Setting

11 May 2006

26/05/2006 11:03:49 26/05/2006 11:03:49 HEREFORDSHIRE NHS PRIMARY CARE TRUST

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Adult Learning Inspectorate

The Adult Learning Inspectorate (ALI) was established under the provisions of the Learning and Skills Act 2000 to bring the inspection of all aspects of adult learning and work-based learning within the remit of a single inspectorate. The ALI is responsible for inspecting a wide range of government-funded learning, including:

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Adult Learning Inspectorate

• work-based learning for all people aged over 16 • provision in further education colleges for people aged 19 and over • learndirect provision • Adult and Community Learning • training funded by Jobcentre Plus • education and training in prisons, at the invitation of Her Majesty's Chief Inspector of Prisons • adult information, advice and guidance services ( nextstep ).

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Adult Learning Inspectorate

Inspections are carried out in accordance with the Common Inspection Framework by teams of full-time inspectors and part-time associate inspectors who have knowledge of, and experience in, the work which they inspect. All providers are invited to nominate a senior member of their staff to participate in the inspection as a team member.

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Pre-inspection analysis

The resources allocated to a cycle 2 inspection are primarily determined by the findings from the previous inspection. Account is also taken of information about achievement and retention obtained from the funding body, and any significant changes in the size or scope of the provision.

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Pre-inspection analysis

Where a provider has received good grades in cycle 1, the cycle 2 inspection is relatively light. If the provider offers a number of areas of learning, a restricted sample is inspected.

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Pre-inspection analysis

Where a provider has received satisfactory grades in cycle 1, the cycle 2 inspection is less intensive and it is possible that not all areas of learning are included.

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Pre-inspection analysis

Where there are significant unsatisfactory grades from cycle 1, the intensity of the cycle 2 inspection is broadly the same as cycle 1, and all significant areas of learning are inspected.

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Pre-inspection analysis

Providers that have not previously been inspected will receive a full inspection.

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Overall effectiveness

The grades given for areas of learning and leadership and management will be used to arrive at a judgement about the overall effectiveness of the provider.

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Overall effectiveness

An outstanding provider should typically have leadership and management and at least half of the areas of learning judged to be a grade 1. All area of learning grades will be graded 1 or 2.

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Overall effectiveness

A good provider should have leadership and management and at least half of the area of learning grades judged to be a grade 2 or better. A good training provider should not have any grade 4s, and few grade 3s in the areas of learning.

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Overall effectiveness

A satisfactory provider should have adequate or better grades in leadership and management and in at least two thirds of the area of learning grades. An adequate provider might have a range of grades across areas of learning, some of which might be graded 4.

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Overall effectiveness

Provision will normally be deemed to be inadequate where more than one third of the area of learning grades and/or leadership and management are judged to be inadequate.

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Overall effectiveness

The final decision as to whether the provision is inadequate rests with the Chief Inspector of Adult Learning. HEREFORDSHIRE NHS PRIMARY CARE TRUST

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Grading

Inspectors use a four-point scale to summarise their judgements about the quality of provision in occupational/curriculum areas and Jobcentre Plus programmes, as well as to summarise their judgements about the quality of learning sessions. The same scale is used to describe the quality of leadership and management, which includes equality of opportunity and quality assurance. The descriptors for the four grades are:

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Grading

• grade 1 - outstanding • grade 2 - good • grade 3 - satisfactory • grade 4 - inadequate

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Summary

Description of the provider 1 Overall effectiveness 1 Key challenges for Herefordshire NHS Primary Care Trust 2 Grades 2 About the inspection 2 Key Findings 3 What learners like about Herefordshire NHS Primary Care Trust 6 What learners think Herefordshire NHS Primary Care Trust could improve Leadership and management 7

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Summary

7 Leadership and management Equality of opportunity 8 Quality improvement 9 Health, public services and care 10

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DESCRIPTION OF THE PROVIDER

1. Herefordshire NHS Primary Care Trust (HPCT) training centre is part of the local National Health Service (NHS). It provides work-based and other training for employees of the trust and other organisations that operate mainly in the health and social care sectors, such as dental practices, nursing homes, residential care homes and early years settings. The training centre operates from two sites. The Thorn training centre on the outskirts of Hereford has a computer suite, offices and a number of training rooms where health and social care learners and skills for life team are based. Skills for Life is the government’s strategy on training in literacy, numeracy and the use of language. The site closer to the town centre accommodates the foundation programmes. HPCT has a contract with Herefordshire and Worcestershire Learning and Skills Council (LSC) to provide apprenticeships in business administration, retailing, early years care and education, oral

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DESCRIPTION OF THE PROVIDER

health programmes for dental nurses and entry to employment (E2E) programmes. It also has a contract with Jobcentre Plus to provide vocational training, jobsearch and support services for substance misusers and a specialist mentoring programme for New Deal participants. In addition, HPCT provides training directly for the NHS trust and for a number of other organisations on a commercial basis.

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DESCRIPTION OF THE PROVIDER

2. There are 146 learners on the inspected programmes of whom 65 are advanced apprentices, 74 are apprentices, and seven are working towards national vocational qualifications (NVQs) only. All advanced apprentices and most of the apprentices are employed.

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Grade 2

3. The overall effectiveness of the provision is good. HPCT’s leadership and management are outstanding. The arrangements for quality improvement and equality of opportunity are good. The provision in health, public services and care is good.

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Grade 2

4. The inspection team was broadly confident in the reliability of the self-assessment process. The most recent self-assessment report is the sixth produced by HPCT. Each has been developed following an in-depth evaluation within each department by staff and includes the views of employers and learners. The current self-assessment report is supported by a comprehensive action plan. It focuses appropriately on significant issues affecting learners. Inspectors agreed with most of the strengths and weaknesses in the report.

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Grade 2

5. The provider has demonstrated that it is in a good position to make improvements. HPCT has improved the retention and achievement rates since the previous inspection. The organisation has produced very effective self-assessment reports and development plans that focus on dealing with the weaknesses identified during previous inspections and maintaining the strengths.

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Grade 2

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TRUST:

maintain the high standards of training • maintain the particularly good support for learners • maintain the good strategic and operational management • improve the capacity to monitor equality of opportunity • share good practice across the provision in basic skills •

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GRADES

grade 1 = outstanding, grade 2 = good, grade 3 = satisfactory, grade 4 = inadequate

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Leadership and management 1

Contributory grades: Equality of opportunity 2 Quality improvement 2

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Health, public services and care 2 Health, public services and care

Contributory areas: Number of learners Contributory grade Dental Apprenticeships for young people 31 3 Social care Apprenticeships for young people 71 2 Early years Apprenticeships for young people 44 1

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ABOUT THE INSPECTION

6. The area of learning inspected was health, public services and care with contributory grades for early years, social care and dental nursing. Business administration and retailing programmes, and foundation programmes were not included in this inspection.

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ABOUT THE INSPECTION

Number of inspectors 4 Number of inspection days 12 Number of learners interviewed 38 Number of staff interviewed 43 Number of employers interviewed 10 Number of locations/sites/learning centres visited 11

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ABOUT THE INSPECTION

2 © 2006 ADULT LEARNING INSPECTORATE HEREFORDSHIRE NHS PRIMARY CARE TRUST

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Achievements and standards

7. Achievement rates on social care and early years programmes are good and improving. Retention rates on the dental programmes were poor but are improving. Achievement rates are satisfactory.

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Achievements and standards

8. The standard of learners work is generally good in the social care programmes with good practical skills acquisition and a good knowledge of care standards. The standard of learners work in dental and early years programmes is satisfactory. In the early years programme, learners have well organised and presented portfolios.

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The quality of provision

9. Teaching and learning are good. There is a wide range of training available in the care programme linked to clear assessment planning and target-setting.

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The quality of provision

10. There is too much use of written evidence in the assessment of learners on the

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dental programme and initial assessment is not used to carry out teaching and learning

11. Off-the-job training is good. Planning is well organised with schemes of work, session outlines and lesson plans. The dental programmes are enhanced through the use of relevant outside speakers. There is a wide range of training opportunities in social care.

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dental programme and initial assessment is not used to carry out teaching and learning

12. Support for learners is good. Learners have good access to assessors. There is good pastoral and vocational support for learners on the cadet nursing programmes. Visits are frequent and there is good target-setting and monitoring of performance. L d hi d

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Leadership and management

13. The programmes are well managed. Staff in all areas have very effective working relationships with employers. Strategic planning is excellent and makes effective use of management information. Staff receive very good support and are well qualified. Staff appraisal is comprehensive and up to date with good opportunities for continuing professional development.

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Leadership and management

14. Staff have a clear understanding of their roles and responsibilities. The needs of the learner are fundamental to the organisation. Work placements are well managed, as is the management of resources and finance.

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Leadership and management

15. There is a very effective range of strategies to widen participation and recruit learners from under-represented groups. The training centre manager sits on a wide variety of groups to identify training needs in the local community. The equality of opportunity strategy is detailed with a related action plan. However, there is insufficient monitoring of

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the action plan and there is no evidence of monitoring of equality of opportunity in the

16. There is very effective implementation of procedures to improve quality. The

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the action plan and there is no evidence of monitoring of equality of opportunity in the

3 © 2006 ADULT LEARNING INSPECTORATE HEREFORDSHIRE NHS PRIMARY CARE TRUST

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the action plan and there is no evidence of monitoring of equality of opportunity in the

systems are detailed and reviewed systematically each year. The monitoring of performance is comprehensive and is applied rigorously. Each department completes a critical internal review which forms the basis of the effective self-assessment process. L d hi d

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Strengths

excellent strategic management 00 • particularly good partnership work 00 • very strong leadership and management 00 • good training and support for staff 00 • very effective strategies for widening participation 00 • very good support and facilities for learners with disabilities and additional needs 00 • very effective procedures to improve quality 00 •

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Weaknesses

insufficient monitoring of the equality of opportunity strategy and action plan 00 •

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Dental

Strengths very good off-the-job training 00 • effective strategies to improve provision 00 • Weaknesses too much use of written evidence 00 • insufficient use of initial assessment to carry out teaching, learning and assessment 00 •

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Social care

Strengths good achievement rates 00 • good teaching and learning 00 • good support for learners 00 • good management of training 00 • Weaknesses no significant weaknesses identified 00 •

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Social care

4 © 2006 ADULT LEARNING INSPECTORATE HEREFORDSHIRE NHS PRIMARY CARE TRUST

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Early years

Strengths very good achievement rates in 2004-05 00 • well planned off-the-job training 00 • very good support for learners 00 • particularly good working relationships with employers 00 • excellent leadership and management 00 • very good integration and promotion of equality and diversity 00 • Weaknesses inappropriate delivery of application of number key skills 00 •

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Early years

5 © 2006 ADULT LEARNING INSPECTORATE HEREFORDSHIRE NHS PRIMARY CARE TRUST

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CARE TRUST:

the friendly and approachable staff • ’working at my own pace’ • ’nice to start learning again and doing something worthwhile’ • training days - ’we learn something every time we attend’ • combining college with work •

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TRUST COULD IMPROVE:

the amount of individual time with tutors • the time spent at college • the relevancy of key skills to early years training •

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TRUST COULD IMPROVE:

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Strengths

excellent strategic management • particularly good partnership work • very strong leadership and management • good training and support for staff • very effective strategies for widening participation • very good support and facilities for learners with disabilities and additional needs •

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Strengths

very effective procedures to improve quality •

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Weaknesses

insufficient monitoring of the equality of opportunity strategy and action plan •

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Weaknesses

17. Strategic planning is excellent. HPCT has a three-year development plan that contains a clearly stated mission statement. The annual business plan outlines a vision statement and objectives for the year set out as performance targets. These targets are monitored closely throughout the year and reviewed at the senior management meetings. The strategy aims to meet local needs and there are strong links with the community. Retention and achievement rates are showing a consistent trend of improvement and are generally good.

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Weaknesses

18. Partnership work is particularly good. The training centre manager is on the board of many local organisations and this enables the identification of the most appropriate type of provision and the best way in which HPCT can provide it. As well as meeting local community needs the strategy takes account of LSC priorities. For example, as part of the government 14-16 vocational alternative to general certificates of secondary education HPCT offers pupils the chance to complete foundation certificate awards leading to advanced awards. These learners can then progress to complete a cadet programme or stay in school to study towards A levels.

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Weaknesses

19. Leadership and management are very strong. The roles and responsibilities of all staff are clear and well understood. A culture aimed at providing the best possible service to learners is fundamental to the organisation. The organisation and planning of the programmes are very good. Work placements are well managed and progress reviews are thorough and effective. Management of resources is good. Financial management is good and is reviewed at the senior management meeting. Management information data is readily available and is used effectively for management decisions over strategy and operational issues. The area not included in this inspection accounts for 30 per cent of the provision. It was looked at before the main inspection by the lead inspector and the work seen was outstanding.

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Weaknesses

7 © 2006 ADULT LEARNING INSPECTORATE HEREFORDSHIRE NHS PRIMARY CARE TRUST

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Weaknesses

20. Staff at HPCT are well supported and have good access to training. The new staff appraisal system has been fully implemented and is very thorough. Each member of staff has been reviewed and there is good target-setting within the staff appraisal. In-house and external training is readily available to maintain professional qualifications and further continuing professional development. Staff are allowed time off to complete this training which is financed by HPCT. The impact of this training is assessed and used for the appraisal process. Wherever possible this training is shared with other staff. Staff are supported in a variety of ways, such as flexible working, which includes working from home with the support of resources such as laptop computers. Help with childcare is available and there is rapid access to HPCT’s occupational health facilities. Staff are well informed and there is frequent contact with the training centre manager. The meeting

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Weaknesses

structure promotes good communication and meetings are well recorded with timely action points identifying the staff member responsible. The staff handbook is very comprehensive and the induction is thorough and well planned and monitored.

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Equality of opportunity Contributory grade 2

21. HPCT has developed a good range of very effective strategies to widen participation and recruit learners from under-represented groups including E2E learners and travelling families. All learners who apply for care provision are enrolled and are put on an appropriate course at an appropriate level. The centre manager sits on a wide variety of groups including a vulnerable young persons working group for 14-19 year olds, and a disabilities and difficulties sub-group. Through this work HPCT has developed work in schools in care and early years. HPCT also has a joint programme with Mencap and it is hoped that some of the learners on that programme will progress to apprenticeships. In care, HPCT runs a cadet scheme that enables school leavers with no formal qualifications to prepare for higher education nurse training by fast-tracking the apprenticeship programme. Learners have a good awareness of equality of opportunity and there is good

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Equality of opportunity Contributory grade 2

monitoring of equality of opportunity in the workplace.

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Equality of opportunity Contributory grade 2

22. Good support is provided for learners with disabilities, and those requiring additional learning support. The training centre has very good access for learners with mobility difficulties. The building is on one level and the training rooms are spacious with wide doors. All learners complete an initial assessment and those requiring additional support in early years and care receive it from specialist tutors and their assessors, many of whom have basic skills qualifications. At least one learner with dyslexia has had excellent support and achieved her level 2 and 3 in early years. In care there has been very good support for a learner who speaks English as an additional language. Staff have access to the NHS interpretation service. Leaflets in Braille and Polish have been developed by the centre.

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Equality of opportunity Contributory grade 2

23. Staff training is satisfactory. All staff complete mandatory training in equality and diversity every three years. More recent training includes a presentation by the LSC on the Disability Discrimination Act 1995, attended by eight members of staff. Child protection training has been slow to be put in place as there is no such training available in the local area. However, it is planned that all staff will complete this necessary training by July this year.

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Equality of opportunity Contributory grade 2

24. HPCT has a detailed equality and diversity strategy and an action plan. The strategy is very detailed with clearly defined goals. There is a policy and range of procedures to support the strategy including a policy for harassment and bullying. The action plan directly links to the goals set out in the strategy. However, there is no systematic

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Equality of opportunity Contributory grade 2

8 © 2006 ADULT LEARNING INSPECTORATE HEREFORDSHIRE NHS PRIMARY CARE TRUST

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Equality of opportunity Contributory grade 2

monitoring of the action plan. Some actions have been signed off, but it is not always clear when this has happened. For other actions there is no information on progress. The equality and diversity group has it in its terms of reference to monitor the action plan, but there is very little evidence of this happening. Senior management team meetings do not have equal opportunities as a standing agenda item. No relevant issues are recorded and there is no evidence of monitoring of the action plan in these meetings. HPCT analyses its data on applicants to identify ethnicity, gender and disability but there is no record of what happens following this analysis.

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Quality improvement Contributory grade 2

25. HPCT has put into place very effective procedures to improve quality. The quality assurance systems and procedures are detailed and reviewed systematically each year within each department. Internal verification is now well planned and effective and on- and off-the-job training is now co-ordinated well. Quality monitoring systems are effective and there is a high level of staff accountability. All paperwork is detailed and specifies responsibilities and there is a schedule to ensure that procedures are systematically checked and updated.

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Quality improvement Contributory grade 2

26. The monitoring of performance is comprehensive and is applied rigorously. A comprehensive system for evaluating the quality of every aspect of the provision is now established. Staff in each area of the organisation, including administration and finance, complete a self-assessment and grade their performance against a set of quality criteria appropriate for that area. Grades and proposed actions are then discussed with the training centre manager and agreed. These actions are then developed into strengths and weaknesses that feed into the action plan for that area. These action plans are collated and used to produce the overall self-assessment report. The quality committee is well established and meets monthly to review the quality of provision and also to keep HPCT up to date with any external changes in the quality agenda. Members of the quality committee sit on various quality committees in the trust. There is a detailed quality

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Quality improvement Contributory grade 2

assurance strategy supported by procedures for all key areas of work such as assessment, internal verification, appeals and progress reviews. Master copies of these are maintained on the intranet to ensure that they are up to date.

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Quality improvement Contributory grade 2

27. Lesson observations have now taken place for most staff and these are graded for most departments. These are planned within each department and the feedback is used to improve tutor performance. This information is not analysed centrally to provide an overview of the quality of teaching and learning. Learner and employer feedback are collected annually by questionnaire, but many are not returned. A new interview form for feedback has been designed to remedy this. Learners also give feedback on courses after the completion of subject areas so that areas for improvement can be speedily identified.

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Quality improvement Contributory grade 2

28. The self-assessment report is combined with the business plan to produce a comprehensive evaluation and planning document. The self-assessment report is supported by a comprehensive action plan with clear actions, responsibilities and timescales. Strengths and weaknesses are evaluative and realistic.

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Quality improvement Contributory grade 2

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Health, public services and care Grade 2

0.00 Number of learners Contributory areas: Contributory grade Dental Apprenticeships for young people 31 1 3 Social care Apprenticeships for young people 71 1 2 Early years Apprenticeships for young people 44 1 1

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Health, public services and care Grade 2

29. There are currently 146 learners on work-based learning programmes for young people in care, early years and education, and oral health. There are 71 learners on social care programmes, of whom 17 are advanced apprentices and 54 are apprentices. Learners are placed in residential and nursing homes. There are six learners from a minority ethnic group and five male learners. There are five full-time care staff, two part-time care staff and vacancies for two full-time staff. All staff are involved in teaching and assessing learners at work and are appropriately qualified as teachers, assessors and internal verifiers, as well as vocationally qualified as nurses and carers.

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Health, public services and care Grade 2

30. There are 44 early years learners, of whom 23 are advanced apprentices and 20 are apprentices. The remaining early years learner is working towards an NVQ at level 2. Of these learners, 41 are women and none is from a minority ethnic group. Early years learners are recruited each year in September. There are currently eight staff in the early years care and education team. Three staff share the off-the-job tutoring and have a relevant teaching qualification in addition to their professional early years or care qualifications, and assessor and internal verifier awards. Early years learners are employed or placed in private and community-run nurseries.

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Health, public services and care Grade 2

31. All advanced apprentices are employed. For most learners, off-the-job training for technical certificates, the NVQ and key skills is provided at the Thorn training centre. Apprentices attend off-the-job training on a weekly basis for a full day. Employed apprentices attend a weekly four-hourly session during the late afternoon and evening. Progress reviews are carried out every 12 weeks in the workplace.

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Health, public services and care Grade 2

32. There are 31 learners working towards a level 3 NVQ in oral healthcare. Two learners are from minority ethnic groups and all learners are women. The programme lasts for 22 months. Seven learners are under 19 years of age and 24 are aged between 19 and 25. In addition to the NVQ, learners are required to pass an external assessment to gain the full dental nurse qualification. All learners are employed in dental practices and their employers train them in most of the practical skills they require. Learners attend off-the-job training sessions for one day a month in Hereford or Worcester. Four part-time assessors are employed to visit learners in the workplace every four weeks. There are also four work-based assessors. A progress review takes place in the workplace every 12 weeks.

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Health, public services and care Grade 2

33. All learners are referred through Connexions, are self-referred, or are recruited through

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Health, public services and care Grade 2

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Dental

Strengths very good off-the-job training 00 • effective strategies to improve provision 00 • Weaknesses too much use of written evidence 00 • insufficient use of initial assessment to carry out teaching, learning and assessment 00 •

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Achievement and standards

34. Learners’ achievements are satisfactory as is the standard of their work. Learners make steady and satisfactory progress.

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Achievement and standards

35. Retention was poor during 2003-04. HPTC identified this inadequacy and also the reasons why learners left early without achieving all aspects of their individual learning plan. To make improvements a number of changes to the management and delivery of the programme were introduced nine months before the inspection. These changes included the withdrawal of the full framework qualification. In 2003-04 and 2004-05, 50 per cent of learners achieved the NVQ. These strategies are having a positive effect on learners’ experience and retention has improved. Of the 16 learners who started the programme in 2005-06, 15 are still in learning. There is no data table for dental learners as the data was judged by inspectors to be unreliable.

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The quality of provision

36. Off-the-job training is very good. Planning is comprehensive with schemes of work, session outlines and lesson plans. The programmes are delivered at sites in Hereford and Worcester on different days to provide flexibility of attendance for learners, particularly where there is more than one learner in a workplace. Tutors use a wide range of strategies to engage learners including individual and group work activities, practical sessions and formal presentations. The programme is enhanced by visiting speakers with relevant expertise. A good range of appropriate resources is used. Tutors make good use of questioning to improve learners’ understanding and to reinforce important information. Overall attendance at the training centre is good.

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The quality of provision

37. Progress reviews are satisfactory and carried out regularly. Where additional skills for life support needs have been identified progress reviews take place more frequently. Employers and learners are fully involved in progress reviews and receive a copy of the completed review form. Reviewers take the time to refer to previous set targets and progress made. Discussions with employers include the development of learners’ skills, performance as a team member, and communication skills. Targets for the next period are agreed but targets do not always specifically outline how the actions will be achieved.

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The quality of provision

38. There is too much use of written evidence in the assessment of learners’ knowledge and understanding. Most learners have to complete this work in their own time. Many

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The quality of provision

11 © 2006 ADULT LEARNING INSPECTORATE HEREFORDSHIRE NHS PRIMARY CARE TRUST

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The quality of provision

learners are frustrated by the number of questions that they are expected to answer and many of the questions are repetitive. There is insufficient use of witness testimony and professional discussion.

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The quality of provision

39. Insufficient use is made of initial assessment to carry out teaching, learning and assessment. All learners are required to complete a literacy and numeracy initial assessment. Learners, tutors and assessors are informed of the results. However, tutors and assessors are not informed of the specific issues or how to best support learners. They are unable to consider specific learners’ needs, to integrate appropriate support in the planning and delivery of off-the-job training or when preparing learners for assessment.

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Leadership and management

40. There are effective strategies to improve the provision and the retention and achievement of learners. These strategies were introduced nine months before the inspection and include staff taking up new job roles and additional training. A more formal and structured approach to the learner interview process has been designed. Interviews are carried out by two staff. Learners are made aware of the extent of their role as a dental nurse if they are not already in post or are new to the job role. Learners are informed of the requirements of the range of qualifications that they will be working towards. They are made aware of the expectations HPCT has and also what they can expect of HPCT. Learners are clearly aware of what they are required to do. The programme has been extended from one year to 18 months. This provides flexibility and more time for learners to acquire new knowledge and skills, complete assessments, and prepare for examinations.

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Leadership and management

Off-the-job training has altered from one evening a week to one day a month. Attendance is now very good. A one-hour session of key skills specialist support is included during off-the-job training. Three months before the inspection key skills work books, relevant to specific subjects, were introduced.

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Leadership and management

41. Staffing arrangements are satisfactory. All staff are well qualified and experienced. A wide variety of staff training and development opportunities is available. Arrangements for internal verification are satisfactory. However, there have been some delays in internal verification for learners who started in September 2004. This inadequacy was identified by the internal verifier and arrangements are in place to rectify it. Assessors are observed annually. Assessor standardisation meetings take place regularly. The ratio of assessors to learners is adequate.

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Social care

Strengths good achievement rates 00 • good teaching and learning 00 • good support for learners 00 • good management of training 00 •

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Social care

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Social care

Weaknesses no significant weaknesses identified 00 •

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Achievement and standards

42. There is good achievement in both apprenticeship and advanced apprenticeship frameworks. In 2003-04 and 2004-05, 80 per cent and 78 per cent of advanced apprentices respectively completed their full framework. Of these, 57 per cent completed early or on time in 2003-04 and 17 per cent completed early or on time in 2004-05. Achievement rates for apprentices are 74 per cent and 64 per cent for the same years. All these achievements are well above the national average. There is no data table for social care learners as the data was judged by inspectors to be unreliable.

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Achievement and standards

43. The standard of learners’ work is good. Employers have confidence in the learners’ practical skills at work and their knowledge of care standards.

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The quality of provision

44. The teaching and learning on the care programmes are good. The learning is well planned and key skills and technical certificates are introduced at an appropriate time. All learners are seen in their workplace every two weeks. The teaching of equality of opportunity and diversity is included in all training materials. Learners have access to a wide range of on- and off-the-job training. Employers are informed of training courses available for all learners at the Thorn Training Centre and assessors are aware of training provided in the workplace. Staff keep themselves professionally updated and have a range of professional qualifications and experience. They are supported by a number of specialist professionals who tutor part time on courses or are involved in assessment of practice.

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The quality of provision

45. Support for learners is good in the workplace and at the training centre. Learners have good access to assessors. Those assessed as having literacy and numeracy support needs receive individual support from specialist staff. There is very good pastoral and vocational support for learners on the cadet nursing programme. They are able to fast track the full award to enable them to continue their nursing studies in higher education. This has had an impact on the achievement rates for full apprenticeship frameworks. Learners are also given additional support and coaching to prepare for study at a higher education level.

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The quality of provision

46. Assessment activity is good. Assessors have copies of work rotas and schedules so they know when learners are on duty. They are encouraged by employers to visit learners in the workplace and to carry out observations during working hours. Assessors use a range of assessment methods and there is appropriate use of oral questioning and professional discussion to ensure the learners’ understanding.

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The quality of provision

47. Learners receive frequent visits at work from assessors and trainers, and those on the cadet scheme all have a named buddy in the workplace. Training and assessment are designed to take account of learners’ individual needs and progress reviews are carried out every 12 weeks.

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The quality of provision

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Leadership and management

48. Management of training is very effective. Staff work well together to support the development of the training programme. They have a good understanding of learners’ progress and achievements and ensure that progress reviews are held as planned. Employers are informed of learners’ progress and attendance. Regular meetings are used to standardise teaching and assessment practice and this is shared with work-based assessors. Five members of the care team are also internal verifiers. All assessors are observed and feedback is given to develop their skills. The external verifier’s report is good.

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Leadership and management

49. Communication with employers is effective. Information about the training programme for apprentices and off-the-job training opportunities at the Thorn Centre is sent to employers in the Acute Trust and the independent sector. Equality and diversity training is an integral part of the care programme and staff are very aware of their responsibilities to learners and employers.

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Leadership and management

50. Provider staff together support 15 work-based assessors. The individual ratio between staff and learners remains higher than the provider policy of one to 30. Two staff vacancies have recently been advertised, but staff are aware that learners will not want to change assessor/trainer during the course of their programme so the impact of the workload relief will be slow.

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Leadership and management

51. All staff contribute to the self-assessment process and action plan. They use feedback from learners and employers to help develop and improve the provision.

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Early years

Strengths very good achievement rates in 2004-05 00 • well planned off-the-job training 00 • very good support for learners 00 • particularly good working relationships with employers 00 • excellent leadership and management 00 • very good integration and promotion of equality and diversity 00 • Weaknesses inappropriate delivery of application of number key skills 00 •

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Achievement and standards

52. Achievement rates have improved significantly over the past two years and are now very good. For example, in 2004-05, 75 per cent of advanced apprentices and 86 per cent of apprentices completed their full framework. In 2005-06, all advanced apprentices and 87 per cent of apprentices are still in learning. The standard of learners’ work is satisfactory. They have well-organised portfolios that are well presented and they develop appropriate skills in the workplace. There is no data table for early years learners as the data was judged by inspectors to be unreliable.

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Achievement and standards

14 © 2006 ADULT LEARNING INSPECTORATE HEREFORDSHIRE NHS PRIMARY CARE TRUST

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The quality of provision

53. Off-the-job training is very well planned. Detailed programmes for each learner group are shared with learners and employers. Lesson plans are detailed and identify learning objectives. However, they do not identify how learners’ individual needs will be met during lessons. Tutors use a good range of teaching techniques to ensure lessons maintain learners’ interest. Off-the-job training is planned well to meet employers’ and learners’ individual needs and there are good links between on- and off-the-job training. All employers receive the training programme and are able to plan learners’ work activities to support their training. There are good training resources and handouts.

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The quality of provision

54. All learners receive very good support from their tutors and assessors. Assessors make frequent visits to their learners and, as well as observing learners and completing formal progress reviews, they also provide additional support when needed. Learners also attend off-the-job training once a week. During these sessions they receive very good support from their tutors. They have regular tutorials where progress is monitored. Tutors always ensure that learners who miss any learning sessions receive handouts from the session and have access to additional individual support if necessary. All learners complete an initial assessment and those identified as requiring support receive it through specialist tutors and their assessors.

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The quality of provision

55. HPCT has particularly good working relationships with employers and external agencies. The early years development and childcare partnership delivers the training on careers advice and a range of other topics. Other groups, including one that supports families with disabled children, also deliver aspects of the training. Many employers have worked with HPCT for several years.

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The quality of provision

56. Assessment is satisfactory. Many learners have sufficient observations in the workplace and these are very detailed and fully cross-referenced. However, some learners are not given enough observations. Good use is made of witness statements and other evidence. Assessment is planned with learners and employers.

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The quality of provision

57. There is inappropriate delivery of application of number key skills. Key skills are delivered in discrete sessions and are not vocationally relevant. Much of learners’ work has no relevance to their NVQ or occupational area.

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Leadership and management

58. Staff meet regularly to discuss relevant issues, monitor learners’ progress and share good practice. There are regular assessor meetings to ensure standardisation across the programme and to share good practice. Tutor meetings have recently been introduced and are held approximately every six weeks. In a recent meeting, health and social care resources were reviewed and staff shared good practice in their most effective use. Staff are well qualified and carry out a good range of staff development activities to ensure their professional knowledge and practice is up to date.

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Leadership and management

59. There is very good integration and promotion of equality and diversity. Equal opportunities and diversity are covered well in every lesson in very appropriate ways. Issues are identified in the lesson plans and are fully supported by very good resources. For example, in a lesson covering sleep and rest for young children, the needs of children

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Leadership and management

15 © 2006 ADULT LEARNING INSPECTORATE HEREFORDSHIRE NHS PRIMARY CARE TRUST

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Leadership and management

from a variety of cultures are discussed and examined.

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