Sirona Care & Health C.I.C.

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that safety was a priority for everyone, and leaders embedded a culture of openness and collaboration. We checked that people were safe and protected from bullying, harassment, avoidable harm, neglect, abuse and discrimination. We also checked people's liberty was protected where this was in their best interests and in line with legislation.

We looked for evidence that safety was a priority for everyone, and leaders embedded a culture of openness and collaboration. At our last inspection we rated this key question as good. At this inspection the rating has remained good.

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. However, there were not always enough staff with the right skills, and experience, but managers made sure staff received training and regular appraisals to maintain high-quality care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had effective systems for staff to report incidents and concerns. Lessons learnt following incidents were shared and used to make improvements. Staff described the process for reporting adverse events using an electronic system, which they found easy to use. They received feedback about progress of actions taken. Learning from incidents was also shared at meetings with managers. Staff told us they had attended training in the Patient Safety Incident and Response Framework (PSIRF) which was a mandatory module. Staff described actions to improve confidential data sharing between partner agencies which span county boundaries. Managers produced and shared PSIRF learning in newsletters and team meetings

Staff felt supported to respond to patients’ concerns and would try to resolve them at the time. Staff we spoke with demonstrated a clear understanding of the duty of candour and discussed how they would be open and honest with patients and families, and give a full explanation if and when things went wrong. The duty of candour Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 is a regulation, which was introduced in November 2014. This regulation requires the organisation to be open and transparent with a patient when things go wrong in relation to their care and the patient suffers harm or could suffer harm, which falls into defined thresholds.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

Arrangements to safeguard children from abuse reflected relevant legislation and local requirements. Staff understood their responsibilities and were aware of the provider’s policies and procedures. Staff received training specific for their role on how to recognise and report abuse. Staff training was audited and monitored. By December 2024, 92% of required staff had completed mandatory training on safeguarding children (level 3 core compliance), against a target of 90%. Staff gave examples of how to protect patients from harassment and discrimination, including those with protected characteristics under the Equality Act. Staff demonstrated an understanding of anti-discrimination and provided person-centred care. For patients with mental health problems staff would consider patient support and safety as part of their risk assessments. Staff knew how to identify children at risk of, or suffering, significant harm and worked with other agencies to protect them. Staff told us the referral process was easy to use. Staff spoke positively of the division’s safeguarding team and told us they received feedback on cases they had referred.

Safeguarding supervision was provided on a regular basis with frequency depending upon staff roles. This was as a one to one support, group discussion and additional support from the safeguarding support line. Lunchtime learning was offered each month by the safeguarding team.

Managers introduced a ‘Safeguarding Single Point of Access’ which oversaw all safeguarding reviews requiring a medical review. Staff attended a child protection conference if they were involved with a family although, the safeguarding specialist team will gather health information and present this at the child protection conference. Managers could provide feedback to the appropriate local team if they needed to provide support, such as support packages. This meant staff were not all attending many child protection conferences at short notice so they can offer support to more children and families to promote health and wellbeing.

Staff described clear processes of how children and families accessed their service. Children and Early Years Practitioners used their skills to check children’s development at nationally mandated ages, for example at 9 – 12 months. If families did not attend, staff contacted them to arrange another appointment or would raise with health visitor colleagues to follow up. This ensured children under 5 years old were monitored and safeguarded. Processes supported staff to monitor and safeguard children under 5 years of age. Staff provided a range of opportunities for children and families to access their service.

Staff had good links with schools to identify vulnerable children. School nursing staff had termly meetings with each school dedicated to identifying where children and families could benefit from additional support. All referrals into the service were reviewed by senior nursing staff who had additional skills to assess needs.

Local authorities had the details of health visiting and school nursing teams and would refer in any home schooled children if needed.

The public health response team reviewed children’s attendances at hospital emergency departments and shared information with public health nurses if relevant.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service did not always make sure there were enough qualified, skilled and experienced staff to cover all patients’ needs and meet waiting list targets, especially with the recent increase in demand for services.. However, managers made sure staff received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs.

Staff were experienced, qualified and had the right skills and knowledge to meet the needs of patients. Managers gave new staff a full induction tailored to their role before they started work, and staff spoke positively about this.

Managers confirmed staff retention had improved over the last two years.

Staff told us they were happy in their roles and all were really positive about their managers and support available.

Staff were trained for their roles. We spoke with a range of staff who described additional training and qualifications which supported their role and development. They described supportive environments and opportunities and time to have discussions with colleagues and managers where additional support was required. Staff spoke positively about using virtual meetings to meet and support each other.

School nursing staff attend training days in September as an update on any skills for their roles.

Staff who had additional training reviewed referrals and allocated work to nursing staff who had the skills to support the child/family needs. Supervision was provided for staff by more experienced colleagues. Staff described being well supported by managers who understood the pressures of their roles. Some managers used a staffing tool to allocate staff to working patterns. Staff felt if their working hours was overly pressurised, their manager would act to reduce the pressures.

Staff felt supported by their managers in all areas we visited. Supervision was seen as supportive and managers approachable. We spoke with many staff who had undertaken additional qualifications and were seeking advancement in their roles as a result.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.