Scarborough NHS Dialysis Unit

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs.

We rated this question as requires improvement.

This meant services were not planned or delivered in ways that met people’s needs.

The service was in breach of person centred care and good governance in relation to providing information.

We have not awarded this service a score for Responsive.

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

The service did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

We saw care was not person centred due to the lack of personalised care planning Specific needs including risk assessments were not always completed. This meant care and treatment was not personalised to each patient and there was a risk that patients did not receive the appropriate care and treatment.

Patients were not always empowered to make choices. We saw unmet need, including support with communication and a lack of swift and necessary referral to renal consultants, when patients' reviews were required.

We were not assured that the service worked proactively with health care partners to ensure patients received the person-centred care and treatment that they needed.

There were some shortfalls in how the service understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Patients accessed the service by referral from the neighbouring NHS trust and a contract review meeting was held monthly.

We did not receive any evidence to show how the service considered the needs of the local community when considering acceptance criteria.

The service did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service did not make sure leaflets, and written information was provided in a language people understood. We reviewed a complaint response letter written in English, which was not the spoken language of the complainant.

We requested a copy of the providers accessible information policy, which they submitted. However, it had not been updated or reviewed since 2021.

Electronic information systems were confidential and protected appropriately in accordance with UK data protection legislation requirements. However, we saw paper-based patients' documents left out with open access. We observed a patient being handed the wrong medication card. Assessment staff intervened to avoid a potential incident.

The provider had made 2 safeguarding referrals to the local authority.

The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve people in decisions about their care or tell them what had changed as a result.

We reviewed the complaint data for the last twelve months and saw 2 complaints had been recorded. These had been investigated and actioned appropriately in accordance with the providers own policy.

All staff we spoke with were able to articulate the complaints process and how they would facilitate patients making a complaint.

However, patients told us that they had raised complaints in relation to delayed connection and disconnection times and had expressed concern about staffing numbers. There was no record of these complaints, which evidenced staff were not always documenting complaints when required. Patients told us these issues were ongoing at the time of assessment.

Staff were aware of their responsibilities under duty of candour.

The service was unable to demonstrate that people could access the care, support and treatment they needed when they needed it.

There were no waiting lists at the time of assessment.

Staff had access to renal consultants and the renal ward staff at the neighbouring NHS hospital.

We requested audits or any monitoring of delays for patient treatment; however, these were not submitted.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Some staff were trained in equality, diversity, inclusion and human rights. However, completion was 78%, which was below the providers 95% target.

We requested the providers equality diversity and inclusion policy and any supporting action plans, but this was not submitted.

The service had not developed any additional communication opportunities in which to discuss inequality in experience or outcomes for this location.

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Managers did not organise services to respond to changing demand within the local healthcare system.

Staff explained dialysis processes and equipment; however, care plans were not in place to support patients with their understanding of their care and to enable informed choices.

This meant the service did not plan care proactively and adapt to individual patient needs.