Scarborough 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 means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

We rated this question as requires improvement.

This meant people were not treat as individuals, did not have individual needs met and did not always have choice and control.

The service was in breach of person-centred care in relation to treating people as individuals and safe care and treatment in relation to responding to people's immediate needs.

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 evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity.

We observed staff interacting with patients, which evidenced that they were discreet and respectful in communication. Patients reported staff treated them with kindness. One patient told us ‘the nursing team work really hard’ and another said ‘All the staff here are wonderful, can’t fault them’.

Confidentiality and privacy could not always be maintained, due to the environmental limitations within the service. Staff worked hard to maintain confidentiality where possible, by lowering voices.

The service did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences.

We reviewed records for a patient who required translation services and saw communication needs were inconsistently recorded and not reliably supported.

Patients did not always receive care tailored to their needs, increasing the risk of unmet needs, distress, and poorer outcomes, particularly for those with complex or communication needs.

Staff were not able to articulate how patients with an additional need would be supported.

The service did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

The service did not demonstrate consistent support for patient choice or independence due to limited personalised care planning. This included but was not limited to seeking and obtaining consent.

We did not find evidence of continuing education to enable patients to make informed choices regarding the types of treatment and vascular access.

The service did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Delays in treatment completion affected patients’ health and experience. Patients told us the delays contributed to their overall wellbeing and care at the unit.

Patients told us there were frequent delays prior to and during treatment sessions and had been historic, with no action taken by the provider to improve. We requested audit data regarding the monitoring of these delays, but it was not submitted.

We observed delays supporting a patient to the toilet during our assessment. We also observed anxiety experienced by a patient due to communication barriers.

We reviewed the latest patient survey and saw 2 areas highlighted for improvement, which related to staff working well as a team and the care team paying attention to patient need. These questions scored below the target set by the provider.

We also reviewed a document showing changes made by the provider following feedback from patients, which showed no dates to show that actions had been taken and they were not sufficiently detailed to drive improvement.

The service did not always promote the wellbeing of their staff.

We requested the latest staff survey and supporting action plan, where improvements were needed, however this was not submitted. We reviewed a document which showed 2 areas for improvement, but this did not align to any survey data or have sufficient detail in which to drive meaningful improvement.

We requested appraisal records at the time of assessment, but these were not provided to inspectors.

However, Staff told us they felt supported by senior staff and we saw adjustments had been made for those staff who required them.

Staff had access to occupational support and discounts through organisational benefit schemes. Staff told us they accessed these services, which were beneficial.