Appendix 6

Description of Cumbria

This section ‘paints a picture’ of our county by describing its geography and the 10-16yrs population and key CYP demographics.. In order to help understand our rationale for our phase 3 approach it is also important to have ‘picture’ of the School, Health, Social Care and VCS infrastructure within the county and we provide a brief overview of each. The opportunities and challenges facing the Cumbria HS programme are then highlighted and the implications for HS discussed.

2.1Geography

Cumbria has a number of unique characteristics; its physical size and landscape, its dispersed population and the relative remoteness of parts of the county on the west coast. It is the most north-westerly county in England and the second largest, based on its geographical size (2,613 square miles).

Cumbria is a predominantly rural county and much of its terrain is mountainous. All of the territory in England that is over 3,000 feet above sea level is located in Cumbria, including England’s highest point, Scafell Pike, which stands at 978m (3210 feet). Cumbria is home to England’s largest National Park, the Lake District National Park, which is considered to be one of the most beautiful areas of the United Kingdom and has provided inspiration to generations.

Cumbria is a two tier authority made up of Cumbria County Council and six local authority districts; Allerdale, Barrow-in-Furness, Carlisle, Copeland, Eden, and South Lakeland. The map below plots Cumbria’s Local Authority Districts with key population centres:

Cumbria’s 6 Local Authority District Councils

2.2Population

With a population of 497,900 (ONS 2014) Cumbria is the second least densely populated county in England (191 persons per sq. mile). Cumbria is home to approximately 104,000 (20.9%) children and young people aged between 0 and 19yrs; marginally lower than the national proportion (23.8%) of whom 36,400 are 10-16yrs.

The population in Cumbria is dispersed mainly because of the geographical landscape; centrally the county contains many hills, lakes and mountains. Only five urban areas have a population of over 20,000 people; Barrow-in-Furness, Carlisle, Kendal, Whitehaven and Workington. Carlisle is the only city in Cumbria located in the north of the county. The largest town Barrow-in-Furness (in the South West of the county), is between two and three times larger than the second largest town (Kendal) Two of these urban areas (Whitehaven and Workington) are situated on the relatively remote west coast.

54% of the Cumbrian population live in rural communities (compared to just 18% of the population nationally) spread across the county which brings diverse and unique challenges for partners and authorities and the way in which we provide services.1

Number/% of total pop

0-4 yrs.

%

5-9 yrs.

%

10-16 yrs.

%

17-19 yrs.

%

0-19 yrs.

%

Allerdale 4,834 5 5,003 5.2 7,212 7.5 3,266 3.4 20,315 21.1

Barrow-in-Furness 3,654 5.4 3,803 5.6 5,256 7.8 2,363 3.5 15,076 22.3

Carlisle 6,274 5.8 5,888 5.5 7,626 7.1 3,699 3.4 23,487 21.7

Copeland 3,723 5.3 3,689 5.3 5,055 7.2 2,298 3.3 14,765 21.1

Eden 2,382 4.5 2,571 4.9 3,833 7.3 1,683 3.2 10,469 19.9

South Lakeland 4,307 4.2 4,869 4.7 7,380 7.1 3,311 3.2 19,867 19.2

Cumbria 25,174 5.1 25,823 5.2 36,362 7.3 16,620 3.3 103,979 20.9

Across Cumbria’s six districts the proportion of 10-19 yr olds ranges from 19.2% in South Lakeland to 22.3% in Barrow-in-Furness

1 Briefing – Accessibility Statistics Cumbria & Districts 2013 Cumbria Observatory available at : http://www.cumbria.gov.uk/eLibrary/Content/Internet/536/675/4356/41939145415.pdf

Numbers/Proportion of Children & Young people by Age Group/District (Source: Office for National Statistics, Mid-2014 Population Estimates by single year of age)

The map of the county below demonstrates the dispersion and concentration of children aged 0-19 years.

The population of households in Cumbria that have lone parents with dependent children is a lower proportion overall than the English average. ((5.7% vs 7.1% ONS 2011).

2.3CYP Demographics

Ethnicity

The January 2015 School Census reported that 3,083 statutory school aged pupils in Cumbria (4.4%) were from Non-White British ethnic (BME) groups. This is lower than the national average (28.6%), with Carlisle and South Lakeland having the greatest proportions of pupils from BME groups (6.8% and 5.2% respectively). The January 2010 School Census reported that 2,186 pupils in Cumbria (3%) were from BME groups; suggesting that numbers of pupils from BME groups have increased by 897 (41%) over the last five years. All of Cumbria’s districts have experienced large increases in numbers of pupils from BME groups in this time, with Carlisle, Barrow and Eden experiencing the greatest proportional increases (+60.3%, +45.2% and +42% respectively).

English as an additional language

The January 2015 School Census reported that 1,482 statutory school aged pupils in Cumbria (2.4%) had a first language known or believed to be other than English. This was

BME - statutory school aged pupils

District 2015 2015 not known

Allerdale 2.73% 7.64%

Barrow in Furness

3.53% 8.90%

Carlisle 6.79% 5.28%

Copeland 3.53% 6.65%

Eden 4.13% 6.43%

South Lakeland

5.16% 5.42%

Cumbria Total 4.43% 6.63%

National 28.60%

Source -Cumbria data - School Census - Jan 2015,  national- SFR Pupils and their characteristics Jul 15

Please note ethnicity was not obtained/known for 6.63% (4612) pupils in 2015, which could further increase BME proportions very slightly in each district

much lower than the national average (17.3%) but has proportionally increased by 65% from January 2010 (England +31%).

Educational Attainment

The Department for Education (DfE) reported that 56.8% of Cumbrian pupils, in 2013/14, achieved at least five GCSEs (key stage 4) at grades A*-C (including English & Maths); this proportion is the same as the national average (56.8%). The districts of Barrow-in-Furness and Carlisle, however, had lower proportions of pupils achieving the same level of attainment, 50.5% and 47% respectively

Educational Attendance.

Carlisle has worse absence rates (4.9% of school sessions missed due to overall absence vs. 4.5% nationally and 4.6% of pupils classed as persistent absentees vs. 3.6% nationally); and Cumbria has a higher rate of fixed period exclusions (368 vs. 350 per 10,000 pupils nationally).2

Deprivation

Cumbria ranks 86th nationally for overall deprivation (out of 152 upper tier local authorities, where 1 is the most deprived). There has been no change in Cumbria’s relative level of overall deprivation when compared to other upper tier local authorities since 2010.

Of Cumbria’s districts, Barrow-in-Furness has the highest level of overall deprivation, ranking 29th nationally (out of 326 local authorities) whilst Eden is the 2nd least deprived district in the county, however, it falls within the 10% most deprived nationally for living environment; South Lakeland is the least deprived district in Cumbria.

Cumbria & Districts: Overall Deprivation: National Rankings: 2010 vs. 2015:

Source: The Indices of Deprivation (ID) & Index of Multiple Deprivation (IMD) September 2015 http://www.cumbriaobservatory.org.uk/elibrary/Content/Internet/536/675/1766/1775/422771749.pdf

2 JSNA Topic Summary Children & Families November 2015 http://www.cumbriaobservatory.org.uk/elibrary/Content/Internet/536/671/4674/6164/6995/42341152435.pdf

Cumbria is divided into 322 communities (lower super output areas LSOA); 29 of which (41,450 persons, 8.3% of the county’s population) are among the most deprived 10% of communities in England (England has 32,482 communities). The map below shows the LSOAs by overall deprivation score in Cumbria.

Although deprivation is most in our urban areas there are also hidden pockets of deprivation in some of the county’s most rural communities.

Child Poverty

The Child Poverty Needs Assessment 2014 reports that in Cumbria there are 13,585 children aged 0-19 years living in poverty (14.1%), nationally the average percentage is higher (18.6%). Unfortunately this doesn’t mean the entire county is below the national average as Barrow-in-Furness has 20.4% of 0-19 years living in poverty. A total of 29 wards (out of 166 in the county) have levels of child poverty above the national average; the most extreme ward is within Barrow-in-Furness where the percentage of children in poverty approaches half (Central ward 48.4%). Areas with high levels of child poverty are predominantly concentrated in deprived urban areas accounting for 66% of child poverty, however, there are pockets of child poverty in some of the most rural communities with a total of 4,975 children living in poverty in rural areas across the county.3

3 Child Poverty Needs Assessment, February 2014 update Cumbria intelligence Observatory available at:http://www.cumbriaobservatory.org.uk/elibrary/Content/Internet/536/671/4674/5223/4170511816.doc

Free school meals

In 2013/14, 11.9% of pupils in Cumbria were eligible for free school meals compared to 17% nationally. The percentages of pupils eligible for free school meals vary by district: Barrow-in-Furness 19.3%, Copeland 15.4% Allerdale 13.2%, Carlisle 12.9%, Eden 6.1% and South Lakeland 5.6%.

Level of Child Poverty in Cumbria (by census wards)

Children in Need (CiN)

The March 2015 CiN Census shows there were 3,421CiN and that Cumbria has a higher rate of children in need than the national average (366.7 compared to 337.3 per 10,000). Rates of children in need varied across the county’s localities, with Allerdale & Copeland and Barrow & South Lakeland having higher rates than Carlisle & Eden (376.4 and 379.5 compared to 334.8 per 10,000 respectively).

children in need (CIN) (Source: CCC Performance & Risk Team)

Allerdale & Copeland

Barrow & South Lakes

Carlisle & Eden Total

31 March 2011 908 811 755 2474

31 March 915 1067 940 2922

2012

31 March 2013 1013 1084 1075 3172

31 March 2014 1294 1302 1305 3901

31 March 2015 1197 1203 1021 3421

Data from Cumbria’s Children’s Services (August 2015) identifies a number of wards within the county as having particularly high rates of children in need, with rates in the following wards being three or more times the county average: Barrow Island (Barrow-in-Furness); Kendal Far Cross (South Lakeland); Central (Barrow-in-Furness); Hindpool (Barrow-in-Furness); and Sandwith (Copeland). The map in Appendix ? plots rates of children in need across Cumbria’s wards.

Children Subject To a Child Protection Plan

The March 2015 CiN census reports that there are 325 children with a child protection plan in Cumbria; this equated to a rate of 34.6 children with a child protection plan per 10,000 population aged 0 – 17 years. Rates of children with a child protection plan varied across the county’s localities, with Allerdale & Copeland having higher rates than Barrow & South Lakeland and Carlisle & Eden (43.1 compared to 32.2 and 28.2 per 10,000 respectively).4

Of the 3421 children in need 169 had child sexual exploitation recorded as a factor as part of their assessment (CiN Census 2015). There were 27 known cases of children at risk of CSE in Cumbria in June 2015; and one case of repeated CSE. The current figures are likely to underestimate the true extent of CSE in Cumbria.5

Children Looked After

In Cumbria in March 2015 there were 681 children and young people looked after; this equates to a rate of 72.4 per 10,000 0-17 year olds which is significantly higher than the national rate of 60 per 10,000.

Refugee Children

Home Office statistics report that there have been less than five asylum seekers of all ages in receipt of Section 95 support across Cumbria over the last five years.

4Children Looked After Sufficiency Statement 2015-18 http://www.cumbria.gov.uk/eLibrary/Content/Internet//536/6181/42354104126.pdf5 CCC Scrutiny Advisory Board Child Sexual Exploitation in Cumbria Eptember2015http://councilportal.cumbria.gov.uk/documents/s42480/Appendix%201%20Scrutiny%20Review%20-%20Child%20Sexual%20Exploitation.pdf

2.4 Young people health needs analysis

General Health and Wellbeing

28.5 % young people reported that their general health as ‘excellent’ this is lower than the regional (30.7%) and the national (29.5%) results (WAY 2014).

12.1% of Cumbrian young people reported that they had low satisfaction with life scores (WAY 2014). This is lower than the national rate of 13.7%.

The mean score of the 14 Warwick-Edinburgh Mental Well-being (WEMWBS) statements was 47.3 (out of a highest possible score of 70 and a lowest possible score of 14).This was similar to the regional (47.8) and national (47.6) scores.

12.5% young people stated that they had a long-term illness, disability or medical condition that has been diagnosed by a doctor this is lower than the regional (14.2%) and national (14.1%) results (WAY 2014).

Bullying

58% of young people had been bullied in the last couple of months, higher than the regional (54.2%) and England (55%) results. 8% of Cumbrian young people reported they had bullied someone in the last couple of months this was lower than the England result of 10.1% (WAY 2014).

Cumbria’s 2012 Health-Related Behaviour Survey found that the fear of going to school because of bullying occurred in both primary and secondary pupils, with more primary pupils (35%) reporting this fact compared to secondary pupils (24%). Nationally only primary pupil data were available, which found 30% primary school children reporting the same fear. Among primary aged pupils, 22% reported that they thought they were bullied because of the way they looked and 17% thought because of their size or weight.

Estimated prevalence of mental health problems in Cumbria’s CYP

It is not possible to provide definite numbers of children affected by mental health issues in Cumbria. Main sources for prevalence estimates are national surveys carried out in 1999 and 2004. In recent years many changes have occurred in the lives of CYP, in particular the dramatic rise in the internet and world wide web followed by the more recent ‘social media explosion’, which may have impacted on patterns of mental health.

Furthermore, given the social stigma of mental ill-health, it is likely that prevalence figures are under-estimations. For example, research indicates that only one in eight children and young people who self-harms presents to medical services. In Cumbria, about 400 children and young people per year attend accident and emergency departments in the county following an episode of self-harm, signifying the actual numbers who are self-harming may be around 3,000 children and young people per year.

The last update of the Joint Strategic Needs Assessment (JSNA) of Children’s and Young People’s Emotional Health and Wellbeing in Cumbria, completed in November 2013,

estimated that 10,000 to 11,000 children in Cumbria aged between 5 - 19 years were likely to have an emotional or mental health difficulty.

Estimates published by ChiMat, which extrapolate data from Kurtz’s guidance to commissioning mental health services (Kurtz,1996), indicate that about 14,200 Cumbrian children and/or young people may experience mental health problems appropriate to a response from ‘tier one’, 6,600 from ‘tier two’, and 1,750 from ‘tier three’ CAMHS.

Findings of the national survey ‘Mental health of children and young people in Great Britain, 2004’ (Green et al., 2005) indicate that overall boys are more likely to experience mental health problems than girls, and children aged 11 to 16 years olds are also more likely to experience mental health problems than younger children (5 to 10 year olds).

The National Child and Maternal Health Intelligence Network provide estimates of prevalence for children and young people aged 5-16 years by applying the 2004 survey results to Cumbria population estimates: see table below:

Suicide

Every death by suicide is a potentially preventable tragedy. Work underway to prevent suicides in Cumbria has a strong focus on CYP, in response to recent suicides in young people in Cumbria (see http://www.cumbrialscb.com/professionals/scr.asp )

Suicide statistics are difficult to interpret because numbers are relatively low (~ 50 suicides in Cumbria per year, all ages). It is even more difficult to draw statistical inferences about child suicides. About 30 CYP aged 0-18 die from all causes in Cumbria each year, with very low suicide numbers varying year-on-year from zero to three deaths per year.

However, Cumbria’s suicide rates, all ages, are consistently higher than the national average, with highest rates in Copeland and South Lakeland. Rates were also higher than national in the 15-34 age band in 2011/13 (Cumbria11.21 vs. national 5.94 per 100,000). As elsewhere, more than 75% of suicides are male.

Uptake of services

Service use gives an indication of population mental health needs; however activity data also reflects the quality and availability of services in a local area. The unequal distribution of integrated, high quality (mental) health support for our CYP across schools, health and care, impacts on their ability to access, early on, the support they need. This makes service uptake data difficult to interpret.

High hospital admission rates may mean that there is more need in the community, and/or that preventive and primary care/’tier 1’/‘tier 2’ interventions are sub-optimal. For example, in Cumbria in 2013/14, there were 385 observed unplanned hospitalisations for asthma, diabetes and epilepsy in under 19s; this equates to a rate of 381.4 per 100,000 registered patients under 19, which is higher than the national average (311.4), with under 19s admissions for epilepsy in the area being in the highest quartile of all CCG areas nationally. It is likely that these results reflect both higher prevalence (for example of diabetes, related to our high overweight in CYP rates) and to the way local services are operating together.

Unintentional and Deliberate Injuries

Cumbria’s rate of hospital admissions caused by unintentional and deliberate injuries in young people aged 15-24 years also worse than the national average (160.1 vs. 136.7 per 10,000 population nationally) and an increase from the previous year (155.3 per 10,000). Barrow-in-Furness, Copeland and South Lakeland have significantly higher rates than the national average for this measure.

Mental health Disorder Hospital Episodes

The Health and Social Care Information Centre (HSCIC) reports there were 104 children and/or young people admitted to hospital for mental health disorders (not including self-harm) in Cumbria during 2013/14; corresponding to a rate of 111 admissions per 100,000 population aged 0-17 years, which is higher than national rate of 87 admissions per 100,000 population aged 0-17 years.

Referrals To Child And Adolescent Mental Health Service (CAMHS)

2958 referrals were made into Cumbria CAMHS in the 12 months leading up to March 2015, with around one third of those being inappropriate for CAMHS Tier 3 as the tier 3 criteria was not met. Currently there are 1578 young people open to CAMHS, and caseloads average across the county approximates at around 600 in South Cumbria, 450 in East Cumbria and 500 in West Cumbria. Referrals are increasing year on year

2.5 Infrastructure

2.5.1 Schools

Schools in Cumbria educate 39,017 (primary and nursery) and 29,581 secondary pupils.

LA Maintained No. Academy No. Other Schools No.Infant, Junior andPrimary

247 Infant, Junior andPrimary

23 Free School 1 271

Secondary 15 Secondary 21 TechnologyCollege

1 37

Special 4 Special 1 5

Nursery 6 6

Pupil Referral/Short stay school

3 3

TOTALS 275 45 2 322

We have 271 Infant, Junior and Primary, 37 Secondary, 5 Special, 6 Nursery and 3 PRU’s spread around the county as shown on the map below. These schools are dispersed over a large geographical area and operate in many different ways due to their size, and legal status.

Number of Schools by District with pupils 10-16 yrs (296 schools)

Primary schools vary in size from 19 (Captain Shaw's CofE School, Millom) to over 400 pupils (Stanwix School, Carlisle).

Secondary schools vary in size from 100 (Samuel King's School, Alston) to over 1500 pupils (Trinity School, Carlisle).

Allerdale

PRU 1

PRIMARY 53

SECONDARY 10

TOTAL 64

Barrow

PRU 1

PRIMARY 27

SECONDARY/FREE 5

SPECIAL 1

TOTAL 34

Carlisle

PRU 1

PRIMARY 45

SECONDARY 6

SPECIAL 1

TOTAL 53

Copeland

PRU 0

PRIMARY 35

SECONDARY 4

SPECIAL 1

TOTAL 40

Eden

PRU 0

PRIMARY 37

SECONDARY 5

TOTAL 42

South Lakeland

PRU 1

PRIMARY 51

SECONDARY 9

SPECIAL 2

TOTAL 63

The number of children that CCC are aware of home educating in Cumbria October 2015 is 283 of whom 190 are between10-16yrs and 27 children aged 16-18yrs.

Pupil Referral Units (PRUs) are a type of school that offers education to students who are; at risk of exclusion, permanently excluded from, or are not attending school for other reasons, such as illness (physical and psychological) or pregnancy. In Cumbria, there are three PRUs:

o Newbridge House (54FT) in Barrow (South)

o Gilford Centre (51FT) in Carlisle (North)

o West Cumbria PRU (52FT) in Distington (West).

Each PRU currently offers education to students aged 7-16 with the exception of the North PRU who also offer support to the 5-7 age group.

Special Schools

11,203 of our 68598 pupils have SENs (15.6%), with 2,141 pupils having a Statement/ EHC plan (3%); similar to the national averages (15.4% and 2.8% respectively) (DfE SFR 2015). 69.7% of newly issued statements and plans were for pupils with a placement in maintained mainstream schools compared to North West 53.9%, Statistical Neighbours 47.0% and England 52.4% (Source: SFR School Census Jan 2015). This suggests that in Cumbria, mainstream schools accommodate a higher proportion of CYP with special needs than elsewhere in the country.

Special School (3-19yrs) District NOR

George Hastwell School, Barrow

Barrow75 FT

Sandside Lodge, Ulverston

South Lakes

65 FT / 1 PT

Sandgate School, KendalSouth Lakes

72 FT/ 1 PT

James Rennie School, Carlisle

Carlisle140 FT / 3 PT

Mayfield School, Whitehaven

Copeland120 FT / 3 PT

In addition to our 5 Special Schools, specialist provision is also available in our 21 resourced provision schools (9 secondary & 12 primary). These are schools which have developed expertise in a particular area of SEN and receive additional funding to enable them to make specialist support available. In January 2016 101 pupils were in receipt of this service andwe will seek to engage all of these schools in HS in phase 3.

Primary School Name Resourced Specialism District

Ashfield Junior SchoolResourced for Physical and Medical Difficulties

Allerdale

Thomlinson Junior School

Resourced Provision for AutismAllerdale

Wigton Infant SchoolResourced for Autism & Severe /

Profound Learning DifficultiesAllerdale

All Saints C of E School Resourced Provision for Dyslexia Allerdale,

Vickertown School Resourced for Physical / Medical Barrow

Newtown Community Primary School

Resourced in Severe Learning Difficulties Carlisle

Secondary School Resourced Specialism District

Caldew School Autism Carlisle

Cockermouth School

AutismAllerdale

Stainburn SchoolPhysical & Medical Disabilities

Allerdale

Queen Katherine School

Learning DifficultiesSouth Lakes

Trinity School Hearing Impairment Carlisle

William Howard Learning Difficulties Carlisle

Settlebeck School AutismSouth Lakes

The Lakes School Physical / MedicalSouth Lakes

Ullswater Community

College

Severe & Profound Multiple Learning Difficulties & Physical Medical Difficulties

Eden

Bransty Primary School Resourced for Deaf/Hearing ImpairedCopeland

Appleby Primary SchoolResourced for Severe and Profound Multiple Learning Difficulties and Physical and Medical Difficulties

Eden

Beaconside C of E School

Resourced in Profound Multiple Learning Difficulties and Physical and Medical Difficulties

Eden

North Lakes SchoolResourced Severe and Profound Multiple

Learning Difficulties and Physical DifficultiesEden

Vicarage Park CE School

Resourced Provision for Learning Difficulties or

Medical & Physical Needs

South Lakes

Goodly Dales Community & Primary School

Resourced Provision for Physical &

Medical Disabilities

South Lakes

The Learning Improvement Service (LIS) provides a service for monitoring, supporting and challenging schools and settings to ensure high quality provision and improved outcomes for children and young people in Cumbria.

The Cumbria Alliance of System Leaders (CASL) Over the last 2 years, officers of the local authority and representatives from the Cumbria Association of Secondary Headteachers, Primary Headteachers Association, School Leaders, University of Cumbria, Local Leaders in Education (LLEs), National Leaders in Education (NLEs) and the two Diocese and our National College Associate, have worked together to establish an integrated system of School to School support. It is Cumbria’s response to the challenge of creating a self-improving, school led system and close the gaps for disadvantaged pupils.

The CASL is a strategic board with three operational groups; Local Alliance of System Leaders (LASL) which operate in South Lakeland and Furness (South), Allerdale and Copeland (West), Carlisle and Eden (North) attended by representatives drawn from the clusters in each area. The Executive Headteacher of The Queen Katherine School is chair of the Emotional Wellbeing and Mental health Partnership, sits on executive board of CASL, and chairs the South LASL.

The Local Authority (LA) works in partnership with others, such as Teaching Schools, Cumbria Alliance of System Leaders (CASL), Local Alliance of System Leaders (LASL) and the diocesan boards, in order to provide comprehensive support for governors. The Governor Support Team is currently working with clerks and chairs to governing bodies to enable them to work together within clusters, as well as sharing training.

The Traded Services team co-ordinate a training programme for governors, associate members and school based staff: Cumbria’s Training Events for School Based Staff and Governors. This programme brings together the courses which are delivered through the Cumbria Continuing Professional Development, Local Learning Network and Governor Development Programmes.

The Virtual School and Equalities Learning Team encompasses the following vulnerable groups: Children Looked After; Children with English as an Additional Language (EAL); Black and Minority Ethnic groups (BME); Travellers; and Young Carers. The team work to improve outcomes of each of these groups as well as promoting a better understanding of their specific needs and of equality issues.

2.5.2 Health

NHS Cumbria Clinical Commissioning Group (CCG): Cumbria CCG is the main commissioner of local NHS services in the county. Current CCG Children’s Commissioned Contracts are as follows: Audiology; Dietetic; Specialist safeguarding; Community paediatrics; Tier 3 Child & Adolescent Mental Health Services (CAMHS); Physiotherapy; Children’s Community Nursing; Speech and Language Therapy; Occupational Therapy; Children’s LD Nursing; Children Looked After specialist nursing.

Primary Care provide emotional wellbeing and mental health support to children, young people and their families and where appropriate start an early help assessment and make referrals to other services. There are 77 GP practices based within local communities across Cumbria.

Cumbria Partnership NHS Foundation Trust (CPFT) is the lead statutory provider, Cumbria-wide, of adult mental health and children’s specialist and community services (including CAMHS, 9 community hospitals, health visiting, school nursing, children looked after). CPFT’s Tier 3 CAMHS service is in on an improvement journey, including taking part, with 3rd sector partners, in the national quality improvement programme, improving access to psychological therapies for children and young people, CYP IAPT.

Two Hospitals Trusts: University Hospitals Morecambe Bay NHS Foundation Trust (UHMB), serving the South Lakes, Barrow and Lancaster populations, and North Cumbria University Hospitals Trust (NCUH), serving

the Eden, Carlisle, Copeland and Allerdale populations, are respectively engaged in the ‘Vanguard’ and ‘Success Regime’ large scale improvement programmes

Sexual Health Treatment and Advice in Cumbria: Provided in a variety of settings across the county including Sexual Health Clinics (combined GUM and Contraceptive services), GP surgeries, community pharmacies, and Inspira. Confidential help is provided by the Sexual Healthline Cumbria signposting service.

Primary Mental Health Early Intervention Service (PMHEIS) :This new service is expected to commence April 2016 and will develop a single point of access for all Tier 2 and Tier 1 referrals for emotional and mental wellbeing. It will provide both indirect support to Tier 1 (training, consultation and supervision) and brief direct interventions.

Cumbria Learning and Improvement Collaborative (CLIC): Driving a positive transformation in health and social care across Cumbria and the Morecambe Bay area by leading and embedding a culture of collaboration for continuous learning, continuous improvement and living within our means.

Public Health

Active Cumbria is hosted by public health and is one of 45 County Sports Partnerships (CSP’s) in England and has established a successful inclusive sports delivery system through a network of providers and deliverers committed

to working together to achieve active and healthy communities in Cumbria through sport and physical activity.

Unity:Unity is a drug and alcohol recovery service, providing treatment and recovery support for individuals and their family members who are affected by substance misuse.

2.5.3 Social Care Infrastructure

Below are the key services that link to CHS and further Services can be found in Appendix ?

The Early Help Team hosted by the County Council is in place to support practitioners understand the importance of Early Help and support the initiation of Early Help Assessments. Multi-Agency Thresholds Guidance is supported by a model called the ‘Wedge’, which identifies the needs of the child and required responses see Appendix 1.

Focus Family Programme: The Focus Family project is part of the national Troubled Families programme, a Department for Communities and Local Government initiative to support local authorities in addressing the needs of the most challenging and hard to reach families. Nationally these are families considered to have children not attending school, family members involved in crime or anti-social behaviour and adults on out of work benefits. In Cumbria this programme works closely with over 1,000 families who meet a number of criteria including worklessness and financial hardship.

Cumbria Children’s Centres: There are 28 Sure Start Children`s Centres across Cumbria. They provide information and access to services and activities for children aged up to 19.

Edge of Care Service provided in Kendal at Sedburgh Drive (and 1 in development) providing overnight respite at weekends and school holidays to young people and outreach support for families.

Cumbria Youth Offending Service (YOS) - principle aims are to: prevent offending and reoffending by young people; deal appropriately with those who offend including encouraging them to make amends for their crimes; and to support victims of crime.

Early Help Services –

Chidren’s Centres for 0-12s: provision by third sector organisations Barnardo’s, Action for Children and the Howgill Family Centre.

Early Help Youth Service for 12-19s: includes Early Help Front Door (drop-in); Team Around the Community; Focused Early Help and Prevention; Youth Work in Schools, Family Support, Youth Participation; Equality and Diversity; Fire Cadets and Young Firefighters. They support 6 District Youth Councils, Cumbria Children in Care Council, LSCB Young Peoples Advisory Forum and CLA Voice.

Cumbria Local Offer: A signposting service for parents/carers and their children with special educational needs and/or disabilities (SEND), to information about provision that they expect to be available across education, health and social care for children and young people with SEND.

Assertive Alcohol Outreach Workers providing Direct individual and family intervention following referral rom A & E/police.

2.5.4 Voluntary and Community Sector

Cumbria’s varied and skilled third sector, comprising 65 organisations, working alongside health and social care, offering direct provision, training, advocacy and other services, and fore-fronting the ‘voice’ for local young people.

A network of over 400 youth clubs can be found throughout the county e.g. Young Farmers, faith groups, leisure and sports clubs, interest groups.

Targeted third sector support services include: Self-harm Awareness for All (SAFA) Cumbria, Cumbria Alcohol and Drug Advisory Service (CADAS), Cumbria DeafVision, Creative Futures Cumbria, Carlisle Mencap, Inspira, Carers and Young Carers Services, West Cumbria Rape Crisis NACRO, East Cumbria Family Support (ECFSA) Families Matter, East Cumbria Family Support (ECFSA), Mind, Guide Dogs for the Blind, PAC Therapy Service, Safety Net Advice and Support Centre, Brathay Trust.

Key organisations that support the youth network:

o Cumbria CVS (Cumbria Council for Voluntary Service)

Offers help, advice, training and support to third sector groups throughout Cumbria. It supports the CYP VCS Reference Group.

o Cumbria Youth Alliance

CYA offers infrastructure support to and is a key sign-posting organisation for young people, workers, organisations, parents and carers, with over 90 organisations as members from all over Cumbria. They also support young people (primarily aged 12-25) through the direct delivery of goods and services. They also run projects which young people can access to further their skills and increase their employability.

o Young Cumbria

Young Cumbria is an umbrella organisation that provides guidance, information and development support services to youth clubs/projects/groups based in Cumbria as well as direct delivery of youth work within the most disadvantaged communities in the county. Supports over 100 community youth groups across Cumbria with over 800 volunteers and 5000 young people between the ages of 8-25 benefitting. They also have a residential centre on Derwent water.