Nestor Primecare Services Ltd

Overall effectiveness Requires improvement

Effectiveness of leadership and management Requires improvement

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Overall effectiveness Requires improvement

Quality of teaching, learning and assessment Requires improvement

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Overall effectiveness Requires improvement

Personal development, behaviour and welfare Requires improvement

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Overall effectiveness Requires improvement

Outcomes for learners Requires improvement

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Overall effectiveness Requires improvement

Overall effectiveness at previous inspection Requires improvement

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This is a provider that requires improvement

 Too few apprentices remain on programme or achieve their qualifications within the expected timeframe.  Trainers and assessors do not routinely and systematically promote the development of apprentices’ English and mathematics skills in classroom and workplace sessions.  Communication between trainers, assessors and service managers is not sufficiently cohesive to allow the fine-tuning of training programmes to meet apprentices’ individual needs.  Quality assurance and quality improvement arrangements, including the observation of teaching and learning, have not resulted in sufficient improvements since the previous inspection.  Trainers and assessors are not yet sufficiently skilled or confident in teaching apprentices how to identify signs of, and protect themselves from, radicalisation and extremism.  Leaders and managers do not plan for, or monitor, progression sufficiently well.  Teachers and support staff do not use the results

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This is a provider that requires improvement

of their assessment of learners’ starting points well enough to plan learning and training effectively.

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This is a provider that requires improvement

 The content of the apprenticeship programme matches closely the requirements of the care sector and the career aspirations of care workers.  Current apprentices enjoy learning, demonstrate good standards of behaviour and adopt positive attitudes to their work.  Apprentices develop good vocational and employability skills and have good opportunities for promotion to higher-paid roles.  Apprentices’ first-time pass rates in functional skills English are high.  Learners have a good understanding of safe working practices and know how to keep themselves safe.

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Information about the provider

 Nestor Primecare Services Limited, recently purchased by the Aurelius investment group, trades as Allied Healthcare. It is one of the country’s largest providers of domiciliary healthcare staff with over 100 branches nationwide. The company holds contracts with Clinical Commissioning Groups (CCGs) in the geographical areas within which it operates.  The company employs around 14,000 people, including care and support staff and registered nurses. Apprentices account for approximately 400 of the company’s employees. Almost all apprentices are adults studying programmes in health and social care, with just over half at intermediate level and the remainder at advanced level. A few apprentices are studying administration and business management programmes at intermediate and advanced levels.

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What does the provider need to do to improve further?

 Review arrangements for the coordination of service delivery, training, and apprenticeship programme management to enable effective information sharing. Ensure all staff understand the contribution they make towards ensuring apprentices are able to make the rapid progress of which they are capable and achieve within the expected timeframe.  Review quality improvement arrangements, including the observation of teaching, learning and assessment, to ensure that further improvements are made to the quality of provision.  Rapidly improve the quality of English and mathematics training and support by: – ensuring all staff have the confidence and skills to support apprentices’ English and mathematics development – ensuring all staff consistently reinforce the importance of English and mathematics in all aspects of apprentices’ work, especially in their written work – enabling apprentices to complete external tests in English and mathematics earlier in their programme

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What does the provider need to do to improve further?

so they have a better chance of achieving the full framework within the expected timeframe.  Thoroughly review the arrangements for information, advice and guidance that apprentices receive to ensure they have the opportunity to continue their studies when contracts change and when they leave the company.  Rapidly improve the retention of apprentices by: – ensuring all apprentices are fully aware of the commitments of the programme and the time it will take to complete successfully – ensuring that managers are aware of the importance of supporting apprentices to complete their training in a timely manner – motivating apprentices to complete their training through high-quality teaching, learning and assessment, including the development of the key personal and social skills that will enable them to advance their careers – ensuring trainers and assessors use the results of initial assessments, including apprentices’ personal

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What does the provider need to do to improve further?

and social needs, to plan learning – ensuring that learners have detailed and clear short- and medium-term learning targets, so that they are aware of the progress they are making and can plan their work.  Ensure that trainers and assessors receive urgent training in how to teach apprentices how to identify the signs of radicalisation and extremism, including what apprentices need to do to keep themselves and their clients safe from such risks.

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Effectiveness of leadership and management requires improvement

 Leaders and managers have brought about improvements in the majority of the key areas for improvement identified at the previous inspection. However, these have yet to have sufficient impact on the quality of teaching, learning and assessment and on the outcomes for apprentices for the provision to be good.  Leaders and managers have insufficient knowledge and understanding of apprentices’ destinations. The destination of the majority of early leavers is unknown. Learners who leave the company as a result of local authorities deciding to contract with providers other than Nestor do not receive information and guidance to help them complete their framework with their new employer.  The self-assessment report and quality improvement plans, although broadly accurate, do not give sufficient weight to poor retention of apprentices and the impact of the late introduction of a strategy to promote achievement in functional skills. The use of data to support judgements is weak. Self-assessment

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Effectiveness of leadership and management requires improvement

grades are too generous and many of the judgements in the report fail to distinguish sufficiently the quality of provision received by apprentices.  Managers regularly observe all trainers. However, observation reports are too generous in their judgements and describe processes too much with insufficient focus on the impact of the trainer on effective learning. Action plans arising from observation reports are generally too brief and insufficiently challenging to enable trainers to make appropriate progress.  Leaders and managers have been slow to implement improvements in the development of apprentices’ English and mathematics skills. While the number of apprentices who achieve their qualifications has increased, leaders and managers accept that more work is needed to bring about further improvements. Managers’ strategy for developing apprentices’ achievement of functional skills is appropriate. Managers

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Effectiveness of leadership and management requires improvement

have recently appointed a specialist functional skills team, although it is too soon to judge the impact of this initiative on current apprentices’ experience.  Leaders’ and managers’ use of data has improved since the previous inspection and is effective, although it is not used well in the self-assessment report. Senior leaders now use data on the progress apprentices make more effectively to monitor the quality of provision and hold managers to account. They use the data presented at monthly meetings to ensure apprentices are making the progress expected as well as reviewing the effectiveness of recruitment to the apprenticeship programme, budgeting and resourcing. The meetings also help to steer the company’s approach to developing the apprenticeship programme.  Leaders and managers have ensured appraisal and performance management arrangements are generally effective in challenging staff at all levels to meet the company’s expectations for apprentices. Managers

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Effectiveness of leadership and management requires improvement

take appropriate actions to deal with underperforming staff and help them to improve their practice. The company provides a good range of in-house training and development in domiciliary care for all staff who are encouraged to enrol on apprenticeship programmes. Links between branch managers, training staff and the apprentice coordinator are not clear and do not promote effective joint planning.  Leaders and managers provide clear strategic direction for the company. Managers and staff at all levels are able to articulate the company’s mission to provide high-quality domiciliary care for vulnerable adults, many of whom suffer from mental ill-health, terminal illness or physical disability. Senior managers have high expectations of their staff and are particularly committed to helping staff to learn new skills and to develop a career in the field of domiciliary care. They provide good opportunities for staff to seek

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Effectiveness of leadership and management requires improvement

promotion and to further their career within the company.  Partnership arrangements are effective and include collaborative arrangements with a large number of local authorities and local enterprise partnerships across the country. Leaders are keen to build on the reputation of Allied Health Care and engage well in joint working with National Health Service Trusts to bring about improvement in the care sector. Leaders and managers have used their extensive knowledge of the care industry to ensure that the range of provision meets national and local needs well. The company is currently at an advanced stage in its plan to extend the apprenticeship programme to learners aged 16 to 18, and to develop and offer career pathways in the health care industry.  Leaders and managers at all levels have improved the promotion of equality and diversity through staff training and innovative projects such as ‘Dementia Friends’ which now has 1,300 members across the

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Effectiveness of leadership and management requires improvement

organisation; they ensure that apprentices have a good understanding of the diverse needs of clients.  The governance of the provider – The head of learning and development provides appropriate support and challenge for the apprenticeship manager through monthly performance management meetings. – The company’s board of directors receive regular reports on the performance of the learning and development team. However, they do not receive specific reports on the performance of the apprenticeship programme, including results of observations of teaching and learning; this limits their ability to provide high-level scrutiny and challenge.  The arrangements for safeguarding are effective – All staff have received appropriate training. Designated officers are in place. Learners understand who they can talk to if they feel unsafe or threatened. – All staff who come into contact with clients are required to undergo stringent checks on their suitability

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Effectiveness of leadership and management requires improvement

for work in the sector, and managers do not allow any employee to begin work until they have received evidence of their suitability. – Senior managers acknowledge that the company is still in the early stages of implementing the ‘Prevent’ duty in full. Trainers and assessors have had basic training in the subject but they need more training before they are able to reinforce apprentices’ understanding of the risks of extremism and radicalisation confidently.

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Quality of teaching, learning and assessment requires improvement

 Assessors do not plan for the delivery of apprenticeship programmes effectively enough to ensure all apprentices make the progress of which they are capable. Too many assessors do not gather a broad enough range of evidence to confirm apprentices’ understanding and are over-reliant on the completion of workbooks. While assessors ensure that awarding body requirements are met, they do not routinely encourage apprentices to extend their knowledge beyond the qualification and develop a deeper understanding of the subject or develop their broader thinking skills.  Assessors provide good support to help apprentices overcome personal and social problems which cause barriers to their learning. However, the majority of assessors do not make good enough use of the information gathered from the assessment of apprentices’ starting points, including the assessment of their personal and social development needs. As a result, apprentices’ individual needs and interests are

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Quality of teaching, learning and assessment requires improvement

not considered sufficiently when determining the length of programmes and when setting short- and longer- term targets. Consequently, too many apprentices do not receive an appropriate level of challenge to help them learn, develop new skills and make the progress of which they are capable.  Trainers and assessors do not consistently reinforce the development of English and mathematics skills during training and assessment activities. Trainers and assessors do not focus sufficiently on identifying areas for improvement in apprentices’ written work. As a result, the quality of apprentices’ written work, though improving, is not yet as good as their practical work.  In the North of England Region, too many apprentices do not receive good enough support to help them learn and gain confidence. In practical assessments and in progress review meetings, assessors do not do enough to promote apprentices’ spelling, grammar, punctuation and numeracy skills to help them

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Quality of teaching, learning and assessment requires improvement

improve their work.  Most assessors check apprentices’ completed work frequently for progress and provide good verbal feedback with a good level of encouragement; this motivates apprentices and helps them to improve their skills. However, too many assessors do not provide apprentices with sufficiently detailed written feedback to help them improve their work. In addition, assessors do not consistently ensure that apprentices’ managers attend meetings to plan learning and review progress. As a result, apprentices’ managers are not sufficiently involved in the targets set for apprentices to ensure they make rapid progress.  Assessors promote apprentices’ understanding of equality and diversity effectively in reviews and during observations of their work. For example, assessors ensure that apprentices plan care packages for clients, which promote independence and recognise their level of vulnerability.

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Quality of teaching, learning and assessment requires improvement

 Assessors have a good range of relevant experience and qualifications, which they use well to ensure apprentices develop good practical skills across a range of caring roles, including dementia care, personal care, learning disability and re-enablement with people of all ages, including children.  Trainers and assessors develop well apprentices’ understanding of safe working practices, and safeguarding clients is rightly a high priority for all apprentices.

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Personal development, behaviour and welfare requires improvement

 Information, advice and guidance for apprentices while on programme and when they leave employment are not well coordinated. Trainers, assessors and managers do not plan for apprentices’ progression. As a result, apprentices do not receive sufficiently detailed advice and guidance on their next steps when they leave the company.  Induction for new care workers is comprehensive and covers all key aspects of the knowledge and skills needed to work in the sector through well-presented materials and support from experienced staff. However, trainers and assessors do not use information gathered during the assessment of learners’ starting points to develop the personal and social needs of apprentices sufficiently well. Where identified, these are largely related to apprentices’ English and mathematics achievements.  Apprentices are confident in their skills and abilities and take pride in their work. For example, they are

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Personal development, behaviour and welfare requires improvement

proud to have made a career choice to enter the care sector from other industries and value the rewards gained from working in domiciliary care. Apprentices can confidently articulate the positive difference they make to the lives of their clients and they strive to reach the highest standards of intimate care. They develop good employability skills, demonstrating a responsible and mature attitude to their work, as evidenced by the sensitive way they communicate with vulnerable or elderly and infirm clients.  Apprentices are safe and feel safe. They demonstrate safe working practices well and apply the company’s lone worker policy to protect themselves when working in isolation or late at night or when visiting clients in their homes. However, apprentices’ understanding of how to protect themselves from extremism and radicalisation is not yet sufficiently good.  Approximately half of all apprentices complete additional qualifications and training through a good range

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Personal development, behaviour and welfare requires improvement

of enrichment opportunities linked to their job roles. For example, learners can attend detailed training programmes on dementia care and on procedures for dispensing medication. Managers have also recently implemented a much wider range of additional online training. However, it is too early to determine how well these resources have extended apprentices’ understanding.

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Outcomes for learners require improvement

 The proportion of apprentices completing their programmes within planned timescales has improved but remains low. The number of apprentices who leave the company before completing their qualification is too high and contributes significantly to the low overall success rates on the apprenticeship programme.  The progress that apprentices make has improved since the previous inspection but is not yet consistently good. The provider’s own data for 2015/16 indicate that the number of apprentices who have already completed has increased considerably although still remains below that of other providers nationally. Apprentices who complete their qualifications are more likely to continue working for the company than their non-apprentice colleagues.  The proportion of apprentices who achieve their functional skills qualifications in English and mathematics is improving. The number of apprentices who pass the external tests at the first attempt is now high,

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Outcomes for learners require improvement

especially in English at level 1 and 2 and in mathematics at level 1. However, the proportion of apprentices who achieve their mathematics qualifications at level 2 remains low and requires further improvement. The practice in a few centres of apprentices studying for their functional skills towards the end of their apprenticeship does not help them to complete the framework within the planned period of study.  Apprentices on care and team-leading programmes develop good vocational skills through their work and training. Care apprentices write good-quality care plans that place the client at the centre of decision- making. These plans promote independent living, such as enabling clients to decide what to wear, how to spend their time and what meals they want to prepare. Level 3 apprentices on team-leading qualifications use their skills well to schedule the staff for whom they are responsible to meet the needs of supported-

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Outcomes for learners require improvement

living clients.  No significant differences exist in outcomes for male and female apprentices. Outcomes for the few apprentices who declare a disability are higher than for those who do not declare a disability.

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full contract year

Principal/CEO Gerhart Engleder Website address www.alliedhealthcare.com

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Intermediate Advanced Higher

16-18 19+ 16-18 19+ 16-18 19+ 10 214 0 193 0 0 Number of traineeships 16-19 19+ Total 0 0 0 Number of learners aged 14-16 None

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Intermediate Advanced Higher

Funding received from Skills Funding Agency (SFA)

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Inspection team

Mr Shane Langthorne, lead inspector Her Majesty’s Inspector Mr Jai Sharda Her Majesty’s Inspector Dr Daniel Grant Ofsted Inspector Ms Kathryn Townsley Ofsted Inspector Ms Maureen Deary Ofsted Inspector

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Inspection team

The above team was assisted by the head of learning and development as nominee. Inspectors took account of the provider’s most recent self-assessment report and development plans, and the previous inspection report. Inspectors used group and individual interviews, telephone calls and online questionnaires to gather the views of students and employers; these views are reflected within the report. They observed learning sessions, assessments and progress reviews. The inspection took into account all relevant provision at the provider. guidance ‘Raising concerns and making complaints about Ofsted’, which is available from Ofsted’s website: www.ofsted.gov.uk If you would like Ofsted to send you a copy of the guidance, please telephone 0300 123 4234 , or email enquiries@ofsted.gov.uk .

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Inspection team

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Inspection team

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Inspection team

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Inspection team

T: 0300 123 4234 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.ofsted.gov.uk Learner View is a website where learners can tell Ofsted what they think about their college or provider. They can also see what other learners think about them too.

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Inspection team

To find out more go to www.learnerview.ofsted.gov.uk

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Inspection team

Employer View is a new website where employers can tell Ofsted what they think about their employees’ college or provider. They can also see what other employers think about them too.

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Inspection team

To find out more go to www.employerview.ofsted.gov.uk

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