Tees, Esk and Wear Valleys NHS Trust

Inspection number 318307 Tees, Esk and Wear Valleys NHS Trust

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Contents

Background information ......................................................................................................... 3 Inspection judgements........................................................................................................... 3 Scope of the inspection.......................................................................................................... 3 Description of the provider...................................................................................................... 4 Summary of grades awarded .................................................................................................. 5 Overall judgement.................................................................................................................... 6 Effectiveness of provision ..................................................................................................... 6

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Contents

Capacity to improve............................................................................................................ 6 Key strengths ............................................................................................................................ 6 Key areas for improvement..................................................................................................... 7 Main findings............................................................................................................................ 8 Achievement and standards................................................................................................... 8 Quality of provision............................................................................................................... 8 Leadership and management ................................................................................................. 9

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Contents

Equality of opportunity....................................................................................................... 9 What learners like.................................................................................................................. 11 What learners think could improve...................................................................................... 11

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Inspection judgements

Inspectors use a four-point scale to summarise their judgements about achievement and standards, the quality of provision, and leadership and management, which includes a grade for equality of opportunity.

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Key for inspection grades

Grade 1 Outstanding Grade 2 Good Grade 3 Satisfactory Grade 4 Inadequate

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Key for inspection grades

Further information can be found on how inspection judgements are made on www.ofsted.gov.uk.

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Scope of the inspection

In deciding the scope of the inspection, inspectors take account of the provider’s most recent self-assessment report and development plans, and comments from the local Learning and Skills Council (LSC) or other funding body. Where appropriate, inspectors also consider the previous inspection report ( www.ofsted.gov.uk ), reports from the inspectorates’ quality monitoring or annual assessment visits, and data on learners and their achievements over the period since the previous inspection.

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Scope of the inspection

In addition to reporting on overall effectiveness of the organisation, its capacity to improve further, achievement and standards, quality of provision and leadership and management, this inspection focused on specialist provision in:

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Scope of the inspection

 Health, public services and care 1. Tees, Esk and Wear Valleys Trust (the Trust) was formed in April 2006 as a result of a merger between Tees and North East Yorkshire NHS Trust and County Durham and Darlington Priority Services NHS Trust. It provides mental health and learning disability services for 1.4 million people. The organisation covers a large geographical area of some 2,000 square miles between Durham, the Tees Valley and North Yorkshire. It operates from 89 sites in the area and employs approximately 5,500 staff. The Trust also provides specialist mental health and learning disability services to other parts of northern England.

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Scope of the inspection

2. The Trust offers nation vocational qualifications (NVQ) in health and social care, advanced apprenticeships for young people and adult apprenticeships for those over 25 years of age. In addition a nursing cadet programme started in 2006. Learners from this programme are able to progress onto the second year of the Teesside University nurse training programme. Currently the trust has 22 apprentices, 10 of whom are completing the cadet nursing scheme. Tees Valley LSC funds the Trust’s provision. The Trust delivers Train to Gain as a subcontractor.

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Scope of the inspection

3. Provision is managed through a workforce development team which is part of the human resources directorate of the Trust. The team is based on two sites, one in Durham and one in Middlesbrough. Programmes are managed and led by the head of workforce development, a workforce development manager and a vocational skills facilitator. These staff are supported by two senior administrative staff and a number of workbased assessors. The programme is delivered in partnership with the University of Teesside which delivers the NVQ, and East Durham and Houghall Community College which delivers the literacy, numeracy and language programme and provides additional learning support. The Trust has recently begun to deliver the technical certificate. Learners attend the learning centre on one day each week.

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Scope of the inspection

4. Middlesbrough is ranked as the ninth most deprived area in the country and has an unemployment rate of 6.4% compared with a national average of 4.8%. Currently 19.4% of the working age population are qualified to NVQ level 4 or above compared with 27.4% nationally.

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Summary of grades awarded

Effectiveness of provision Satisfactory: Grade 3

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Summary of grades awarded

Capacity to improve Satisfactory: Grade 3

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Summary of grades awarded

Achievement and standards Satisfactory: Grade 3

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Summary of grades awarded

Quality of provision Satisfactory: Grade 3

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Summary of grades awarded

Leadership and management Satisfactory: Grade 3

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Summary of grades awarded

Equality of opportunity Contributory grade: Satisfactory: Grade 3

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Sector subject area

Health, public services and care Satisfactory: Grade 3 5. The overall effectiveness of the provision is satisfactory. Achievement and standards are satisfactory. Good progression opportunities ensure most learners move from health care programmes into higher education. The standard of learners’ work is good. Recent action by the Trust has been successful in enabling learners to make good progress and all have now gained the technical certificate. However, overall and timely success rates for apprentices on health care are poor.

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Sector subject area

6. The quality of the provision is satisfactory. Teaching and learning are satisfactory. Good use is made of all training opportunities and resources are used well to enhance learning. Support and guidance for learners are good. All learners value the individual support they receive. However, target-setting for learners is poor and many learners have stayed on programme beyond their expected completion dates. Line-managers are not routinely involved in training or in progress reviews.

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Sector subject area

7. Leadership and management are satisfactory. Effective strategic direction is provided by the Trust. Working relationships with external partner organisations are extremely good. However, provision was poorly managed during the merger of NHS Trusts in 2006 and learners’ progress suffered as a result. The Trust makes insufficient use of data to monitor and improve provision and its quality assurance arrangements are not yet complete.

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Satisfactory: Grade 3

8. Tees, Esk and Wear Valley NHS Trust demonstrates a satisfactory capacity to improve. Since the previous inspection some strengths have been maintained and some weaknesses have been rectified. However, other areas for improvement have emerged and the grades awarded at this inspection are lower than at the previous inspection. The Trust has taken recent, successful action to improve learners’ progress, strengthen partnerships and increase staffing resources. However, before these recent changes, it has been slow to implement its post-inspection action plan and subsequent quality improvement plan.

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Satisfactory: Grade 3

9. The self-assessment process is unsatisfactory. It is insufficiently inclusive and not internally validated by senior managers. It does not use accurate and up-to-date data to help make judgements. The self-assessment report is insufficiently evaluative. Judgements in the report do not match those found during inspection. The focus on quality improvement within the new quality assurance arrangements is insufficient.

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Key strengths

 Good progression to higher education  Good resources to support learning  Good support and guidance  Particularly effective strategic direction by the Trust

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Satisfactory: Grade 3

 Extremely good working relationships with external partner organisations

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Key areas for improvement

 Poor success rates on apprenticeship programmes  Poor target-setting  Inadequate involvement of line-managers in training  Poor management of the provision during Trust merger  Poor use of data to manage provision  Incomplete quality assurance arrangements

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Satisfactory: Grade 3

10. Achievements and standards are satisfactory, as they were at the previous inspection. The Trust has taken recent successful action to improve learners’ progress. Currently achievement rates are 40% and all learners have gained their technical certicate. However, overall success rates have declined over a three year period, from 63% in 2004/05 to the poor rate of 33% in 2006/07, 12 percentage points below the national average. Timely success rates in 2006/07 are very poor at 7%. This area for improvement is recognised in the Trust’s self-assessment report.

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Satisfactory: Grade 3

11. Learners develop good workplace skills and their line-managers comment on their increased confidence. They produce very well presented portfolios and most written work is of a high standard. Attendance of learners is carefully monitored.

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Satisfactory: Grade 3

12. The Trust offers good progression opportunities. Advanced apprenticeship and cadet learners have direct entry onto the second year of the nursing programme at the University of Teesside. Many other learners progress to mental health nursing or programmes for nursing people with learning difficulties or disabilities. For those learners interested in psychological therapies a new foundation degree is being developed, which will offer progression to level 4 qualifications.

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Satisfactory: Grade 3

13. The Quality of the provision is satisfactory. Teaching and learning are satisfactory. An effective induction helps learners understand the requirements of the programme. Learners enjoy a safe and healthy environment and all staff are cleared by the criminal records bureau. Current apprentices are taught by the University of Teesside and by the staff at the Trust. These sessions are well planned and learners make good progress. Learners attend a training centre for literacy, numeracy and language sessions at East Durham and Houghall Community College. Aspects of these sessions are productive and help learners improve their skills. However, these sessions are not planned effectively to meet the individual needs of the learners.

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Satisfactory: Grade 3

14. The Trust provides good resources to support learning. This strength is highlighted in the self-assessment report. Learners are provided with appropriate texts at the start of their programme. They make effective use of these books and of good library resources at the learning centre and in the workplace. Training rooms are well-equipped with specialist resources. Teaching sessions make good use of information technology equipment and online programmes, particularly to support learners’ literacy and numeracy skills needs.

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Satisfactory: Grade 3

15. Target-setting is poor. This area for development is not recognised in the self-assessment report. Individual learning plans are insufficiently detailed. Short-term targets are not regularly set with learners or shared with employers. Targets and assessment requirements set by the university are not entered onto individual leaning plans. Some learners are unclear about what is required of them or when assessments need to be completed. Assessment activities are insufficiently broken down into set tasks for learners. A few learners have waited a long time for work-based assessments to be completed. Many learners have exceeded their target dates for completion of the programme.

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Satisfactory: Grade 3

16. The range of provision meets learners’ needs and interests well. Partnership working is positive and opportunities are available in suitable mental health and learning disability settings. A wide range of additional learning opportunities are available to learners including, for example, sessions on challenging behaviour. Most learners complete an additional continuing professional development award. This is effective in preparing them for advanced entry onto the nursing programme.

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Satisfactory: Grade 3

17. Line-managers are insufficiently involved in learners’ training. This was not highlighted in the self-assessment report. Line-managers are required to sign a contract agreeing to learners’ participation in the programme, but this is not effectively monitored by the training team. Support for learners, from their line-managers is inconsistent. Some managers allow learners to attend the training centre regularly for off-the-job training, while others do not. Managers are not routinely involved in learners’ progress reviews. Although review documents are given to line-managers they are not required to make a comment or contribute to the review. The views of line-managers are not systematically collected and analysed to make improvements to the programme.

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Satisfactory: Grade 3

18. The training team and staff on the wards give good support and guidance to learners. The support is very flexible, with work-based assessors working evening and shift patterns to accommodate learners’ needs. Learners on the cadet programme are visited at least weekly and sometimes more frequently if they have particular problems or concerns. Effective career guidance is available from the Trust, and learners make good use of this to continue their studies. All learners have completed an initial assessment of their additional learning needs and further support is provided effectively, through subcontracting arrangements. The Trust achieved the Matrix accreditation standard in 2005.

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Satisfactory: Grade 3

Equality of opportunity Contributory grade: Satisfactory: Grade 3

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Satisfactory: Grade 3

19. Management of the provision is satisfactory. The Trust provides good strategic direction and has successfully integrated the programme’s objectives within its workforce development plan. The workforce development team works well with the various departments of the Trust. This collaboration is effective in providing additional trainers to teach on specialist courses within the programme. The team is represented on many steering and working groups such as the Trust’s equality and diversity steering group. It has recently taken effective action to improve learners’ progress. 20. The Trust has excellent working relationships with all external partner organisations. Links with the strategic health authority and a local Centre of Vocational Excellence are very productive, and have resulted in additional learning resources. The University holds the centre approval for the NVQ and works closely with around 40 work-based assessors

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Satisfactory: Grade 3

from within the Trust. Internal verification is detailed and thorough. Communications are good. Meetings of staff are regular and contact with partners is frequent and effective.

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Satisfactory: Grade 3

21. Staff development and professional development is satisfactory with an effective approach to supervision and personal development planning. Staff within the team are suitably qualified and recruitment processes are thorough.

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Satisfactory: Grade 3

22. The Trust has a thorough approach to equality and diversity with a range of policies that affect both staff and service users. The Trust’s range of safeguarding policies includes child protection for service users but it currently has no policies to cover employees under the age of 18. Nominated senior managers within the Trust are responsible for equal opportunities and an equality and diversity steering and working group.

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Satisfactory: Grade 3

23. Management of provision was poor during the merger of Trusts in 2006. This created a period of uncertainty and the team was under-resourced. It was unable to meet the needs of the large number of learners that were on programme. Assessors were re-deployed and communication with learners was poor. Several learners left the programme without completing their training. This situation was resolved when the team developed a new delivery model that was put into effect from February 2007.

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Satisfactory: Grade 3

24. The Trust makes poor use of data to manage provision. Targets and success rates are not shared with external partners. Management of under-performance is poor and understanding of how to tackle slow learner progress is insufficient.

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Satisfactory: Grade 3

25. Quality assurance arrangements are incomplete. The Trust has recently created a new quality assurance system which ensures that everyone in the team participates in the development and accurate implementation of procedures. However, the system does not focus effectively on quality improvement. Audit of the procedures has only just started. The Trust has no procedures in place for data management, self-assessment and improvement. It has no formal agreements in place with either subcontractor. The trust has not carried out teaching and learning observations of their subcontractors. The Trust has observed a very small number of training sessions delivered by the Trust, but none of these were in 2008. The trust appeals and review process does not include follow-up observations where necessary.

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Satisfactory: Grade 3

26. Learner feedback is collected well, and in a range of ways. However, analysis of the feedback to identify trends is insufficient. Results of surveys are discussed at team meetings. However, some key messages from the feedback have not been recognised by the team or acted upon. No evaluation of additional learning support provided to learners takes place. Website: www.ofsted.gov.uk

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Satisfactory: Grade 3

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What learners like :

 ‘I enjoyed completing my assignments’  ‘I enjoyed doing my NVQ’  ‘I liked getting back to study after 30 years’  Being paid to study  Excellent support from training staff and ward staff  Access to computer and good books  ‘I enjoyed the range of placements’  ‘I enjoyed the teaching on the technical certificate’

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What learners think could improve :

 More group sessions for literacy, numeracy and language  ‘More support from my line-manager’  Need more clarity at the start of the programme  Better understanding of progression routes available

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