Sirona Care & Health C.I.C.

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

At our last inspection we rated this key question good. At this inspection the rating has remained good.

Leaders and staff had a shared vision and culture based on listening, learning and trust. Local managers were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas.

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.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. Leaders had a good understanding of the services they managed and the current challenges they faced. Leaders we spoke with were knowledgeable about issues and priorities for the quality of services. Nursing staff we spoke with were positive about the support from their immediate managers and leaders in the department. Staff had access to the provider’s workplace health and wellbeing initiatives.

Staff were unanimous in all areas we visited that their line managers were supportive, understood the challenges of their role and took action to relieve pressures so staff could work effectively. Staff felt they were listened to and were not afraid to provide their opinion.

Managers were confident in their roles and themselves and felt supported. We observed open and honest conversations between staff and managers.

Staff felt their managers represented their views and feedback at a senior lever. However, not all staff were sure how well senior and executive leaders took their views into account. We were told that there was a lack of traction at executive level in regards to the concerns raised by the children’s services leadership team, such as demand and capacity concerns, and ADHD transition concerns.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Most staff knew how to contact the trust’s Freedom to Speak Up (F2SU) Guardian and what this process involved. Those who did not know the process knew how they would find the information if needed. Staff felt able to speak up without a fear of retribution.

Children’s services had six freedom to speak up champions at the time of the assessment, and champions represented different services. The F2SU service contributed to staff inductions, and promoted its service within staff networks, including the global majority network, and the lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) network.

The F2SU guardian reported receiving on average one concern regarding children’s services a month.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The children’s service had clear responsibilities, roles, systems of accountability and a good governance structure. Staff used these to manage and deliver good quality, sustainable care, treatment and support. Staff acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. However, it was not clear how issues, risks, performance and outcome issues were escalated to board level.

The children’s senior leadership team held comprehensive monthly performance and assurance reviews, identifying highlights and successes, key risks, areas of underperformance and actions, and items for escalation. We saw that reports also included information on workforce, incidents, complaints, safeguarding and risks.

Staff understood their role and responsibilities. Leaders understood the key risks affecting their service and worked to mitigate them. For example, leaders understood the risks in relation to staff meeting the demand for the autism and ADHD assessment services and had introduced a suite of ‘waiting well’ initiatives to support families and carers.

Managers had a strong awareness of the risks of managing patient flow through the services, and staff were positive about the processes for clinical escalation and told us managers were approachable and supportive.

Staff were also provided with information about how the services were performing. Audit results were shared with staff at team meetings.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. Staff shared information and learning with partners and collaborated for improvement.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Staff made sure there was continuity of care, including when people moved between different services.

Managers analysed information to understand the needs of the local communities.

Managers discussed local community needs with commissioners of the service. Staff provided information on themes they identified, which were based on conversations with schools about requests for parts of their service, support programmes used and referral reasons. This was recorded on the electronic record keeping system and provided information for senior leaders to identify where there were gaps in service provision.

Staff provided information for children and families to help them make decisions about their future choices. For example, making healthy food choices and sexual health. This was provided at relevant ages for children and in collaboration with school staff.

Managers met with local authorities, social care services, schools and other agencies to provide a supportive network for children and families. Partnership agreements provided a framework for providing the service. Nursing staff collaborated with schools to provide a service which was relevant to the needs of that community. For example, the way they provided sexual health education to ethnic and religious communities.

Meetings with commissioners of the service highlighted where health support was needed in the community. A recent focus had been on oral health for children and the school nursing team had supported this programme of work, contributing to the oral health and dental strategy.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.