THE health and care regulator has called on an organisation providing care for thousands of people across the region to improve.
The Care Quality Commission says there are “significant leadership challenges” at Sirona Care & Health CIC, with a “disconnect between leadership and frontline services”.
The not-for-profit social enterprise provides NHS and council-funded community healthcare across Bristol, North Somerset and South Gloucestershire, serving a population of around 940,000 people.
The CQC announced the downgrading of Sirona’s leadership rating from ‘good’ to ‘requires improvement’ in November, but said it was based on an inspection held in February.
It said the inspection was carried out “due to concerns about the quality of care across various services and the stability of leadership following recent, unexpected changes at board level”.
The CQC said: “Inspectors found the organisation was in breach of legal regulations relating to the good management of the service.”
The inspectors said staff felt leaders “lacked transparency and stability” and had a culture which “discouraged speaking up and created fear of retribution”.
However they also found that staff were “hard-working, dedicated and knowledgeable”, and leaders worked together well in areas around the quality and improvement of care.
CQC deputy director for the South West Catherine Campbell said: “When we inspected Sirona, we found staff trying their best, but we found an organisation facing significant leadership challenges that were affecting its ability to deliver consistently good care to the communities it serves.
“The board had been through a period of instability, with several interim appointments and departures, which meant leaders weren’t working together effectively to address the serious issues the organisation faced.
“This lack of grip from the board meant staff on the ground didn’t feel heard or supported.
“Many told us there was a disconnect between leadership and frontline services, and that their concerns about things like demand and capacity weren’t being taken seriously or acted on quickly enough.
“When staff don’t feel supported or listened to, it makes it harder for them to provide the quality of care people deserve.”
Sirona has been without a permanent chief executive and chair for 18 months and had also been missing some non-executive directors and other senior leaders.
The organisation says it has continued to have good patient satisfaction ratings despite the uncertainty at the top.
A spokesperson for Sirona said: “While it is disappointing that our well-led rating has gone down a band, this is not a reflection on the care Sirona delivers or on our dedicated and hard-working staff, but on our internal arrangements and processes as they were in February 2025.
“Since then, we have made substantial progress in our leadership, governance and culture. We have addressed and continue to address issues with recruitment.
“We are confident that, under the leadership of our new chief executive and senior team, Sirona will continue to improve significantly, becoming a stronger organisation that can better support our frontline staff as they provide vital community care to patients and their families.”