst this may work for the majority of pupils, it was not effective in Harry’s case, and this is likely to be the same for many young people in his situation.  The new schools were not aware of key information known to the previous schools, or the involvement of partnership agencies who were working with Harry and his family.  This lack of information meant that Harry was not fully understood, and this had two effects:  a) During the admission process the schools could not properly assess whether they were able to meet Harry’s needs.  This led to placements failing, causing significant distress to Harry and the disruption of his education.   b) In not understanding Harry, effective planning to deliver his needs could not be achieved from the outset of his school placement.    In examining the reasons as to why information was not effectively shared, the review identified the following:  Firstly the lack of an enhanced process for the sharing of information about pupils with complex needs; and secondly that following an exclusion there is often pressure to find any school placement, rather than the correct placement.  To address both of these issues, the experts on the review panel recommended that a professionals meeting should be held when a young person with an EHCP changes educational establishments or when a new placement is sought by the local authority.  Whilst the required attendance list should be flexible to reflect the circumstances of the young person, it should where possible include parental representation and any relevant agencies working with the family.  Should the meeting identify the necessity to change the EHCP, then the SEN service may be requested to arrange and attend an emergency review meeting.   This new procedure would make a difference to many children and young people and therefore forms a recommendation of this review.    Whilst examining the quality of the school planning for Harry, it was recognised that the high number of exclusions had a negative impact upon him.  Not only did this affect his mental wellbeing, it also pushed him away from supportive figures and made him more susceptible to exploitation.  The schools explained that exclusions were used as a last resort, however there was a need to safeguard other pupils and maintain school discipline.  It was further explained that resources and options available to the schools are limited and that if the use of exclusions was to be reduced then new pathways and resources would need to be developed and made available to them.  Reducing the use of exclusions for children and young people with an EHCP is already an ambition for the local authority and if this is to be delivered then it would be helpful to use the expertise of school staff in any future development plans.   It is therefore recommended that the local authority develops the pathways and resources available to schools, aiming to reduce the use of exclusions.  In order to achieve this it would be desirable to form a working group involving head teachers and special educational needs staff, ensuring their expertise and professional views are captured.  The findings may then form part of a new strategy to reduce exclusions from school or may be incorporated into the current Wokingham SEND Strategy 2021-2025.      12Recommendation 3: New information sharing procedures should be developed in the Berkshire West partnership area, to provide an enhanced level of information sharing for students who have an EHCP at the time of changing education establishments.  This should include professional meetings attended by the relevant schools, the agencies working with the young person, and the parents/ guardians.     Recommendation 4: The local authority should review the provision of resources and pathways available to schools, in order to reduce the use of exclusions for children and young people with EHCP.  This should be delivered by a working group that involves headteachers and specialist staff from both maintained and non-maintained schools.     Finding 3:  The Police Response to Young People and Suspected Criminality Learning:   If Thames Valley Police are to improve the service provided to young people, there is a need to develop a culture of safeguarding within front line staff.  This needs to be supported through organisational strategy that clearly sets safeguarding as a priority and a strategic aim.   Whilst participating in this review, Thames Valley Police conducted a detailed analysis of their processes and identified a number of opportunities to improve the service delivered to young people and their families.  This was an excellent piece of self-reflection and has resulted in a significant number of improvement recommendations.  As these are mainly ‘single agency’ actions they are not fully presented in this report, which instead focusses on a smaller number of key issues that have the potential to improve multi-agency working.   There would be great value in Thames Valley Police presenting details of their action plan to the BWSCP, so that the implementation of change and the outcomes may be assessed during the existing annual Section 1115 quality assurance processes.     In Harry’s case there were two key areas of police practice that directly affected how the police and the partnership agencies were able to safeguard him.  These being: a) Safeguarding referrals were not consistently submitted and information was not shared.  This directly affected the quality of subsequent multi-agency decision making and planning.  b) There were significant delays during the investigation of offences and incidents, during which time the risk to Harry and other young people was not proactively managed.  The police had requested the October 2020 strategy meeting and made representations that a multi-agency response was required.  Following the decision to follow a single agency children’s services response, the police did not take any further action in relation to the risks and concerns that they had originally identified.     In examining the reasons for this, the review identified the following:   There was a culture of police officers and staff only seeing Harry as an offender and not seeking to understand why he may have become involved in such serious crime and disorder.  For example within one official document was the wording, “Harry’s main danger is himself and his attitude.  He has no respect for authority and will not be told what to do”.  In cases of exploitation a young person may be both a victim of crime as well as preparator, however this did not appear to be understood by those who came into contact with him.     15 Section 11 of the Children Act 1989     13 There was a pattern of crimes and incidents being dealt with in isolation and by different officers.  Police information systems were not researched at the time of offences being investigated and offence were not connected.  The pattern of escalating incidents was not identified and therefore risk was not properly assessed.   There was a lack of priority placed upon the investigation of crimes and incidents, leading to a significant delay in which risk was not proactively managed.    There was a lack of understanding in relation to child safeguarding and the benefits of partnership working.  This was demonstrated by the failure to quickly inform Harry’s mother and partnership agencies of incidents, so that Harry could be safeguarded and deterred from criminality.  Whilst it was policy to submit a child safeguarding referral as soon as a young person came to notice as a potential suspect, it was common practice for this not to be done until the end of an investigation, or in many cases not at all.    Thames Valley Police has identified a need to develop a safeguarding mindset and culture, and an organisation wide training programme has already been agreed.  Whilst this is a positive step, it will need to be supported through strong policy and guidance.  It is therefore recommended that the police produce new operational guidance in relation to children and young people who are identified as suspects in a criminal investigation.  This should be underpinned by an annual training programme to develop a culture of safeguarding and partnership working.  The training should be delivered to all frontline police officers and police community support officers.     Recommendation 5: Thames Valley Police should produce new policy and guidance in relation to children and young people who are identified as suspects in a criminal investigation.  This should be underpinned by an annual training programme to develop a culture of safeguarding and partnership working, delivered to all police officers and police community support officers.      Finding 4:  Children’s Services – Response to Safeguarding Concerns  Learning:   Whilst reviewing safeguarding referrals and contacts, Wokingham Children’s Services did not understand the needs of Harry or his family.  The understanding of SEND needs requires specialist knowledge and this is not currently held in the Referral and Assessment team.   Throughout 2018 to 2020, a significant number of safeguarding referrals and contacts from partnership agencies were received by Wokingham Children’s Services.  This should have provided the opportunity for positive outcomes delivered within a multi-agency plan, but instead a pattern developed in the repeat tasking of early help services.  On a number of occasions it was determined that a referral did not meet the threshold16 to hold a multi-agency strategy discussion, to share information and to consider multi-agency planning.  These decisions have been subject of review by the children’s services review panel representative, who agrees that at times circumstances met the threshold for a social care assessment and that opportunities to engage with Harry and his family were missed.    The pattern of referrals assessed as not meeting the threshold for an enquiry under Section 47 of the Children’s Act17, was not only evident in the referral and assessment practices, but also in the decision making at the October 2020 strategy meeting, where a decision was taken that a single agency response led by children’s services was appropriate.  This missed the opportunity to develop a robust  16 https://www.berkshirewestsafeguardingchildrenpartnership.org.uk/scp/wokingham/wokingham-threshold-guidance 17 Where a child is suspected to be suffering, or likely to suffer, significant harm - https://www.legislation.gov.uk/ukpga/1989/41/section/47    14multi-agency plan, which should have included a role for the police to proactively address the ongoing issues of violent crime and disorder.   Opportunities for early and effective interventions were missed and in examining the reasons for this the following key issues were identified: a) An understanding of Harry’s situation and his needs was never fully developed, particularly how his special educational needs increased the level of support that he required and how it made him more vulnerable to exploitation.   b) The review of referrals and contacts did not fully consider the outcome of previous offers of early help.  Particularly why they had not delivered successful outcomes and whether the further offer of early help was an effective option.     c) There was a focus on Harry’s mother, rather than the needs of Harry and his sibling.  There was too much optimism about the ability of Harry’s mother to meet his needs without a more robust multi-agency response.    Wokingham Children’s Services has since introduced a new trauma informed approach for the initial review of all child protection referrals and contacts.  This is reported to have improved the outcomes for children and young people, however it does not specifically aim to improve the understanding of young people with special educational needs and disabilities.  There would be great benefit in complementing the trauma informed approach with a specific policy in relation to children and young people with such needs.  The SEND Codes of Practice18 recognises the importance of this and requires local authorities to develop policy and guidance to ensure that this is achieved.  Currently Wokingham does not have clear guidance for staff working in the referral and assessment team.  Had policy and procedure been in existence and understood by staff, then this may have greatly improved the chance of providing better outcomes for Harry.    Recommendation 6: Wokingham Children’s Services should update policy and guidance for the review of referrals and contacts that involve children and young people with special educational needs and disabilities.      Finding 5:  Early Help Services for Children and Young People with SEND Needs Learning:   Harry’s mother felt that the Early Help offer was ineffective in providing the emotional and practical support that she and Harry needed.  There is an opportunity to use this review to improve the services offered to young people and their families, making a greater use of different agencies and community organisations.    The Early Help service19 was tasked to support Harry and his family on several occasions, however up until November 2020 this was unsuccessful in securing any effective engagement.  Referrals were closed with a rationale that Harry’s mother had declined support or withdrawn her consent for services.  Harry’s mother explained that she was desperate for support and had in fact contacted children’s services on more than one occasion to seek support.  In her opinion she had never declined services but had just not been offered anything that met her and Harry’s needs.  She provided examples of this, indicating that there is potential to improve the services offered to children and young people with special educational needs and disabilities.    One of the key things needed by Harry’s mother was additional support in addressing Harry’s schooling and whilst this was identified by Early Help workers, there was no support offered in relation  18 https://www.gov.uk/government/publications/send-code-of-practice-0-to-25  19 Wokingham Integrated Early Help Service    15to this.  Whilst it is accepted that the schooling should have been progressed by the SEN service, this had not happened.  After being tasked to support Harry’s family it would have been beneficial for the Early Help service to have taken a multi-agency approach, holding a Team Around the Family (TAF) meeting to ensure that Harry’s needs were fully understood and acted upon within a coordinated multi-agency plan.  This could have included his schools and the SEN service.  Such a multi-agency plan would have helped to secure the engagement of Harry’s mother, providing her a greater level of emotional support whilst providing the opportunity to address Harry’s early signs of offending behaviour.  A local outreach service is a key pillar of support offered to young people with a developmental disability and signposting the family to this service, or making a referral for focussed 1-1 support, would have been supportive.  This was not however offered to Harry’s mother, who was left to discover the existence of the service herself and then self-refer.    Following the October 2020 strategy meeting, a child and family assessment was completed, and Harry’s case was ‘stepped down’ for early help.  At this time two things should have occurred to ensure that Harry’s needs were understood and that partnership agencies were considered in the response.   a) A formal step-down meeting between the social worker completing the assessment and the relevant early help staff.   b) A ‘Team Around the Family’ meeting, to consider the involvement of partnership agencies and to develop multi-agency planning.   Neither of these things was done, illustrating how whilst providing services to Harry the early help service worked in isolation.    The children’s services representative informed the review panel, that since Harry’s case a number of improvements have been made to the early help and youth justice20 services, including a performance framework that measures the quality and outcomes of interventions.  The improvements relevant to Harry’s case include: a) An enhanced Early Help Hub, involving a greater number of partnership organisations and groups, to provide additional pathways of support for young people and their families.   b) Early help multi-agency processes include holding an early Team Around the Family meeting where a case is led by the Early Help service, ensuring that a multi-agency support plan can be developed.   c) Improved youth justice service pathways, including targeted intervention for young people who display offending behaviour, including a specific referral process for schools.    d) A new exclusion prevention programme that is currently being trialled within a number of schools in Wokingham, offering targeted 1-1 support for a young person instead of the use of exclusion.  Should the trial prove to be successful then there is an intention to apply for funding from the Office of the Police and Crime Commissioner so that the service may be expanded and opened to all young people living and attending school in Wokingham.   e) The Children with Disabilities Service has developed a continuum of need document, outlining the support that may be offered to young people.  This includes the ASSSIT service, with clear referral pathways that may be used by other departments within children’s services and partnership agencies.  It also includes methods of self-referral for use by families.    Whilst this development is positive and encouraging, there would be great value in reviewing how this has been embedded into routine practice, to ensure that an effective multi-agency approach is consistently achieved and that families are receiving the type of help they need.  It is therefore recommended that children’s services, supported by the wider safeguarding partnership, conducts a multi-agency audit of cases where the Early Help service has recently been assigned to support young  20 During 2022 the Wokingham youth offending service has been rebranded to the Prevention and Youth Justice Service.    16people with special educational needs and disabilities.  This should include direct representation of the families involved in the cases, to ensure that services are delivering their needs and that the safeguarding partnership understands how it feels to be in receipt of early help services.   School exclusion was a key issue that affected Harry and for this reason the new exclusion prevention programme is an exciting development that has the potential to make a significant difference to young people in the future.  Whilst Harry lived in Wokingham, he went to a school in an adjoining local authority area and as the intention is to deliver this scheme at schools in Wokingham it is not clear if he would have benefitted fully from this initiative.  Should the trial be successful, and a decision taken to implement it fully, then consideration should be given as to how the full benefits are provided to young people in Harry’s situation.  Due to local capacity of suitable school placements, it is likely that other young people living in Wokingham will attend schools in adjoining local authority areas and it is essential that they are not denied the full benefits of the exclusion prevention scheme due to their disability.      Recommendation 7: Wokingham Children’s Services, with the support of the BWSCP, should conduct a multi-agency audit of cases where the Early Help service has been tasked to support young people with special educational needs and disabilities.  This should include direct representation of the families involved in the cases, to ensure that services deliver their needs, and that the safeguarding partnership understands how it feels to be in receipt of early help services.   Recommendation 8: Wokingham Children’s Services should consider how the full benefits of the Exclusion Prevention scheme may be provided to young people who live in Wokingham, whilst attending school in a different local authority area.  These arrangements should be included in any future policy and procedure that is developed to support the scheme.           17 5. CONCLUSION AND SUMMARY OF RECOMMENDATIONS Concluding Comments This child safeguarding practice review has identified key learning for both single agencies and for the development of partnership working.  The Berkshire West Safeguarding Children Partnership should now consider the recommendations and consider how they intend to deliver improvements to safeguarding practice.  In addition to addressing multi-agency recommendations it should hold individual agencies to account for delivering the single agency recommendations.    Summary of Recommendations Recommendation 1: The local authority should develop new procedure for the early review of EHCPs when a child or young person moves local authority area at the same time as transitioning from primary to secondary school. Recommendation 2: The Local Authority should develop arrangements with the BWSCP, to provide ongoing assurances that the improvement board is effective in the delivery of change and that it is able to evidence how improvements are delivering better outcomes for children and young people.   Recommendation 3: New information sharing procedures should be developed in the Berkshire West partnership area, to provide an enhanced level of information sharing for students who have an EHCP at the time of changing education establishments.  This should include professional meetings attended by the relevant schools, the agencies working with the young person, and the parents/ guardians.   Recommendation 4: The local authority should review the provision of resources and pathways available to schools, in order to reduce the use of exclusions for children and young people with EHCP.  This should be delivered by a working group that involves headteachers and specialist staff from both maintained and non-maintained schools.   Recommendation 5: Thames Valley Police should produce new policy and guidance in relation to children and young people who are identified as suspects in a criminal investigation.  This should be underpinned by an annual training programme to develop a culture of safeguarding and partnership working, delivered to all police officers and police community support officers.    Recommendation 6: Wokingham Children’s Services should update policy and guidance for the review of referrals and contacts that involve children and young people with special educational needs and disabilities.    Recommendation 7: Wokingham Children’s Services, with the support of the BWSCP, should conduct a multi-agency audit of cases where the Early Help service has been tasked to support young people with special educational needs and disabilities.  This should include direct representation of the families involved in the cases, to ensure that services deliver their needs, and that the safeguarding partnership understands how it feels to be in receipt of early help services. Recommendation 8: Wokingham Children’s Services should consider how the full benefits of the Exclusion Prevention scheme may be provided to young people who live in Wokingham, whilst attending school in a different local authority area.  These arrangements should be included in any future policy and procedure that is developed to support the scheme.  