Chandlers Ford Dialysis Unit

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on the best available evidence. At our last assessment we rated this key question as good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

The service had clear admission criteria to assess whether patients were suitable for dialysis at the centre. This criteria was developed in partnership with the local NHS renal service. This supported safe patient selection and ensured the service could meet patients’ needs.

Staff completed individualised care plans for all patients. These included dialysis-specific requirements and wider care needs. Areas covered included mobility, communication, skin integrity, and social or work-related needs. Care plans were developed with patients. Discussions during the inspection confirmed patients were involved in this process. This ensured care reflected individual needs and preferences.

Care plans were reviewed regularly to ensure they remained current. Staff carried out monthly audits to check the completeness and accuracy of records. Data provided by the service showed records were completed accurately and updated when required. Our review confirmed that care plans were updated consistently and reflected patients’ current needs.

The service had a structured audit process for nursing documentation. A sample of patient records were reviewed at regular intervals. This included a range of patients and staff to provide oversight of practice. Audits checked key areas such as risk assessments, dialysis evaluations, prescriptions and emergency planning. Documentation was assessed for completeness, accuracy and compliance with current standards.

Findings from audits were shared with clinic leaders and staff. Errors, such as missing signatures or incomplete entries, were identified and addressed. Recurrent issues were tracked and discussed in team meetings. Corrective actions were taken and signed off within set timescales. Trends were monitored to support continuous improvement.

Patients received care, treatment and support that was based on current evidence and recognised good practice. The service followed policies and procedures developed by the provider, Fresenius Medical Care. These generally reflected national guidance and clinical standards.

For some aspects of clinical care, staff followed policies set by the local NHS trust. The trust retained overall responsibility for patients’ clinical management. This ensured consistency with NHS standards and supported safe, coordinated care.

Patient records showed staff used recognised tools to assess and monitor risks. These tools were based on national guidance and supported consistent clinical decision-making. For example, the service used an adapted sepsis risk assessment pathway. This was based on NICE guidelines and the UK Sepsis Trust screening tool. It had been adapted to reflect the needs of dialysis patients and the setting of a satellite unit without on-site medical staff. This ensured assessments remained relevant and effective in practice.

The service carried out regular audits to monitor compliance with evidence-based standards. This included audits of medicines management and infection prevention and control. Audit results were used to identify areas for improvement and to provide assurance that care was delivered in line with current guidance.

Staff worked collaboratively with the local NHS trust. The service was commissioned to provide renal dialysis for NHS patients, all of whom remained under the care of a named renal consultant at the trust. Staff described positive working relationships with the trust, including access to dietetic services and the use of trust policies and protocols where required. The service had also worked in partnership with the trust to trial dialysis protocols, which were subsequently implemented more widely across services.

Multidisciplinary meetings involving the unit staff and the NHS renal consultant were held regularly to review and plan patients’ dialysis treatment. The registered manager described effective working with the trust’s renal coordinator to support timely access for new patients.

The service also worked collaboratively within the wider Fresenius Medical Care network. This included supporting patients to arrange dialysis at alternative units while on holiday and accommodating patients visiting Chandlers Ford Dialysis Unit for treatment during their stay.

Staff supported patients to live healthier lives. The service displayed information within patient areas to promote healthy lifestyles and signpost available support. Information in waiting areas included advice on how patients could access resources to improve their health and wellbeing.

Staff provided education and guidance to patients about their renal conditions and how to optimise their health outcomes. Discussions with patients confirmed staff regularly spoke with them about how to manage and maintain their renal health effectively.

The service had effective systems to monitor patient outcomes and support continuous improvement. It participated in national audits and submitted dialysis outcome data to the UK Renal Registry in line with national standards. Evidence provided by the service demonstrated how patient outcomes were routinely reviewed and benchmarked to identify potential risks and opportunities for improvement.

We reviewed a mortality risk benchmarking report for 68 patients receiving dialysis at the Chandlers Ford Clinic. A mortality risk report is a clinical monitoring tool that uses patient outcome data and key health indicators to identify factors associated with an increased risk of poor outcomes. For example, nutritional support for patients receiving dialysis. The report compared the clinic’s mortality risk profile with national benchmarks. The clinics overall mortality risk score was 24%, which was lower than the national average of 27%, despite the service caring for a clinically complex patient population. Where more than one third of patients had diabetes and over 80% required specialist medication to manage anaemia. This data suggested patient outcomes were comparable to, or better than, those achieved nationally for similar patients.

Other results were positive. Measures used to assess the effectiveness of dialysis treatment, including the removal of waste products from the blood and management of fluid levels, compared favourably with benchmarks. This indicated patients were receiving effective dialysis care. The service reviewed this information regularly to monitor outcomes, identify areas for improvement and support the delivery of safe and effective care.

However, data showed that nutritional status was the main factor contributing to the clinic's mortality risk score. This risk had increased during May 2026 compared with the previous 6-month average, indicating that nutrition remained an area requiring ongoing attention. Leaders reviewed this information through governance processes and used it to identify where additional support, such as dietetic input and nutritional interventions, may be needed.

All patients received regular clinical reviews from a consultant at the NHS trust at least every 3 months, or more frequently if required. These reviews included key aspects of care such as vascular access, infection, medicines and anaemia management. This ensured patients’ treatment remained appropriate and responsive to their needs.

The service used an electronic patient record system to monitor patient outcomes. This system provided a live overview of patient data. It highlighted results that were outside expected parameters, allowing staff to escalate concerns to clinicians promptly. This supported timely clinical decision-making and oversight of treatment effectiveness.

The service monitored performance through agreed key performance indicators. This data was shared with the NHS trust and reviewed regularly. These processes helped identify any areas for improvement and ensured dialysis treatment remained effective.

Staff took steps to support patients to make informed decisions about their care and treatment. They demonstrated a clear understanding of the importance of gaining consent and their responsibilities under the Mental Capacity Act (MCA).

Records confirmed patients had provided consent for their dialysis treatment. This was also verified through discussions with patients during the inspection. Patients told us they felt involved in decisions about their care and understood the treatment they were receiving.

At the time of inspection, no patients had been identified as lacking capacity to make informed decisions. However, staff demonstrated a good understanding of how to assess mental capacity where required. They were able to describe the process for making best interest decisions in line with the MCA.

All staff were compliant with MCA and Deprivation of Liberty Safeguards (DoLS) training. This supported staff to apply the principles of the legislation in practice and ensured patients’ rights were respected.