Lancashire Teaching Hospitals NHS Foundation Trust

Inspection number 331547 Lancashire Teaching Hospitals NHS Foundation 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 .................................................................................................. 4 Overall judgement.................................................................................................................... 5 Effectiveness of provision ..................................................................................................... 5

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Contents

Capacity to improve............................................................................................................ 6 Key strengths ............................................................................................................................ 6 Key areas for improvement..................................................................................................... 6 Main findings............................................................................................................................ 7 Achievement and standards................................................................................................... 7 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 Learners’ achievements......................................................................................................... 12

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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’ monitoring 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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Description of the provider

1. Lancashire Teaching Hospitals NHS Foundation Trust (the Trust) Education Service is based in Preston and has delivered Train to Gain programmes since August 2007. The human resources development team delivers Train to Gain programmes in health. The range of national vocational qualifications (NVQs) offered at levels 2 or 3 include clinical laboratory, perioperative care, clinical support, general healthcare support and pharmacy. North West Regional LSC fund the Train to Gain provision; 76 employed staff are currently on the programme, with 19 learners receiving numeracy support.

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Description of the provider

2. The Trust’s services are based at three sites, Royal Preston Hospital, Chorley and South Ribble Hospital and Preston Business Centre. Train to Gain NVQ programmes are provided to staff from other Trusts. The associate director for human resources development has responsibility for strategic management. A team leader co-ordinates the provision supported by two tutor/assessors and administrative staff. A part-time tutor is employed for skills for life.

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Description of the provider

3. The Trust’s three sites cover a 13 mile area. The city of Preston is one of the most deprived areas in the country. Minority ethnic groups in Preston make up 15.2% of the population compared with 9.1% of England as a whole. In comparison, minority ethnic groups in South Ribble and Chorley make up approximately 3.5% of the population. The Trust is one of the largest NHS providers in the region and employs over 6,000 staff.

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Summary of grades awarded

Effectiveness of provision Good: Grade 2 Capacity to improve Good: Grade 2

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Summary of grades awarded

Equality of opportunity Contributory grade: Good: Grade 2

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Sector subject area

Health, public services and care Good: Grade 2

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Good: Grade 2

4. The overall effectiveness of provision is good. Achievements and standards are good. Success rates for NVQ provision are high. The quality of provision is good. Teaching and learning are satisfactory. The Trust is particularly effective in supporting learners and the range of provision is good.

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Good: Grade 2

5. Leadership and management, and equality of opportunity are good. The strategic management of the Trust is very effective in developing the provision. Operational teamwork and liaison with work-based trainers, assessors and occupational staff to support learners to achieve their qualification is good. The recording of some operational issues is insufficient. The resources to support learning and achievement are good. Staff have good access to a wide range of training and development. Quality improvement arrangements are weak.

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Good: Grade 2

6. The Trust has demonstrated that it is in a good position to make improvements. Very effective strategic management structures are in place. The quality improvement arrangements of the Train to Gain provision are incomplete. The Trust acknowledges the need to develop the quality arrangements, and structures are in place to monitor and improve educational quality standards across all areas. It is too early the judge the full impact of these structures. NVQ success rates are high and learners make good progress. The Trust makes good strategic use of management information to improve the provision.

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Good: Grade 2

7. The self-assessment process is good. The self-assessment report is the Trust’s first and it is evaluative and largely accurate. The report identifies many of the strengths and areas for improvement identified during the inspection. The quality improvement plan is comprehensive. This is the Trust’s first inspection.

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Key strengths

 High NVQ success rates  Good range of provision  Particularly effective support  Very effective strategic management

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Key areas for improvement

 Incomplete quality improvement arrangements

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Good: Grade 2

8. Achievement and standards are good. As identified in the self-assessment report, success rates for NVQ programmes are high; the timely success rate is 95% and the overall success rate is 97% for 2007/08. Of 100 learners who started during this current year, 19 have already completed their NVQ and others are making good progress. In 2007/08 on the level 2 numeracy programme, some learners made slow progress. The timely success rate is 62% with three learners still in learning. It is very early in the current year but timely support arrangements are in place for all learners with additional numeracy needs. 9. Learners are developing the skills and knowledge to be competent in the workplace. They make good gains in confidence and communication skills. Written work in portfolios is of a satisfactory standard. Attendance and punctuality is good.

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Good: Grade 2

10. The quality of provision is good. Teaching and learning are satisfactory. Most learners enjoy their training. The sessions are well planned but teaching and learning methods are limited with an over emphasis on PowerPoint presentations. Good learning support promotes the development of learners’ confidence and involvement. Training plans meet the range of learners’ work specialisms. However, attention in sessions to the differing needs and abilities of individuals is insufficient. Links between theory sessions and work- based learning are very well developed. A wide range of learning resources includes well- equipped training facilities, library resources and good access to e-learning. However, some training rooms are small for the group size. Trainers and assessors are appropriately qualified and experienced.

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Good: Grade 2

11. Identification of learning needs and numeracy support are good. Learners with additional numeracy needs are referred to a specialist tutor and work towards numeracy qualifications at level 1 or 2. An educational psychologist assesses learners with dyslexia and a detailed report promotes good learning support.

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Good: Grade 2

12. Assessment practice is satisfactory. Planning is clear and meets the needs of the workplace. The range of assessment methods is satisfactory but an over reliance is placed on written questions, which some learners find repetitive or difficult to understand. Assessment feedback is timely and appropriate. Learners’ progress is carefully monitored. However, in some instances, units are not completed fully until the end of the learner’s programme and some recording is insufficiently detailed. Review of learner progress is effective and a recently introduced review document has improved the recording of review outcomes. Links between reviews and individual learning plans are insufficiently developed.

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Good: Grade 2

13. The good range of training provision and opportunities for progression meets the needs of learners well. The self-assessment report partially identified this. Most learners who succeed on Train to Gain remain in employment with many securing promotion to a higher pay band. Half of those learners who succeed at level 2 progress to level 3. Some learners progress to professional training and examples exist of learners who have progressed through levels 2 and 3 to become staff nurses or sisters within the Trust. All learners are employed by the Trust and have good access to a range of other training and social opportunities to support their personal development.

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Good: Grade 2

14. Support for learners is particularly effective. The self-assessment report partially identifies this. Induction is comprehensive and supports learners well to understand their programmes. Learners spend an initial three weeks in the training centre where they develop a range of skills that support them to settle into their jobs effectively. This is followed by a comprehensive three week induction on the wards or departments. All learners receive good support from work-based assessors or expert witnesses who act as mentors. Managers are highly supportive of the training, which is a requirement of the learners’ employment, and are given time off for study. Tutors provide good individual support to learners. Arrangements to support access to learning are good. Out-of-hours contact and support from tutor/assessors is available to learners. Communication between tutor/assessors and the workplaces is good and enhances the learners’ experience.

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Good: Grade 2

Managers are clear about the programmes and provide a range of experiences to support learning and assessment. Learners receive good initial advice and guidance ensuring suitable recruitment to each programme and a clear understanding of progression opportunities.

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Good: Grade 2

Equality of opportunity Contributory grade: Good: Grade 2

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Good: Grade 2

15. Leadership and management are good. The Trust has very clear leadership with a particularly effective approach to strategic management, which it uses well to develop the provision. The clear and specific targets in the education training and development strategy and human resources and development business plan provide a clear vision and direction. Staff are set clear targets in their annual appraisal and progress towards targets is monitored carefully. Data is used well to identify issues and develop strategy. The strategy for literacy, numeracy and language is well established and comprehensive, additional needs are identified well at recruitment and induction. Level 1 and 2 literacy and numeracy provision is offered to all staff including national accreditation. The management of resources to support learning and achievement is good. Train to Gain learners benefit from a good range of specialist resources. These include good access to a

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Good: Grade 2

clinical skills laboratory and human patient simulator to develop their clinical skills. Staff development is particularly well-planned and managed. Staff have good access to a wide range of staff development and training. Staff benefits are good. A wide range of clear and comprehensive employment policies and procedures are in place.

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Good: Grade 2

16. Overall co-ordination of the Train to Gain provision is effective. Liaison with work based trainers, assessors and occupational staff to support learners to achieve their qualification is good. However, while aspects of co-ordination of the programme are effective, the recording of some operational issues is insufficient. Minutes of the Train to Gain team meetings have an insufficient focus on evaluating the provision and recording quality improvements, and they often contain insufficient detail and action points.

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Good: Grade 2

17. The procedures for safeguarding learners meet current government requirements. Comprehensive policies and procedures are in place for child protection and the protection of vulnerable adults. The policies clearly identify designated members of staff and referral procedures. Significant staff development has taken place. All staff undergo enhanced Criminal Record Bureau (CRB) checks at entry to their job. A single central record is in place.

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Good: Grade 2

18. Equal opportunities are good. The strategic management of equality and diversity is very effective. A comprehensive single equality scheme with a detailed action plan is implemented and monitored comprehensively through a strategic quality group. The strategic management of impact assessments is very effective. A very clear and detailed equality and diversity training strategy exists and staff at all levels receive a range of training. Equality data is used particularly well to identify areas for improvement. Staff at all levels demonstrate a good level of commitment to equality and diversity as well as to widening of participation to under-represented groups. Clear and specific strategies are in place to consult stakeholders on the quality of services for different needs. This includes an annual consultation exercise. A project is in place to train key staff in understanding the needs of blind and deaf people and to promote improved more effective

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Good: Grade 2

communication. A detailed communication book is available to help service users with learning difficulties to communicate effectively.

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Good: Grade 2

19. The Trust has developed good partnerships with local colleges to implement a workplace familiarisation programme for young people with learning difficulties. This includes work experience and two young people gained paid employment with the Trust in 2008. Particularly good support is provided for staff to engage in learning, to promote progression and to widen participation. Promotion of equality and diversity to Train to Gain learners is good. Equality and diversity is promoted effectively at induction. Training officers discuss equality and diversity with learners in their progress reviews but do not always sufficiently challenge their understanding of issues. The Trust complies with relevant equality and diversity legislation.

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Good: Grade 2

20. Quality improvement arrangements are incomplete. The observation of NVQ sessions by peer tutors takes place annually. While observation identifies strengths and some actions for improvement, the process is insufficiently thorough and focuses too greatly on teaching processes rather than on learning. End of course learner feedback is collected but its use is insufficiently formalised. Learner standardisation meetings and internal verification are adequate. The quality assurance of equality and diversity impact assessments is good. The self-assessment report is the Trust’s first and it is evaluative and largely accurate. The report identifies many of the strengths and areas for improvement identified during the inspection. The quality improvement plan is comprehensive. The process is adequately inclusive. However, a recently developed educational governance framework is in place that clearly identifies actions to develop quality assurance

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Good: Grade 2

arrangements. The framework is not yet fully implemented although two staff have very recently been appointed to fully implement its development. A new educational governance committee has recently met with a remit to monitor and improve educational quality standards across all areas of the Trust. It is too early to assess the effectiveness of these initiatives.

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What learners like :

 ‘Staff are incredibly supportive with family and work problems’  ‘The good support’  ‘Having the opportunity to get a recognised qualification’  ‘The assessor is easy to contact’  ‘Their priority is to make sure you succeed’  ‘I’m learning a lot’  ‘Learning more about patients and what they need’  ‘You can attend a different group’s training day if you miss one’  ‘Makes you think about all the skills you use’  ‘Attending training and meeting other people’  ‘I have done the job for a while and I feel as though I am achieving something’

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What learners think could improve :

 ‘It would be useful to see an example of what the work should look like’  Complicated repetitive written questions  ‘Witness statements are sometimes repetitive’  ‘We need the candidate packs earlier’  ‘More expert witnesses because just one is not always on shift’  ‘More hours training in the education centre’  ‘The teaching room is too small and cramped’ Annex

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What learners think could improve :

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Learners’ achievements

Success rates on work-based learning, Train to Gain, NVQ programmes managed by the provider 2006 to 2008

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Learners’ achievements

Programme End Year Success rate No. of learners* provider NVQ rate** overall 38 97% 2007/08 timely 38 95% overall 100 Train to Gain NVQ 2008/09 (11 months) timely 100 19%

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Learners’ achievements

Note: 2008/09 data is ‘part year’ only and is representative of the first three months or greater of the LSC contract year

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Learners’ achievements

* Learners who leave later than originally planned are counted in the year they actually leave. This group of learners are then added to the learners who planned to complete in a given year and did so or left earlier than planned ** NVQ qualification success rates are calculated using data supplied to Ofsted by the provider before inspection

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Learners’ achievements

Success rates on work-based learning, Train to Gain, skills for life programmes managed by the provider 2006 to 2008

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Learners’ achievements

Programme End Year Success rate No. of learners* Provider skills for life rate** overall 21 62% 2007/08 timely 21 62% overall 16 Train to Gain (skills for life) 2008/09 (3 months) timely 16

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Learners’ achievements

Note: 2008/09 data is ‘part year’ only and is representative of the first three months or greater of the LSC contract year

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Learners’ achievements

* Learners who leave later than originally planned are counted in the year they actually leave. This group of learners are then added to the learners who planned to complete in a given year and did so or left earlier than planned ** Skills for life qualification success rates are calculated using data supplied to Ofsted by the provider before inspection

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