Birmingham Community Healthcare NHS Foundation Trust

Birmingham Community Healthcare NHS Foundation Trust (BCHC) Monitoring visit report

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Name of lead inspector: Ian Higgins, Her Majesty's Inspector

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Inspection dates: 22 and 23 September 2021

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Type of provider: Independent learning provider

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Address: Birmingham Dental Hospital 5 Mill Pool Way Birmingham B5 7EG Monitoring visit: Birmingham Community Healthcare NHS Foundation Trust, 23 and 24 September 2021

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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 ‘Monitoring visits’ and ‘Monitoring visits to providers that are newly directly publicly funded’. The focus of these visits is on the themes set out below.

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Context and focus of visit

Birmingham Community Healthcare NHS Trust (BCHC), formed on 1 November 2010, brought together staff from six previous trusts into one community provider organisation. BCHC offers a wide range of services across Birmingham and the West Midlands. Within the trust lies the accredited centre providing the apprenticeship programme, sitting in the learning and development department of the organisational/workforce development directorate. BCHC successfully applied to the register of apprenticeship training providers in October 2019. At the time of the visit, 34 apprentices were in learning. All apprentices were on the level 3 dental nursing standard. All apprentices are based at the Birmingham Dental Hospital and School of Dentistry. All apprentices were aged 19 and above.

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Reasonable progress

Senior leaders within BCHC value apprenticeships. They have a clear rationale for the apprenticeships that they offer: that there is a need to support new staff in developing the knowledge, skills and behaviours they need to work as a dental nurse.

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Reasonable progress

Senior leaders have recruited well-qualified teaching staff. All teaching staff have, or are working towards, at least a level 5 teaching qualification. All teachers spend part of their time working on the clinical areas. They have up-to-date knowledge and experience. They use this well to teach apprentices new content.

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Reasonable progress

Leaders have put in place appropriate arrangements, so that apprentices can undertake their final assessments. Teachers prepare apprentices well, so that they understand clearly what they need to do when they complete their final assessments. Monitoring visit: Birmingham Community Healthcare NHS Foundation Trust, 23 and 24 September 2021 Senior leaders ensure that apprentices have access to high-quality facilities. Apprentices benefit from a range of ‘rotations’, such as in general anaesthetics, orthodontics, and paediatrics. Senior leaders provide apprentices with an ambitious curriculum. Apprentices experience the full range of specialist services offered by BCHC.

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Reasonable progress

Senior leaders have put in place a number of quality assurance processes. For example, leaders undertake a schedule of planned lesson observations. However, leaders do not focus sufficiently well on the quality of teaching that apprentices receive, and the impact of teaching on what apprentices know and remember long- term.

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Reasonable progress

There is a clear structure of governance in place. Leaders have established an apprenticeship steering group. This group reports directly to a sub-committee of the full trust board. The staff in governance roles receive useful information from leaders; for example, they receive a useful report on safeguarding. Board members provide challenge and scrutiny to ensure that appropriate safeguarding is in place for apprentices. However, senior leaders need to provide further information to board members about the quality of teaching that apprentices receive in all areas of their apprenticeship.

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Reasonable progress

Leaders and teachers identify what apprentices know at the beginning of their apprenticeship. They use this information diligently to plan and prioritise what apprentices need to know first in relation to their dentistry knowledge, skills and behaviours. However, senior leaders recognise that they do not use well enough the information they have on the standard of apprentices’ English and mathematics skills. They do not plan sufficiently well how they will support apprentices to develop these skills.

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Reasonable progress

Leaders and teachers order the content they teach in a logical way. Apprentices first develop an understanding of health and safety and patient care. They then develop an understanding of anatomy, before applying this to a range of clinical procedures. As a result, apprentices learn the knowledge and skills they need most urgently at the beginning of their course.

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Reasonable progress

Apprentices develop new knowledge, skills and behaviours. For example, apprentices know clearly the anatomical structures within the mouth. They have a good understanding of the risks of transmission of infectious diseases and the steps to take to reduce this risk. All apprentices who have successfully completed their final assessment are now employed as qualified dental nurses. Monitoring visit: Birmingham Community Healthcare NHS Foundation Trust, 23 and 24 September 2021 In the vast majority of cases, teachers provide useful and precise feedback to apprentices on their work. Consequently, apprentices know what they need to do to improve their work, and so the standard of their work improves over time. However, in a few cases teachers’ feedback focuses too narrowly on whether, or not, work has met the required standard for an assignment. Where this is the case, teachers do not make it clear what apprentices need to do to improve the standard of their work.

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Reasonable progress

Teachers and clinical staff observe and review apprentices frequently in their workplace. They work extremely well as a team to close any gaps in apprentices’ knowledge and skills quickly. For example, apprentices have a ‘clinical skills workbook’ to track their progress. They have regular opportunities to revisit and recap on their learning.

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Reasonable progress

Teachers and leaders link well the on- and off-the-job learning. They plan this coherently, so that apprentices learn new knowledge, which they get to apply quickly in a clinical setting. As a result, apprentices are improving the standard of work over time. Apprentices are highly valued within the NHS trust.

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Reasonable progress

Leaders have put in place clear and safe working practices for apprentices. Apprentices demonstrate a clear understanding of the steps they should take to reduce the spread of infection, including in response to the COVID-19 (coronavirus) pandemic. For example, apprentices talk confidently about the additional steps they need to take when undertaking aerosol-based procedures to reduce the risk of spreading infection.

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Reasonable progress

Senior leaders have in place a clear policy of how they safeguard apprentices. They have identified specific people within the organisation to oversee safeguarding. Staff who have additional responsibilities around safeguarding are well qualified to carry out such roles. Other staff receive regular training and updates. They are clear on their responsibilities in safeguarding apprentices.

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Reasonable progress

Managers have appropriate procedures in place for the reporting of any safeguarding concerns. Those that oversee safeguarding follow up any safeguarding concerns promptly. They provide high levels of support to apprentices. Where senior leaders have identified any trends in any safeguarding concerns that are raised, for example around domestic abuse, they provide additional information to apprentices to raise their awareness of such topics.

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Reasonable progress

Leaders successfully identify those apprentices who may need additional support when they start their programme. For example, where apprentices disclose any mental health concerns leaders are quick to put support in place. However, in a few cases, where apprentices raise concerns about rising levels of stress, apprentices do not feel they receive the support they need to help tackle this. Monitoring visit: Birmingham Community Healthcare NHS Foundation Trust, 23 and 24 September 2021 Managers recruit only those individuals who they identify as safe to work with adults and children. They have in place a rigorous recruitment and vetting process. All staff are required to have an enhanced disclosure and barring service (DBS) check.

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Reasonable progress

Leaders and teachers develop apprentices’ understanding of safeguarding and associated risks. For example, apprentices benefit from ‘life in modern Britain’ lessons where teachers develop apprentices’ understanding of safeguarding risks. However, in a few cases apprentices are not able to recall this information. Where this is the case, apprentices do not have a clear understanding of the risks associated with topics such as county lines and human trafficking. Monitoring visit: Birmingham Community Healthcare NHS Foundation Trust, 23 and 24 September 2021 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

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Reasonable progress

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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Reasonable progress

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Reasonable progress

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Reasonable progress

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Reasonable progress

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