Hull NHS Dialysis Unit

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This key question looks at whether the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment, we did not rate this key question. At this assessment, the service was rated as good.

This rating means people were treated with dignity and respect and were involved as partners in their care.

We have not awarded this service a score for Caring.

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

The provider always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We observed compassionate, personalised care and positive interactions between staff and patients. Patients told us they were treated with “exceptional kindness”, empathy and compassion. They said they felt happy, supported and well cared for.

Staff respected patients’ privacy and dignity throughout care and treatment. For example, they drew curtains around dialysis stations and cubicles and offered fresh linen to keep patients covered and warm during treatment.

Staff took time to engage with patients and those close to them in a respectful and responsive way. We saw staff listen carefully, respond to concerns and provide reassurance throughout dialysis sessions. Interactions were calm, warm and tailored to individual needs.

Staff also showed awareness of patients’ personal, cultural, social and religious needs and how these related to their care.

This meant patients experienced care that was respectful, compassionate and person-centred, which helped them feel valued, comfortable and supported during treatment.

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service adjusted care based on patients’ individual needs, which staff reflected in personalised care plans. Where appropriate, carers or family members were able to stay with patients during dialysis to provide reassurance and support.

Staff made information accessible by providing advice and information in different formats, including large print and other languages. They also ensured patients understood their right to complain and how to raise concerns.

The environment and care arrangements supported people with additional needs, including those living with dementia, autism or mental health conditions. For example, staff supported a patient with dementia who attended twice a week with their daughter by dialysing them in a side cubicle to provide a calmer environment.

However, only 50% of clinic team staff had completed Tier 1 dementia awareness training. This meant we could not ensure they all knew how to meet the needs of patients living with dementia.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Patients were encouraged to make decisions about their treatment. One patient told us staff supported them to learn home haemodialysis, which meant they no longer needed to travel to the unit and had greater control over their treatment.

Staff provided emotional support and advice to patients and those close to them when needed. One patient praised staff for their patience, calmness and reassurance during difficult moments. The waiting area included a range of reading materials for patients and visitors to use while waiting.

The registered manager (RM) told us there was little demand for chaperones. Clinic staff ensured any patient queries or requests were passed to renal consultants. Patients could bring a relative or family member to clinic appointments if they wished and staff understood the importance of maintaining confidentiality at all times.

Staff were aware of the emotional and social impact of dialysis treatment on patients. One patient explained that staff’s positive bedside manner and upbeat interactions helped reduce their anxiety and distract them from needle phobia.

This meant patients felt supported to make informed choices about their care and experienced treatment that recognised both their clinical and emotional needs.

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff understood their patient group and how to meet a range of needs, including for people with complex conditions. Patients told us staff responded quickly when they used call bells. One patient described how several staff intervened promptly and worked together to manage a complication during treatment, which reassured them and resolved the issue effectively.

The service had systems to support patients who needed additional or specialist input. This included access to a dedicated renal social worker and referral pathways to podiatry services. Staff also worked with local Alzheimer’s services to access John’s Campaign and the Butterfly Scheme, which supported people living with dementia. Where needed, staff could source specialist equipment, such as bariatric beds, through the host hospital trust.

Staff took account of patients’ mental health and mobility needs. They arranged transport and equipment to support safe access to care, including wheelchairs or stretchers where required.

Patients, relatives and carers told us they knew how to raise concerns or make complaints. Information explaining how to do this was clearly displayed in patient areas. The service was able to demonstrate learning from recent complaints, which deputy clinic managers handled and resolved promptly.

This meant patients received timely support and access to appropriate services, and concerns were addressed quickly to improve their experience and care.

The provider cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Staff leave was planned to maintain safe staffing levels, and staff could request preferred annual leave. During our assessment, 2 staff were on extended sick leave. The registered manager (RM) told us staff were supported during absence and on return to work. This included wellbeing meetings, support plans and referrals to occupational health where needed. The RM held regular check‑ins with returning staff.

The RM told us staff were occasionally subject to violence or aggression, for example when treatment was delayed due to dialysis machines completing cleaning cycles. Staff reported incidents of abuse, which managers investigated. The provider had a code of conduct and a code of behaviour, which set clear expectations for how staff and patients should treat each other in line with the provider’s values.

Managers addressed staff concerns in line with the employee handbook. Staff were encouraged to raise issues with their line manager first, which supported informal resolution and positive working relationships. We also saw positive feedback about the service as a learning environment. For example, a student nurse gave favourable feedback following a placement, and a staff nurse had been nominated for a Daisy Award in recognition of compassionate care.

However, one nurse raised concerns about on‑call overnight arrangements. They said this could lead to excessive working hours when shifts were worked consecutively. The staff member had raised a grievance more than a year before our assessment, which had not been resolved. There was no formal on‑call policy to guide safe working hours.