Oxfordshire Hospital School Ofsted Report

Full report

In accordance with section 44(1) of the Education Act 2005, Her Majesty’s Chief Inspector is of the opinion that this school requires special measures because it is failing to give its pupils an acceptable standard of education and the persons responsible for leading, managing or governing the school are not demonstrating the capacity to secure the necessary improvement in the school.

What does the school need to do to improve further?

• Urgently ensure that safeguarding arrangements in the outreach sector are effective by:
  • assiduously reviewing safeguarding records from the outreach sector
  • immediately making any referrals to appropriate agencies that have previously been missed following up on referrals that have been made to external agencies, and ensuring any recommendations have been fully implemented
  • ensuring all relevant information is passed on to home schools and this process is carefully recorded
  • making sure new procedures and guidance for following up and recording safeguarding concerns are rigorously adhered to
  • monitoring and evaluating safeguarding thoroughly and frequently, including rigorously scrutinising pupils’ records, as well as other areas of safeguarding.
• Improve the contribution made by those with overall responsibility for whole-school effectiveness, including governors, by:
  • fully implementing planned changes for improving the way the whole school is monitored and evaluated, including the monitoring of safeguarding
  • ensuring that they work effectively with the local authority to resolve accommodation issues in the outreach sector, so this sector can develop and the school can move forward as a whole
  • making sure governors have the training needed to hold school leaders to account with greater rigour. A review of governance should be undertaken as soon as possible, to see how this aspect of leadership and management can be improved. Newly qualified teachers may be appointed in the inpatient sectors.

Inspection judgements

Effectiveness of leadership and management Inadequate

• Up until very recently, each sector of the school has worked in isolation. Although, on the surface, this silo approach worked well, it was deeply flawed. It led to deficits in the overall leadership and management of the school. In particular, monitoring and evaluation have not been adequate. Some poor practices in safeguarding in the outreach sector have also not been picked up.
• Sector leaders, until the advent of the new headteacher, have worked in isolation. They have not been given the opportunity to contribute to developing the school as a whole. Although the new headteacher has provided a route-map of how they can do this from now on, it is too early to say what the impact of this new approach is.
• Temporary and interim leaders have not prioritised developments effectively. This has meant that some big, important decisions have not been taken. For example, decisions about where to accommodate the outreach work, following the imminent closure of the outreach hubs, are still unresolved.
• Governors and temporary leaders have not been effectual, especially when determining big policy decisions. This has meant that the school’s overall development and progress has stalled. In particular, it was set back by a recent failed attempt to become an academy. This dominated improvement agendas for governors and leaders, at the expense of other priorities.
• Senior leaders in the inpatient sectors do a very good job. However, the top layer of leadership has not supported their development well enough. There has not been enough rigour from those with oversight of the school, in monitoring and evaluating their contribution and ensuring their continuous professional development. In the past, senior leaders have expressed concerns about this and have sought to counteract the negative effects by successfully focusing on running their own sectors as well as they possibly can.
• The local authority’s relationship with the school, including governors, over the past year has been limited. This meant that concerns held by governors, and by the authority, were not acted on urgently enough. Relations are now much better and the local authority has supported the new headteacher in her efforts to broker new partnerships within the authority. The new headteacher has also benefited from support programmes for headteachers new to the authority.
• The inpatient leaders have established excellent working relationships with medical staff. For example, the leader in the Highfield sector attends ward rounds and care programme approach meetings, led by health professionals, so she can gain a deep and nuanced understanding of pupils’ mental and emotional needs. As a result of this liaison, the sector leader is able to ensure that the learning provided makes a positive and significant contribution to pupils’ recovery.
• Sector leaders are very well attuned to pupils’ learning needs, including those who have special educational needs and/or disabilities. Such is the expertise of the teachers that they are able to identify pupils’ additional learning needs even when they may be complicated by the medical needs they have. They meet these needs very well, tailoring work so it is both challenging and accessible.
• The curriculum provided is excellent. It is constantly evolving to meet the academic and social needs of the pupils and includes a broad range of subjects and courses, including GCSEs and A levels, vocational qualifications, as well as creative and physical education. School leaders have fully embraced changes to the national curriculum and are fully up to speed, having liaised closely with local good or better schools.
• The sport premium is used imaginatively to ensure pupils have opportunities to keep fit, work in teams and access the therapeutic benefits of exercise, for example yoga lessons. This contributes very well to pupils’ sense of well-being.
• The school provides well-planned opportunities for pupils to reflect on, and learn about, modern British values. These are linked carefully to work done to ensure that, despite being isolated, pupils’ experiences are as diverse as possible. A teacher with special responsibility has carefully mapped the areas in the curriculum where specific British values are taught to identify opportunities where they can make a better contribution to values learning, for example through religious education.
• The new headteacher has made significant changes. These are being effectively and fully implemented and are having a rapid impact. The new headteacher enjoys the full support of the staff and governors, as indicated by very positive responses to the staff survey conducted as part of this inspection. She has swiftly built professional relationships that are based on shared goals and values.
• The new headteacher has used her excellent professional knowledge to create a well-researched and workable definition of what constitutes expected and better than expected progress for pupils at the school. Under the headteacher’s leadership, pupils’ progress across the school is now being analysed thoroughly and in great detail. Previous analysis was very limited, and was not used to help the school move forward.
• New progress measures incorporate a variety of areas, including those relating to well-being. They are shared with parents and are now used as indicators for how well the school is doing. This represents a huge shift in the culture of the school and, although new, is influencing practice throughout the school.
• The new headteacher, in a short time, has fully apprehended the school’s strengths and weaknesses. The improvement plans she has created, in conjunction with senior leaders, are highly effective. They clearly detail how her high aspirations and goals for the school’s development will be implemented, monitored, and judged as effective. These plans have already started to support leaders and governors in moving the school forward apace; for example, an audit has been designed to ascertain how the support provided for pupils with medical needs could be even better.

Governance of the school

• Governance has been ineffective, despite some governors having a deep and long-lasting commitment to the school. This is because governors have not been confident about how best to hold leaders with oversight of the school to account. They have placed a greater emphasis on support than on challenge. Although their intentions were well founded, this resulted in some decisions and priorities not being subject to sufficiently rigorous scrutiny.
• Governors’ concerns about the direction in which interim headteachers were taking the school were not heeded. On occasion, governors did not articulate their concerns robustly enough.
• Operational concerns, particularly finance and plans to become an academy, have dominated governors’ work. Consequently, they have not focused enough on other key aspects of their role, such as rigorously checking safeguarding procedures and policies and reviewing actions taken.
• Governors have been side-tracked from their role of overseeing the development of the school as a whole, especially developing partnerships with other educational providers and stakeholders. In addition, although sector leaders keep a sharp eye on the progress of different groups of pupils, including disadvantaged pupils, governors’ minutes indicate that they have not always placed sufficient emphasis on this aspect of their role.

Safeguarding

• The arrangements for safeguarding are not effective.
• There is a big difference between the arrangements for safeguarding in the inpatient sectors and arrangements in the outreach sector. The former are under the auspices of the National Health Service and carried out in close partnership with hospital staff; the latter are managed by the school and are not effective.
• Leaders with overall responsibility have not checked with enough rigour that records are adequate and that referrals made to the local authority and other external agencies have been satisfactorily followed up.
• There is a high degree of inconsistency in record-keeping within the outreach sector. Some records relating to disclosures made by pupils are effective, others indicate that some follow-up actions have not been adequate. In addition, some records are incomplete, so it is impossible to evaluate whether actions taken are sufficient or not.
• Inspectors found that in some cases where records were insufficient, details of referrals to the local authority and crucial information had not been shared with home schools. These details were significant and would have helped home schools keep pupils who were re-integrating safe.
• Lack of training and experience has meant that some historic poor practices have not been identified by new leaders this academic year. In a very small number of cases, they have continued.
• Following concerns raised by inspectors, leaders took immediate action and rigorously followed up inadequate or incomplete records.

Quality of teaching, learning and assessment Outstanding

• Practice across the school is very strong and much is outstanding. Teachers set work that is appropriate and enables pupils to make the most progress possible so they keep up with their peers at their home schools.
• Subject experts collaborate effectively. They share good practice, including new approaches to teaching acquired from subject-specific training, and the best methods to ensure that pupils make strong progress. Subject proficiency is cascaded very well throughout the school, to the benefit of all pupils. Highly skilled teaching from subject experts in mathematics, science and English has enabled pupils to achieve successes in GCSE and A-level examinations.
• Sector leaders and teachers are very efficient and tenacious when gathering information about what pupils have learned so far and their strengths and weaknesses from home schools. Teachers and sector leaders use this information expertly to plan learning, create resources, set individual learning targets, and establish a very sound understanding of pupils’ starting points. As a result, teaching is highly effective and enables pupils to make strong progress from their starting points.
• Pupils’ learning varies daily based on their needs. Great thought and consideration is given to making sure that each pupil’s daily learning diet is varied, meaningful, stretching and enables them to feel a genuine sense of fulfilment and success. The expert teaching that pupils receive is seen as a contributory factor in their recovery.
• Pupils enjoy their learning and are able to identify precisely how their work with teachers from the hospital school has been just as challenging and stimulating as the work they did in their home schools. They feel they are making strides in their learning.
• Pupils acquire confidence in learning across a range of subjects because teachers use their very strong subject knowledge when introducing new subject content and ideas. In particular, they foresee where misconceptions might arise and ensure that pupils are given the necessary guidance to iron out any confusion and overcome any barriers. For instance, teachers work with pupils so they have a better understanding of key grammatical features, before exploring how writers use them in texts.
• Despite the vast majority of inpatient pupils spending all day in hospital, they have a detailed and extensive understanding of the world beyond the confines of the hospital. This is because pupils are provided with well-planned opportunities to extend their skills, knowledge, and understanding through an array of visiting experts; for example, through workshops given by museums in Oxford, and the loan of microscopes from a medical charity.
• Teaching of the most able pupils is very effective. This group is very well served by the school’s successful drive to recruit subject experts whose knowledge is such that they can stimulate and challenge pupils who have been at the top of their game in their home schools.
• Pupils have benefited from the excellent opportunities the school provides for self-expression, through their effective learning in a range of creative subjects, such as art, music and drama. Pupils’ interest and enjoyment in reading is cultivated effectively by teachers. Pupils read widely and are able to convey their high levels of understanding by their expression when reading aloud.
• Teachers assess pupils’ learning very effectively. The school has recently established a clear definition of appropriate progress and teachers have adjusted their teaching to ensure that pupils’ progress is strong and that teachers’ expectations are sufficiently high.
• The new outreach sector leader has introduced opportunities for pupils to develop their interpersonal skills. For example, every week pupils attend an outdoor learning centre, where they participate in a range of collaborative activities. Highly capable staff guide pupils so they are clear about which interpersonal skills are transferable to other learning contexts, such as negotiation skills.

Personal development, welfare and behaviour Inadequate

Personal development and welfare

• The school’s work to promote pupils’ personal development and welfare is inadequate. This is as a result of ineffective safeguarding procedures in the outreach sector.
• The new leader in the outreach sector has made changes to the curriculum to ensure that pupils have the opportunity to interact with other pupils in the sector. This is having a beneficial impact on their sense of well-being, particularly as outreach pupils often do not mix with other pupils.
• The sector leaders closely track pupils’ well-being, sense of self, and resilience, as well as a range of other emotional indicators. Teachers tilt the content of learning and the learning methods they employ to ensure that pupils have the chance to strengthen those aspects that are underdeveloped, including learning how to value themselves so they stay safe. As a result, despite some pupils being very ill, they display mostly positive attitudes to learning.
• The quality of learning delivered by the inpatient sector is such that medical staff see access to this as part of pupils’ journey back to good health. Pupils really appreciate the dedicated way in which school staff meet their learning needs. Pupils show high levels of trust in their teachers and assistants. This means that pupils are very receptive to the guidance they provide, including about different forms of bullying, and careers advice from an independent adviser.
• Parents commented favourably on the level of care and support that the school provides.

Behaviour

• The behaviour of pupils is outstanding. Pupils behave exceptionally well in lessons. They treat their teachers with respect in all sectors.
• Pupils’ attendance overall is higher than is average for schools in this sector.
• The new leader for the outreach sector has worked closely with teachers who have experience of working with pupils who have additional needs and has initiated well-planned opportunities for pupils to work together in teams. As a result, pupils in the outreach sector mix well with others. They show sensitivity towards each other’s needs and modify their language so it is suitable for this context.

Outcomes for pupils Outstanding

• Pupils achieve highly on the range of courses and qualifications that they undertake. This is because of the way teachers and assistants inspire pupils and ensure they feel confident in their own abilities. As result, pupils work hard and develop effective learning skills. Of note is the way pupils develop their ability to explain their ideas at length in writing.
• Using a measure of expected progress that has been moderated by appropriate external bodies, the vast majority of pupils, in summer term 2016, made expected progress and a significant number made greater than expected progress.
• The school’s own records indicate that in both the hospital sector and Highfield sector, approximately half of the pupils made greater than expected progress. In the outreach sector, the percentage making greater than expected progress was lower. This is because in some cases pupils have significant gaps in their learning from when they did not access education.
• Teachers prepare pupils for examinations very effectively, making very good use of practice tests and questions, and using their expertise to provide pupils with detailed feedback as to their next steps. The highly skilled way in which teachers manage external examinations to minimise their stress supports pupils in completing examination papers successfully. In summer 2016 GCSE examinations, the majority of pupils met or exceeded their predicted GCSE grades provided by the home school.
• The most able pupils achieve very well in the examinations they undertake, with a high percentage achieving the top grades. They have been well supported by the recruitment of specialist teachers with a proven track record in working with most-able pupils. In the hospital sector, teachers have been trained in approaches used by local good and outstanding schools for extending and stretching the most able; for example, providing opportunities for pupils to apply their mathematics knowledge in special challenges based on real-life problems.
• There are very few disadvantaged pupils in the school, typically less than 10, with the vast majority in the outreach sector. Their progress is carefully monitored on an individual basis. Overall, these pupils make progress that is broadly in line with that of others in the outreach sector.
• Across the school pupils who have special educational needs and/or disabilities are well supported because teachers ensure that they use tried and tested approaches from home schools. Teachers’ expertise means they can rapidly identify pupils who may have as yet unidentified special educational needs. The progress of this group is as strong as that of others in the school.

Early years provision Outstanding

• The very small number of children in early years are very well supported exclusively in the inpatient provision at The Oxford Children’s Hospital. They are therefore not affected by weaknesses in safeguarding in the outreach sector.
• Teachers and assistants ensure that children access the support they need to keep up with their learning at this crucial stage in their development. Their time at the hospital school supports the home schools in ensuring that children are ready for the challenges of Year 1.
• Teachers and assistants plan opportunities for children to learn through play. Although this is a challenge if children are based on the wards, teachers work closely with hospital staff and parents to bring play and learning opportunities to the children’s bedsides.
• When children are well enough they attend the school facilities, where they are given very effective support by teachers and assistants. They learn very well and gain confidence in key skills across the prime areas. For instance, children benefit from cooking lessons, where they learn key numeracy skills, such as weight and measurement, as well as how to follow instructions.
• The learning environment meets the needs of the children very well. Although children are taught in spaces shared with older pupils, great care has been taken to ensure there are opportunities for children to learn through play, including role play. Teachers and assistants ask meaningful questions during carefully planned child-initiated play activities. Adult-child interactions are supported by helpful question prompts placed around the room. Children make strong progress during their stay in hospital.
• Children are taught phonics by specially trained staff. They make strong progress because of the focus that is placed on ensuring that children master key skills such as the ability to blend sounds to make words. Children employ these skills confidently when reading books. Teachers’ and assistants’ effective questioning, while children read aloud, is developing their ability to explain what is happening in the book and why.
• Children in the early years display very positive attitudes to their teachers and to learning.

16 to 19 study programmes Outstanding

• Sixth form learners are taught solely in the inpatient sectors. They are therefore not affected by the safeguarding weaknesses in the outreach sector. They are safe and well cared for and treat their teachers and each other with respect.
• Leaders with responsibility for 16-19 study programmes have tirelessly and successfully ensured that the needs of this group are fully met. This includes receiving high-quality careers advice that is bought in from a local outstanding school. Where necessary, they access very well-focused support in English and mathematics. All learners taking either level 1 or level 2 qualifications achieved them in English and in mathematics.
• The provision for post-16 learners has developed and evolved. There is now a dedicated post-16 teacher based at the Oxford Children’s Hospital. This teacher and the sector leader seek out and teach any learners who are over 16. Before the appointment of the dedicated post-16 teacher, the needs of learners on adult wards were not as well met in this sector.
• The 16-19 study programmes have developed very comprehensively since the last inspection. Of note is the way that learners now access a much wider range of courses, including vocational courses, so they can better keep up with their studies and prepare well for their next steps.
• Teachers and assistants have expertise in supporting learners with applications to universities and higher education providers. This in turn means learners feel confident that, despite their time away from their home school or college, their life plans are not diverted. This also improves learners’ sense of well-being.
• Teaching is highly effective and subject experts know the requirements of the courses they teach very well. Learners are supported very effectively in gaining the depth and breadth of knowledge required to succeed in their post-16 qualification by the bespoke online learning resources the school provides. Outcomes are very strong, with 88% of learners achieving A* to C grades at A level in 2016.
• Teachers do whatever is necessary to ensure that learners can continue their studies while in hospital. For example, leaders have, on occasions, bought in a teacher with expertise in the International Baccalaureate (IB) to ensure that learners studying for the IB were able to pursue their studies while in hospital. Learners are also provided with excellent opportunities for self-development and self-fulfilment through the arts as well as physical education.
• Leaders track the destinations of learners closely and the vast majority go on to pursue training, employment or education. A small number are placed in full-time hospital care when they leave this school. The school’s dedication to facilitating learning is such that leaders work determinedly with external agencies to ensure that learners continue to access education.

-

School details

Unique reference number Local authority Inspection number 123337 Oxfordshire 10003678 This inspection was carried out under section 8 of the Education Act 2005. The inspection was also deemed a section 5 inspection under the same Act. Type of school Special School category Age range of pupils Gender of pupils Gender of pupils in 16 to 19 study programmes Community special 3 to 18 Mixed Mixed Number of pupils on the school roll 147 Of which, number on roll in 16 to 19 study programmes 6 Appropriate authority Chair Headteacher Telephone number Website Email address Local authority Dr Jake Piper Angela Ransby 01865 253 177 http://www.ohs.oxon.sch.uk ohsoffice@oxfordshire.gov.uk Date of previous inspection 6–7 December 2012

Information about this school

• The school takes pupils who are experiencing either medical or mental health conditions. The school roll is transient. In 2015–16, approximately 888 pupils were taught by teachers from the hospital school.
• All pupils admitted remain on the roll of their ‘home’ schools. The length of time pupils are with the school varies from one day to several months. Some pupils with specific conditions regularly return to the school. The proportions of pupils who are known to be eligible for the pupil premium (additional money provided by the government), pupils who have special educational needs and/or disabilities or those in the care of the local authority, are continually changing. The school does not receive additional money through the pupil premium.
• The school has three sectors. Two of the sectors support pupils and learners as inpatients, and the third sector supports pupils as outreach.
• The hospital inpatient sector consists of pupils and learners with a range of medical or surgical conditions located at the Oxford Children’s Hospital (Oxford), within the John Radcliffe Hospital, the Nuffield Orthopaedic Hospital and the Helen and Douglas House Hospice (Oxford).
• The Highfield Adolescent Unit sector also supports pupils and learners as inpatients. It is based at the Warneford Hospital (Oxford). This is a psychiatric unit for students with mental health needs.
• The third sector is the outreach sector. This is for pupils in the community with medical or mental health conditions. This sector also supports teaching at the Horton Hospital, Banbury. These students are taught at home or in one of four classroom bases, within LA Early Intervention Hubs. These are based on four different sites across Oxfordshire.
• The Highfield Sector has a post-16 provision. A small number of post-16 learners and children in the early years foundation stage are also taught within the hospital inpatient sector.
• The new headteacher was appointed in March 2016 and took up her post in September 2016. The new assistant headteacher responsible for outreach was appointed in September 2016 and is also the special educational needs coordinator.
• The school meets requirements on the publication of specified information on its website.

.

Information about this inspection

• The inspection started as a short section 8 inspection and then converted to a section 5 full inspection.
• Inspectors made visits to observe learning the Highfield Adolescent Unit on one occasion and at the Oxford Children’s Hospital on two occasions. Inspectors observed learning in the outreach sector twice, including visiting pupils from the outreach sector at an outdoor education facility.
• Samples of pupils’ work were scrutinised.
• Informal meetings were held with pupils as part of all the visits to observe learning.
• Inspectors spoke to teachers and assistants during visits to each sector. On two separate occasions inspectors met with senior leaders who are responsible for each sector. Several meetings were held with the new headteacher. Inspectors also met with governors, spoke to the local authority on the telephone on two occasions and made a call to the parent of a pupil in the Highfield Adolescent Unit. Inspectors also spoke with leaders from a home school in Oxfordshire. An inspector made a telephone call to the local area designated safeguarding officer and the local children and adolescent mental health service (CAMHS).
• Twenty-nine questionnaires submitted by members of staff were scrutinised. Six responses made in response to the online parent survey, Parent View, were taken into account, as were four comments made by parents using the free text facility within this survey.
• Documentation and policies, which included the school’s own evaluation and development plans, were reviewed. Inspectors scrutinised the school’s safeguarding records.

Inspection team

Sarah Hubbard, lead inspector Her Majesty’s Inspector Ross McDonald Ofsted Inspector