University Hospitals Bristol and Weston NHS Foundation Trust

Further education and skills inspection report

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Inspection of University Hospitals Bristol NHS Foundation Trust

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Overall effectiveness Requires improvement

The quality of education Requires improvement Behaviour and attitudes Requires improvement Personal development Requires improvement Leadership and management Requires improvement Apprenticeships Requires improvement Overall effectiveness at previous inspection Not previously inspected

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Information about this provider

University Hospitals Bristol NHS Foundation Trust (UHB) is one of the country’s largest acute NHS trusts. It has around 11,500 staff providing over 100 different clinical services, across nine sites, in and around Bristol and the south west.

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Information about this provider

UHB began delivering levy-funded apprentices in May 2017. At the time of the inspection, 129 apprentices were enrolled on six standards-based apprenticeship programmes. Nearly two thirds of apprentices were following a healthcare support worker programme at level 2 or senior healthcare support worker programme at level 3. The remaining apprentices were either on level 2 customer service practitioner, level 3 dental nursing, level 3 team leadership or level 5 operational department manager programmes. UHB works with one subcontractor, Weston College, which provides apprentices with training in functional skills, English and mathematics.

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Information about this provider

In December 2018, UHB received a new provider monitoring visit from Ofsted. It was awarded a judgement of ‘insufficient progress’ for two of the three themes evaluated. Specifically, leaders had not made sufficient progress in ensuring that the provision met all requirements of successful apprenticeship provision, nor had they made sufficient progress in ensuring that apprentices benefited from high-quality training leading to positive outcomes.

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Information about this provider

Due to the lack of progress identified, UHB has not enrolled any new apprentices this year. 17–20 December 2019

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What is it like to be a learner with this provider?

Most apprentices have the opportunity to learn new skills, knowledge and behaviours from highly experienced and professional ward staff and managers. In the best cases, staff train apprentices using clear information and demonstration. They ensure that apprentices are able to learn effective practical skills and medical procedures.

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What is it like to be a learner with this provider?

Apprentices feel valued by the staff they work with on the wards. Staff on the wards show them respect. Apprentices attend staff meetings and are involved in the decision-making process. Apprentices feel safe in learning and training and they adopt safe working practices.

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What is it like to be a learner with this provider?

All apprentices who complete their apprenticeship either move to employment within the hospital trust, other related job opportunities or into higher education.

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What is it like to be a learner with this provider?

Managers do not plan apprentices’ learning well enough from the outset because they do not take into account what apprentices already know and can do when they begin their programme.

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What is it like to be a learner with this provider?

Managers do not coordinate apprentices’ on-the-job and off-the-job training effectively. As a result, most apprentices do not make the expected progress.

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What is it like to be a learner with this provider?

Much of the teaching apprentices receive from assessors during their off-the-job training sessions is poor and, as a result, many apprentices do not attend.

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What is it like to be a learner with this provider?

Too many apprentices do not know how to improve the standard of their work because the feedback they receive from assessors is not precise or constructive enough.

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What is it like to be a learner with this provider?

Too many apprentices who already have the expected level of qualifications in English and mathematics are not encouraged by assessors to develop their skills and knowledge in these subjects further. This means that they are not achieving their full potential.

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better?

Since the previous monitoring visit, leaders and managers have made effective improvements to governance and strategic management. These have resulted in some improvements to the quality of on-the-job training and the quality of functional skills training.

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better?

Leaders have selected curriculums which meet closely the shortages in skills identified by hospital leaders and local healthcare employers. These include dental nurses, healthcare workers, healthcare supervisors, ward clerks and managers. However, not all these curriculums are well enough designed, leading to inconsistencies in the quality and impact of apprentices’ training. 17–20 December 2019

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For example, managers do not plan all apprentices’ learning programmes to take into account their knowledge, skills, behaviours and attitudes when starting the apprenticeship. They do not build in opportunities for apprentices to fill any gaps in their prior knowledge.

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The on-the-job curriculum develops most apprentices’ broader skills, knowledge and behaviours. For example, the well-planned dental nursing and health and social care curriculums enable apprentices to move into employment and higher levels of study and improve their career opportunities. However, leaders and managers have not ensured that apprentices’ off-the-job training supports each one to develop the knowledge and skills they need. The content is too broad, and the curriculums are not planned effectively to complement apprentices’ on-the-job training and work roles. As a result, apprentices do not value or attend these sessions. They do not all make the expected progress towards achieving their curricular goals and aspirations.

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The curriculums provide apprentices with an improving information, advice and guidance service. However, further improvements are still needed to ensure that apprentices have realistic expectations before starting their apprenticeship. They do not all have a good understanding of their job role, shift-working patterns or the career opportunities available on completing their apprenticeship.

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Apprentices who are exempt from studying functional skills English and mathematics are not encouraged to improve their skills beyond the minimum requirements of the programme. As a result, they are not achieving their full potential.

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Functional skills and dental care teachers use a wide range of teaching and assessment techniques and resources which help apprentices learn and remember new knowledge. These include encouraging apprentices to participate in stimulating debates and using mobile phone applications to make digital measurements of objects. Apprentices then compare their results using more traditional measuring devices. However, a minority of assessors do not provide apprentices with sufficiently detailed or constructive feedback to help them correct their written work. As a result, too many apprentices do not know how to improve that work. Leaders and managers have not ensured that assessors develop their professional skills well enough to make sure that their teaching practice improves in all curriculum areas. Managers use a range of sources to inform individual staff development plans, but these have not been used to improve the quality of off-the-job training, particularly in classroom

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Leaders and managers have not ensured that the information in their quality tracking systems is accurate. This has resulted in leaders’ overly positive view of the progress apprentices are making and the number of off-the-job hours completed. Managers cannot be sure that all apprentices are receiving their full entitlement to off-the-job training or that apprentices who are falling behind are being supported to catch up.

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Apprentices demonstrate respect for, and promote the dignity of, patients and customers. Leaders set clear expectations for the behaviour of staff in the workplace. Staff model these high standards on the wards. Most apprentices use their 17–20 December 2019

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skills well to reassure patients and their families and ensure that they are kept informed about patients’ status. For example, in oncology, apprentices shadow every aspect of the patients’ journey. This enables them to gain a good understanding of the problems each patient faces and support them respectfully.

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Safeguarding

The arrangements for safeguarding are effective.

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Safeguarding

The designated lead for safeguarding within the education department is appropriately qualified and supported well by UHB’s overall safeguarding lead. Apprentices know how to keep themselves safe and play a positive role in modern society. A ‘Prevent’ duty risk assessment is in place, but this does not have a strong enough focus on local priorities.

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Safeguarding

Staff receive mandatory safeguarding training and ongoing updates, in line with UHB’s positive culture of protecting learners. Apprentices are able to demonstrate safe working practices. The safeguarding leads have implemented effective methods for managing safeguarding concerns. Apprentices know what to do and who to go to if they have concerns.

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What does the provider need to do to improve?

 Managers need to plan and implement the curriculum so that it is tailored to apprentices’ individual starting points.  Leaders and managers must make sure that all apprentices receive their full entitlement to off-the-job training. This training should meet each apprentice’s needs and align to their on-the-job training.  Leaders and managers must develop all assessors’ teaching skills so that the quality of teaching is consistently good and effective.  Assessors must provide apprentices with sufficiently detailed feedback, so they can improve their work.  Leaders and managers need to ensure that all apprentices develop their English and mathematical skills and achieve their full potential.  Leaders and managers should improve the information, advice and guidance that apprentices receive, particularly when starting their programme, so that they have a good understanding of their job roles, shift patterns and career options.

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Provider details

Address Upper Maudlin Street Bristol BS2 8AE

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Provider details

Date of previous inspection Not previously inspected

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Provider details

Main subcontractors Weston College 17–20 December 2019

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Information about this inspection

The inspection team was assisted by the trust’s associate director of education, as nominee. Inspectors took account of the provider’s most recent self-assessment report and development plans, and the previous monitoring inspection report. The inspection was carried out using the further education and skills inspection handbook and took into account all relevant provision at the provider. Inspectors collected a wide range of evidence to inform judgements, including observing learning sessions, scrutinising learners’ work, seeking the views of learners, staff and other stakeholders, and examining the provider’s documentation and records.

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Inspection team

Bev Ramsell, lead inspector Her Majesty’s Inspector Paul James Her Majesty’s Inspector Lyn Bourne Ofsted Inspector Daisy Walsh Ofsted Inspector Denise Olander Her Majesty’s Inspector Kathryn Rudd Her Majesty’s Inspector Alun Maddocks Ofsted Inspector 17–20 December 2019

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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 children looked after, safeguarding and child protection.

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