Sandwell and West Birmingham Hospitals

Sandwell and West Birmingham Hospitals National Health Service Trust Monitoring visit report

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Name of lead inspector: Richard Deane, Her Majesty’s Inspector

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Type of provider: Independent learning provider

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Address:

City Hospital Dudley Road Birmingham B18 7QH Monitoring visit: Sandwell and West Birmingham Hospitals National Health Service Trust, 13–14 December 2018

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Context and focus of visit

From October 2018, Ofsted undertook to carry out monitoring visits to all newly directly funded providers of apprenticeship training provision which began to be funded from April 2017 or after by the Education and Skills Funding Agency and/or the apprenticeship levy. This monitoring visit was undertaken as part of those arrangements and as outlined in the ‘Further education and skills inspection handbook’, especially the sections entitled ‘Providers newly directly funded to deliver apprenticeship training provision’ and ‘Monitoring visits’. The focus of these visits is on the three themes set out below.

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Context and focus of visit

Sandwell and West Birmingham Hospitals National Health Service Trust (the trust) is a large hospital trust in the West Midlands, serving the people of Sandwell and Birmingham. It is responsible for three hospitals, Sandwell Hospital, City Hospital and Rowley Regis Hospital and numerous local health-care settings. It employs around 7,000 staff.

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Context and focus of visit

The trust started training apprentices using levy funding in May 2017. It currently provides training for around 140 apprentices, most of whom are on standards-based programmes. A few apprentices are aged 16 to 18, with the large majority aged 19 and over. Apprenticeships are offered at levels 2 and 3. Most apprentices follow courses in health care, business administration, customer service, and team leading. The trust does not subcontract provision to other providers.

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Reasonable progress

Leaders have a clear strategy to extend apprenticeships as part of the trust’s recruitment and organisational development plan. Leaders have high expectations and are ambitious for apprentices to achieve their potential. For example, they have developed direct links with a local charity which supports young people who are homeless. This initiative has enabled the trust to fill an increasing number of apprenticeship vacancies. As a result, these apprentices can have a long-term career within the sector. Senior staff and consultants demonstrate their commitment to apprentices by sharing their experience during apprentices’ off-the-job training sessions. They also attend apprenticeship award ceremonies to celebrate apprentices’ success. Consequently, apprentices are proud of their achievements and feel valued as employees. Monitoring visit: Sandwell and West Birmingham Hospitals National Health Service Trust,

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Reasonable progress

13–14 December 2018 Leaders developed the apprenticeship provision gradually to ensure that appropriate systems and processes were in place before increasing apprenticeship numbers. For example, initially leaders introduced a comprehensive online monitoring system to track apprentices’ progress. Managers and trainers use this system effectively to monitor routinely apprentices’ progress. Most apprentices make good progress in their vocational qualifications and functional skills English and mathematics qualifications. However, managers do not monitor routinely apprentices’ progress from their starting points to ensure that all apprentices achieve their potential.

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Reasonable progress

Leaders and managers have recruited trainers who are appropriately qualified and experienced in their specialist occupational areas. All trainers have – or are working towards – teaching qualifications at level 4. Those in training are developing the requisite teaching, learning and assessment skills. Apprentices benefit from additional guest speakers. Consultants and practitioners from specialist clinical areas within the trust develop apprentices’ knowledge and understanding very effectively.

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Reasonable progress

Senior leaders work effectively with hospital managers to recruit apprentices and provide them with appropriate initial information, advice and guidance. Consequently, most apprentices are on the correct course and level. They develop new knowledge, skills and behaviours that benefit them in their job. Apprentices are clear about the opportunities for progression on completion of their apprenticeship. Many, particularly those following health-care apprenticeships, aim to progress into nursing.

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Reasonable progress

Leaders plan programmes that match closely to apprentices’ job roles. As a result, apprentices develop the specific new knowledge, skills and behaviours needed to undertake their roles successfully. For example, leaders have increased the number of apprentices following team-leader standards to improve the management capacity of the trust.

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Reasonable progress

Hospital managers value highly the contribution apprentices make and in particular the knowledge, skills and behaviours required to provide high-quality care to patients. However, for a few experienced business-administration and health-care apprentices the programme is not sufficiently challenging. Consequently, they do not develop substantial new vocational knowledge, skills and behaviours.

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Reasonable progress

Senior leaders and employers ensure that all apprentices receive the appropriate on- the-job training during their working hours. Workplace managers and mentors enable apprentices to practise the wide range of skills required for their qualification. Managers monitor closely apprentices’ off-the-job training to ensure that all apprentices receive their entitlement. On the few occasions when apprentices fall behind with their work trainers provide the appropriate support for them to catch up. For example, health-care assistant apprentices visit different specialist wards to develop the necessary skills for their qualifications.

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Reasonable progress

Leaders have implemented effective quality assurance processes. They hold regular internal verification and standardisation sessions with staff, providing them with Monitoring visit: Sandwell and West Birmingham Hospitals National Health Service Trust, 13–14 December 2018 useful training to improve teaching and assessment practice. Leaders use teaching observation feedback and apprentices’ and employers’ views appropriately to self- assess performance. They identify key strengths and areas for improvement accurately. However, their improvement actions are not precise enough to help them to drive up the quality of the provision. They do not make sufficient use of information about apprentices’ progress and achievements to demonstrate the impact of their actions.

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Reasonable progress

All apprentices who complete their apprenticeship by the planned end date move on to full-time employment with the trust. For the very few apprentices who leave early most move on to other apprenticeships outside the trust or into further learning.

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Reasonable progress

Executive leaders have a strong oversight of apprentices’ achievements and of the provision’s financial contribution to the trust. However, the information they receive is not sufficiently useful to enable them to hold leaders to account fully.

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Reasonable progress

Apprentices receive effective training, coaching and mentoring that help them to make good progress and develop the knowledge, skills and behaviours required for their jobs. Apprentices demonstrate the appropriate practical skills to fulfil their roles. In particular, younger apprentices with limited experience in the health-care sector develop quickly the necessary workplace skills. For example, they develop and practise their mathematical skills when ordering equipment and they convert accurately centilitres and millilitres when measuring bloods.

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Reasonable progress

Apprentices adapt well to the busy medical environments in which they work. They develop good communication skills and behaviours which they use proficiently to liaise with multi-disciplinary and complex-care teams and patients. For example, apprentices deal with emergency situations, such as taking a call from a patient suffering a suspected heart attack, with a calm and well-informed approach.

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Reasonable progress

Apprentices enjoy their learning and make valuable contributions soon after joining their department. For example, they identify opportunities to improve the service by implementing strategies to save time and make the best use of resources. Line managers are ambitious for their apprentices and encourage younger apprentices to take on greater responsibilities.

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Reasonable progress

Trainers have high aspirations for apprentices. In particular, they are adept at helping older apprentices to regain their confidence and achieve. Many apprentices move on to more complex roles within the trust and increase their workplace responsibilities. Most continue to an apprenticeship at level 3. Trainers are knowledgeable, work well with apprentices and use coaching skills effectively to hone Monitoring visit: Sandwell and West Birmingham Hospitals National Health Service Trust, 13–14 December 2018 apprentices’ practical skills. Apprentices follow trainers’ guidance and instructions and use their time off-the-job productively to complete theory work and revise for future assessments. Apprentices make good use of their workbooks as a way of embedding and reinforcing learning after their off-the-job training sessions. As a result, most apprentices achieve their qualifications.

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Reasonable progress

At the start of their programme, apprentices undertake an appropriate assessment of their starting points. Trainers identify accurately gaps in apprentices’ knowledge of English, mathematics, and information and communication technology. Apprentices benefit from trainers’ effective teaching and assessment practice in these subjects, improving their knowledge and skills, and achieving their qualifications. However, for the minority of apprentices with the necessary qualifications in English and mathematics, trainers do not set targets to enable apprentices to extend their knowledge and skills in English and mathematics. They do not monitor sufficiently apprentices’ development of English and mathematics. In a few cases, trainers do not identify well enough gaps in apprentices’ technical knowledge, skills and behaviours. Consequently, these apprentices do not make the progress of which they are capable.

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Reasonable progress

Trainers review apprentices’ progress frequently. In most cases, employers contribute fully to the process and describe the knowledge, skills and behaviours apprentices develop and the progress they make overall. Trainers set learning targets for their apprentices routinely, which they meet. However, trainers do not encourage apprentices to secure new skills, behaviours and learning beyond the requirements of the qualification when they have the ability and potential to do so. Too few apprentices know how to achieve the higher grades in their end-point assessment.

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Reasonable progress

Apprentices benefit from frequent opportunities to demonstrate their abilities. They receive useful feedback that helps them to make improvements to their work. Trainers are committed to help their apprentices to achieve and their support for those who fall behind is highly effective. For example, one apprentice found themselves homeless; with help from their trainers this apprentice received the support from a local charity to secure their living arrangements and continue with their apprenticeship.

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Reasonable progress

Apprentices undertake additional training and learning opportunities that prepare them for working in the health-care sector. For example, in one session apprentices collectively planned the building of a hospital, which helped them develop their teamwork skills. Others enjoy taster sessions and work-shadow experiences in other departments, increasing their knowledge of future career options.

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Reasonable progress

Apprentices benefit from mental-health awareness and how mindfulness techniques can help with their work. Often, apprentices attend inspirational and informative talks given by their senior clinical specialists, which extend their knowledge. Monitoring visit: Sandwell and West Birmingham Hospitals National Health Service Trust, 13–14 December 2018

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Reasonable progress

Leaders and managers ensure that effective safeguarding arrangements are in place and that apprentices feel safe.

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Reasonable progress

Managers follow the trust’s robust and comprehensive safeguarding policies and procedures. For example, the trust recruits all staff – including new apprentices – through its safer recruitment procedures. The large majority of staff employed at the trust, including all apprentices and employees who come into contact with patients and children, have enhanced Disclosure and Barring Service checks. All apprentices and training staff complete mandatory training on safeguarding, the ‘Prevent’ duty, health and safety, equality and diversity, and basic first aid. Managers check the completion of safeguarding refresher training when members of staff receive their annual appraisal.

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Reasonable progress

Trainers assess routinely apprentices’ understanding of the risks associated with radicalisation and extremism during their regular progress reviews. Apprentices have a working understanding of these topics but are not aware of the range of groups from which such threats may come. Apprentices know how and to whom they should report any concerns.

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Reasonable progress

All the trust’s staff are trained to level 2, with seven staff, including the designated safeguarding lead (DSL), trained to level 3. The DSL maintains a comprehensive and up-to-date incident record. The DSL also reviews and analyses safeguarding records to identify trends or wider concerns. Managers and trainers monitor apprentices’ attendance closely. They record absences accurately and ensure apprentices’ safety at all times.

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Reasonable progress

Apprentices learn about and apply safe working practices as part of their programme. They demonstrate a good awareness of health and safety within their working environment. For example, they implement safe hygiene and infection control practices effectively, and use de-escalation strategies in heightened patient– carer situations. Apprentices benefit from access to a range of agencies, including mental-health and well-being services, to support their individual needs. Monitoring visit: Sandwell and West Birmingham Hospitals National Health Service Trust, 13–14 December 2018 the guidance ‘Raising concerns and making a complaint about Ofsted’, which is available from Ofsted’s website: www.gov.uk/government/publications/complaints-about-ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . Learner View Learner View is a website where learners can tell Ofsted what they think about their college or

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Reasonable progress

provider. They can also see what other learners think about them too. To find out more go to www.learnerview.ofsted.gov.uk .

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Reasonable progress

Employer View Employer View is a 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. To find out more go to www.employerview.ofsted.gov.uk .

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regulates and inspects to 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

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

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T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/ofsted

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