Brighton NHS nursery rated inadequate by Ofsted

An NHS-run nursery in Brighton has been rated “inadequate” by the statutory watchdog Ofsted in a newly published inspection report.

Children were found to be at risk of choking. Staff did not manage bad behaviour well, for instance, children throwing toys and kicking them out of their way.

And they allowed children to swing back on chairs and climb on them which could lead to an accident.

Hilltop Nursery, at Brighton General Hospital, in Elm Grove, Brighton, was graded inadequate on all four measures – quality of education, behaviour and attitudes, personal development and leadership and management – as well overall.

The nursery, which is run by the Sussex Community NHS Foundation Trust, was graded outstanding at its previous inspection in July 2017.

The latest inspection took place on Thursday 9 March, with Ofsted saying: “The provision is inadequate. Children’s safety and well-being at this nursery are compromised due to breaches of safeguarding requirements.

“Staff do not recognise that children who walk around or play while eating food are at risk of choking.

“Staff do not effectively support children who struggle to manage their own behaviour and feelings. This has a negative impact on those children who behave well.

“For instance, staff often fail to respond when some children throw and kick toys out of the way, tease others or stamp on worms that they have found in the garden. This gives mixed messages to other children.

“The quality of education is very variable. Some children play for long periods of time with very little interaction from staff, due to weaknesses in staff deployment and teaching.

“Consequently, although children are generally happy in their play, they do not benefit from high-quality interactions with staff.

“Staff are overstretched because they struggle to manage children’s behaviour effectively. This compromises the overall quality of education.

“For example, children who need further challenges in activities are not given appropriate consistent teaching. This results in children becoming bored and aimlessly wandering around the room.

“Leaders and staff fail to provide a curriculum that meets all children’s learning needs.

“Despite these weaknesses, children are happy to arrive and they form strong bonds with the caring staff. Staff are kind and respectful. They give children plenty of choice in activities.”

Six staff work at the nursery, looking after 42 one to four-year-olds. Hilltop is one of three nurseries managed by Sussex Community NHS Foundation Trust.

The trust’s chief people officer Caroline Haynes said: “We are of course very disappointed with the latest inspection report from Ofsted but we are determined to make the changes needed to improve.

“We are working closely with parents, carers and nursery staff to understand their experiences and will support the team to make the changes we all want to see.

“We will monitor our progress regularly and continue to speak with parents and carers to update them.”

Ofsted inspector Tina Lambert said in her report: “Staff do not take enough action to protect children from potential harm.

“For example, they do not intervene when children play on equipment while eating food, such as apples, or recognise this as a choking hazard. This means children’s safety is not assured.

“Leaders do not have effective oversight of what it is they want children to learn. Although staff plan educational activities, these activities do not consistently build on children’s existing knowledge.

“Some children benefit … but others cannot concentrate or sit still long enough to benefit. As a result, learning is often incidental rather than purposeful.

“Staff do not consistently encourage all children to be polite and have good manners. They do not use effective strategies to help children learn to share or wait their turn during activities.

“Staff spend long periods of time sorting out squabbles and disagreements. However, there are some children who do listen, take part in activities and are respectful of others.

“Leadership arrangements are poor. For example, although staff receive supervision, this is not effective in identifying where they need support or to develop their skills. Leaders do not monitor the quality of practice well enough to ensure they quickly identify any weaknesses.

“Staff provide opportunities for children to listen to stories. However, children struggle to engage when staff fail to address unwanted behaviour, such as children playing instruments during story time. Consequently, children are not fully supported in their literacy and language skills.

“Parents mention that the communication with staff is strong. They look forward to finding out what their children have been doing during the day through a digital learning journal. They comment that the staff are ‘wonderful’ and ‘kind’.

“The baby room offers a calmer environment. Staff are very tactile with the babies and gently soothe them when they become upset.”

The report also said: “The arrangements for safeguarding are not effective. Staff do not adequately protect children. They miss situations that could present as hazards to children’s safety.

“For example, children walk around with food in their mouth, which could present a risk of choking. They swing back and climb on the chairs which could lead to an accident.

“Despite this, staff undertake regular child protection training. They have a sound understanding of other safeguarding issues. For instance, staff know what to do if they have concerns about a child’s welfare.

“Staff know the actions to take if they have concerns about the behaviour of a colleague.”

A section of the report headed “What does the setting need to do to improve?” listed a number of action points to be addressed promptly

• ensure staff have a secure understanding of how to identify and minimise potential risks to children’s safety such as the risk of choking while eating
• implement effective arrangements for staff support and training and for the monitoring of staff practice to help improve the quality of teaching
• improve staff understanding of appropriate behaviour management strategies, to provide children with clear, consistent boundaries and help them manage their emotions more effectively
• ensure staff are appropriately deployed so that children are supervised effectively to promote their safety and wellbeing
• provide a challenging curriculum for children that builds on their existing knowledge and skills and helps them make progress in all areas of development

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To read the full report, click here.