Northern Care Alliance NHS Trust

Further education and skills inspection report

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Inspection of Northern Care Alliance NHS Trust

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Overall effectiveness Requires improvement

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

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Information about this provider

The Northern Care Alliance is an NHS Group formed by bringing together two NHS Trusts: Salford Royal NHS Foundation Trust and The Pennine Acute Hospitals NHS Trust. Northern Care Alliance NHS Trust (the Trust) began to deliver levy-funded apprenticeships as an employer provider in May 2017. At the time of inspection, the Trust had 127 apprentices in learning and 12 apprentices on a break in learning. There are 73 apprentices on level 3 team leader or supervisor, 29 on level 3 senior healthcare worker, 15 on level 2 business administration, seven on level 2 healthcare support worker and three on level 2 customer service apprenticeships. All apprentices are aged 19 years or over. There are 37 apprentices who study functional skills mathematics and 35 who study functional skills English as part of their apprenticeship. 2 to 4 August 2022

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

Most apprentices value the opportunity to study and progress in their chosen careers. Apprentices are mostly positive about their learning and appreciate the support they receive from their tutors and work colleagues. They are proud of the contribution they make to the teams they work with.

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

Leaders have high expectations for their apprentices. They align their apprentices’ standards to the Trust’s core values of ‘saving lives, improving lives’. Apprentices understand and model the Trust’s values well. They treat each other and their patients with respect and dignity.

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

A small number of apprentices do not have access to a permanent line manager or workplace mentor. Continuing staff shortages on wards, which started during the COVID-19 pandemic, have hindered the progress of apprentices. Tutors provide additional support to apprentices, which they appreciate, and help them to catch up.

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

Apprentices become more confident, resilient and independent because of the on- the-job training they receive and the supportive environment in which they work. Through their training, they develop the confidence to communicate effectively. For example, healthcare apprentices support their patients and their relatives in end-of- life care.

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

Most apprentices are prepared effectively for their next steps. Many progress to permanent roles in their ward or hospital setting when they have completed their apprenticeship. Not all apprentices are aware of the wider career opportunities available to them.

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

Apprentices feel safe and are well supported. They say their employer places a high priority on their well-being and work–life balance.

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better?

Apprenticeship programmes are an important part of the Trust’s workforce strategy. Leaders have identified key skills shortages within the Trust and the wider community. For example, they have designed healthcare support worker apprenticeships at level 2 and level 3 to meet identified gaps well.

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better?

Leaders have a clear vision to provide high-quality programmes for apprentices. However, this has not yet been fully realised. Not all apprentices benefit from high- quality training. Leaders have not dealt with the inconsistencies in the standard of training that apprentices receive between different apprenticeships, departments and tutors. The impact of the pandemic has affected the capacity of leaders at the Trust to improve the quality of apprenticeships as there are still staff shortages and absences in key areas. 2 to 4 August 2022

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Leaders ensure they select staff who are well qualified and experts in their field. They provide a range of development opportunities for tutors. They complete industrial updating, higher-level qualifications and digital delivery training. As a result, tutors have the most up-to-date subject knowledge and experience to teach apprentices. However, leaders have not ensured that all tutors have had training on using apprentices’ starting points when planning the curriculum or in giving helpful feedback to apprentices.

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Tutors use their vocational knowledge, skills and experience well to train apprentices. They use examples from their clinical practice to enhance the classroom learning. Healthcare apprentices learn about cross-infection control and personal protective equipment such as masks and gloves which they use to protect themselves and their patients.

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Leaders do not ensure that initial advice and guidance support all apprentices to access the correct apprenticeship standard pathway. For example, due to the duties of the role, apprentices on the allied health care pathway are unable to assist in clinical tasks. Therefore, a change of pathway was required to provide apprentices with the opportunity to achieve the apprenticeship. A few level 2 apprentices study at too low a level.

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Tutors do not use accurate information about apprentices’ starting points to plan an ambitious or individualised curriculum. Too often the curriculum plan for healthcare apprentices is changed due to workload pressures and staff absences. This means that apprentices fall behind in their studies.

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The curriculum is sequenced in a way that apprentices incrementally build their knowledge, skills and behaviours over time. Healthcare apprentices start their apprenticeship by learning about health and safety legislation. They learn how to apply these practices while working with patients on a hospital ward, for example lifting patients safely. They move on to communication skills and the importance of these when dealing with patients.

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Most workplace managers ensure that apprentices develop the skills they need to be proficient in their roles. Team leading apprentices improve their understanding of emotional intelligence and how to apply and adapt management styles to suit the needs of those in their team.

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Apprentices can clearly articulate the skills they have gained as a result of on-the-job training. Level 2 healthcare apprentices learn how to manage tracheotomies and how to clean around them to maintain patient hygiene. Level 3 healthcare apprentices can insert cannulas and provide catheter and stoma care support with confidence. Level 3 team leader apprentices can implement positive change management projects and handle difficult conversations sensitively.

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Tutors ensure that apprentices develop the English and mathematics skills they need for work. Tutors use everyday work examples which apprentices can relate to. In level 2 mathematics functional skills lessons, tutors relate estimation to being able to identify food portion sizes. They learn about the importance of accurately measuring medication quantities. This supports apprentices to apply their knowledge in the workplace. 2 to 4 August 2022

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Most apprentices produce work of a high standard which is well presented. Most tutors provide clear feedback to apprentices on what they have done well and how to improve their work to deal with any gaps in knowledge they may have.

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Most tutors ensure that apprentices who complete their course are well prepared for their final assessment. As a result, these apprentices achieve high grades or improve their grades over time. However, too many apprentices leave early or take a break in learning. Consequently, they do not complete within their planned timescales.

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Tutors of healthcare apprentices do not ensure that all of the on- and off-the-job training is effectively coordinated. They do not routinely involve apprentices’ line managers in the review and planning of apprentices’ progress towards developing their knowledge, skills and behaviours at work. As a result, line managers of healthcare apprentices do not always know what they need to do to help apprentices apply their skills and knowledge at work.

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Tutors of apprentices who study level 3 team leading liaise effectively with employers during frequent reviews to ensure that employers are fully aware of the progress that their apprentices make towards achievement of their apprenticeship.

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Attendance has been adversely affected during COVID-19. The continuing staff shortages in healthcare and the need to maintain safe levels of staffing means that on occasion, apprentices are not able to attend taught sessions and progress reviews.

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Most apprentices do not access personal development activities beyond their main curriculum, such as volunteering or group activities. As a result, apprentices are not supported to develop and discover their interests and talents fully.

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Governors provide appropriate challenge to leaders and managers regarding the quality of education. Governors have a mostly accurate understanding of the strengths and weaknesses of the apprenticeship provision. However, they have not ensured that leaders have fully rectified the areas for improvement from the previous monitoring visit. For example, a minority of apprentices still do not make the progress of which they are capable due to the frequent change in line managers and line managers’ lack of understanding of the apprenticeship requirements.

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Safeguarding

The arrangements for safeguarding are effective.

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Safeguarding

Staff understand clearly their responsibilities to safeguard apprentices. The designated safeguarding lead (DSL) and the safeguarding team are appropriately trained and understand the local risks. They manage and resolve disclosures diligently. The DSL uses links to external agencies to help apprentices access additional help, such as for homelessness.

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Safeguarding

Apprentices feel safe and are safe. They have a thorough understanding of 2 to 4 August 2022

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safeguarding and know how to report any concerns they may have. For example, they report any concerns they may have about their patients such as signs of trafficking.

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Managers ensure that staff are recruited safely. Staff receive regular training and updates on safeguarding and safeguarding-related matters.

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What does the provider need to do to improve?

 Leaders and governors should ensure that rigorous quality improvement strategies are implemented and closely monitored so that the inconsistency in the quality of education between the different apprenticeships is swiftly eradicated.  Leaders should ensure that staff provide effective initial advice and guidance so that apprentices can access the correct apprenticeship standard pathway. Leaders should ensure that apprentices learn about the wider options available to them regarding further study or job opportunities.  Leaders should ensure that tutors use accurate information about apprentices’ starting points to plan an ambitious and individualised curriculum. This should include personal development opportunities so that apprentices make rapid progress and develop their talents fully.  Leaders should ensure that the on- and off-the-job training is effectively coordinated. Tutors should routinely involve apprentices’ line managers in the

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What does the provider need to do to improve?

review and planning of apprentices’ progress towards developing their knowledge, skills and behaviours at work. 2 to 4 August 2022

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Provider details

Address Mayo Building Stott Lane Salford M6 8HD

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Provider details

Website https://www.northerncarealliance.nhs.uk/

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Provider details

Date of previous inspection Not previously inspected

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Provider details

Main subcontractors None 2 to 4 August 2022

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Information about this inspection

The inspection team was assisted by the apprenticeship compliance and data quality lead , as nominee. Inspectors took account of the provider’s most recent self- assessment report and development plans, and the previous monitoring visit 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 visiting 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

Andrea Machell, lead inspector Ofsted Inspector Karen Roberts Ofsted Inspector Suzanne Horner Her Majesty’s Inspector Bob Busby Ofsted Inspector 2 to 4 August 2022

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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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