Lancashire Teaching Hospitals NHS Foundation Trust

Further education and skills inspection report

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Inspection of Lancashire Teaching Hospitals NHS Foundation Trust

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Overall effectiveness Good

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

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Information about this provider

Lancashire Teaching Hospitals NHS Foundation Trust (LTH) provides healthcare for people in the Preston and surrounding area in northwest England. The trust runs the Royal Preston Hospital and the Chorley and South Ribble Hospital and employs approximately 9,900 staff. LTH became a prime-contract employer provider in May 2017.

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Information about this provider

At the time of inspection there were 46 apprentices enrolled on the level 3 learning mentor standard and 31 enrolled on the level 3 senior healthcare support worker standard. There were fewer than five apprentices who were working towards final assessment for both the level 5 operations manager standard and level 3 team leader standard. Both these programmes and the level 2 healthcare support worker have been removed from the curriculum offer.

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Information about this provider

LTH works with one subcontractor partner, Blackpool and the Fylde College, to deliver functional skills qualifications at level 2 in English, mathematics and information and communication technology. 16 to 19 August 2022

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

Apprentices are highly motivated and enthusiastic about their programmes. They demonstrate excellent attitudes to their learning. Apprentices are committed to their training to improve their knowledge, skills and behaviours for their patients and for their future roles within the healthcare sector.

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

Apprentices become more confident in their job role as they develop their knowledge and skills in patient care. Practising skills in a simulated learning environment helps them gain confidence before applying practices in a clinical environment.

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

Apprentices build resilience in managing the demands of their training programme and working in a busy hospital. Attendance across all apprenticeship programmes is high despite the ongoing pressures apprentices face as frontline care workers.

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

Apprentices feel safe. They know who to report concerns to and the procedures to follow. Apprentices’ well-being and safety are checked frequently during review meetings and swift action is taken when concerns are raised.

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better?

Leaders have an ambitious vision and strategy to deliver high-quality training for their apprentices. They have a clear rationale for the apprenticeships they offer. Leaders and managers have reviewed and revised the curriculum offer to meet the local challenges of recruitment and retention of staff within the trust.

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better?

The level 3 senior healthcare support worker apprenticeship provides a pathway for apprentices to progress to training programmes and roles such as associate nurse and registered nurse. The level 3 learning mentor apprenticeship prepares apprentices to support the learning and development of clinical staff who are undertaking training and education programmes within the trust. For example, they mentor nursing students and healthcare support workers.

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better?

Programmes are carefully planned to enable apprentices to develop and build their knowledge, skills and behaviours over time. Level 3 senior healthcare support workers learn about basic health and safety, infection control measures and relevant legislation. Apprentices then study more-complex subjects such as anatomy and physiology and advance their skills in practices such as taking blood samples and cannulation procedures. Apprentices on the level 3 learning mentor programme learn about the role and responsibilities of the learning mentor before progressing to more advanced concepts such as facilitating learning and assessing learners in practice.

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better?

Tutors use a range of assessment activities to accurately identify apprentices’ starting points. They use this information to inform and plan apprentices’ programmes. For example, level 3 senior healthcare support worker apprentices who 16 to 19 August 2022

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work on surgical wards work-shadow staff in operating theatres to broaden their knowledge and experience in different settings.

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Tutors are knowledgeable about their subjects and have relevant experience of working in a clinical environment. They use their experiences to help apprentices learn new theory and apply this to their practice. For example, they explain in detail the anatomy of the heart, which helps apprentices understand the impact of carrying out blood pressure observations.

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Tutors use a variety of teaching approaches to help apprentices learn. They use experiential learning, small-group exercises and discussions. Apprentices enjoy their learning and the different approaches. For example, using the ‘writing wall’ to label drawings of skeletons to help them identify and remember the correct terminology of bones in the human body. Tutors adapt their teaching resources to meet the individual needs of apprentices who require additional support. This ensures that all apprentices can participate and achieve.

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Tutors use recap exercises at the start of sessions and consolidate learning throughout. This enables them to check apprentices’ understanding and helps apprentices embed knowledge into their long-term memory. At the end of each session apprentices evaluate what they have learned and identify how they will develop this further in their professional practice.

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Most apprentices produce work to a high standard. However, tutors’ feedback to apprentices is too variable. Feedback often gives praise but does not always provide guidance or challenge to apprentices to help them improve their work further.

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As a result of their training, apprentices develop new knowledge and gain skills and professional behaviours which they use in the workplace. Ward managers value the contribution apprentices bring to the department. They report that apprentices have a better understanding of patients’ needs, which improves service delivery. Apprentices who remain on their programmes achieve their apprenticeship and many achieve with high grades.

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During review sessions, tutors do not always accurately identify the specific knowledge, skills and behaviours that apprentices need to develop further. Targets are not precise enough to enable apprentices and their managers to understand how these can be achieved quickly.

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Apprentices benefit from a broad range of training provided by the trust such as equality and diversity, safeguarding and the ‘Prevent’ duty. They develop and demonstrate a good understanding of the diverse range of cultures of the patients they care for. Apprentices receive useful careers information from their tutors, managers and higher education partners. This helps apprentices plan their next steps. However, guidance is limited to roles within the healthcare sector.

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Quality processes and reports produced by leaders and managers are too focused on key performance indicators and not on the quality of education that apprentices 16 to 19 August 2022

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receive. Leaders have recently appointed a management role to focus on the quality of training for apprentices. At the time of inspection, it is too early to see the impact of these changes.

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Leaders and managers do not have sufficient oversight of the provision delivered by their subcontracted partner. They do not monitor closely the quality of education of the functional skills programmes to identify strengths and weaknesses.

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Since the new provider monitoring visit, governance arrangements have been strengthened. Board members have a clear understanding of the trust’s strengths and areas for improvement. They hold senior leaders to account for the quality of education apprentices receive. However, they acknowledge that the reports they receive do not provide sufficient detail to enable them to know the progress that apprentices make.

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Safeguarding

The arrangements for safeguarding are effective.

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Safeguarding

Leaders ensure that safeguarding and the safety of apprentices is a high priority. The designated safeguarding lead (DSL) and safeguarding officers are appropriately trained to carry out their roles. They benefit from the support of the trust’s wider safeguarding team to ensure that staff and apprentices receive frequent training on safeguarding and the ‘Prevent’ duty.

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Safeguarding

Leaders follow safer recruitment procedures. They carry out appropriate checks to ensure the suitability of staff who work with apprentices.

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Safeguarding

Staff follow clear, trust-wide procedures to report any concerns they may have. Concerns raised are dealt with swiftly. The DSL works with a range of agencies to provide support for apprentices. For example, the crisis team, police and counsellors.

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Safeguarding

Apprentices feel safe and supported both on the programme and in their employment.

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What does the provider need to do to improve?

 Leaders should ensure that tutors provide all apprentices with useful feedback so that they know how to improve their work further.  Leaders should ensure that during reviews, tutors provide apprentices with targets to help them and their managers know what specific knowledge, skills and behaviours need to be developed.  Leaders should provide apprentices with a broader range of careers information and guidance beyond the healthcare sector. 16 to 19 August 2022

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 Leaders and managers should ensure they have sufficient oversight of their subcontracted provision so they can identify and rectify weaknesses in the quality of education that apprentices receive. 16 to 19 August 2022

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Provider details

Website www.lancsteachinghospitals.nhs.uk

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Provider details

Date of previous inspection Not previously inspected

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Provider details

Main subcontractors Blackpool and the Fylde College 16 to 19 August 2022

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Information about this inspection

The inspection team was assisted by the head of widening participation and apprenticeships, as nominee. Inspectors took account of the provider’s most recent self-assessment report and development plans, and the previous 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 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

Elaine Price, lead inspector Ofsted Inspector Alison Humphreys Her Majesty’s Inspector Angus Forsyth Ofsted Inspector 16 to 19 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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