Worcester Dialysis Unit

Updated 24 May 2023

The service provided over 12,655 dialysis treatment sessions per year and had treated 48 patients at the time of the inspection.

Worcester Dialysis Unit has 20 dialysis stations that provides dialysis for patients with chronic renal failure. The unit was built in 2009 following the increased demand for dialysis in the Worcestershire area. Fresenius Medical Care Renal Services Limited (Fresenius) is contracted to complete dialysis for local patients under the care of nephrologists at a contracting NHS trust.

All patients attending Worcester Dialysis Unit receive care from a named consultant from the NHS trust, who remains responsible for the patient. Fresenius has close links with the trust to provide seamless care between the two services. To achieve this, the service has support from the NHS trust to provide medical support, satellite haemodialysis unit coordinator support, and regular contact with a dietitian. This team attend the unit regularly and assess patients in preparation for monthly quality assurance meetings.

The unit is open between 7am and 12 midnight on Monday, Wednesday and Friday. Tuesday, Thursday and Saturday 7am to 6.30pm. It is currently providing treatment for over 90 patients. The main service provided was a dialysis service only for people over the age of 18 years of age.

Services provided via contract include:

• Domestic cleaning.

• Equipment maintenance.

The service is located away from an acute hospital site. Facilities included 20 dialysis stations (four of which were in isolation rooms), three consulting rooms, and a meeting room.

Dialysis units offer services that replicate the functions of the kidneys for patients with advanced chronic kidney disease. Dialysis is used to provide artificial replacement for lost kidney function.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

During the inspection visit we spoke with, 7 staff members including nurses, healthcare assistance and clinical leads. We spoke with 4 patients, and we reviewed 8 patient records.

The service was last inspected in 2017 but was not rated because at that time CQC did not have the legal duties to rate the service.

During the 2017 inspection, the service was issued with 2 requirement notices. The legal requirements that were not being met during 2017 inspection were:

Regulation 13 HSCA (RA) Regulations 2014 Safeguarding service users from abuse and improper treatment. How the regulation was not being met:

• The safeguarding lead was trained to level 2 in safeguarding adults. This was not in line with national guidance, which recommends that designated safeguarding leads should be trained to level 3 in safeguarding adults.
• Not all staff had completed appropriate safeguarding training in order to protect children associated with the adults they were caring for from abuse.

Regulation 18 HSCA (RA) Regulations 2014 Staffing; How the regulation was not being met:

• Not all staff had completed the mandatory training required for their role in order to provide safe care and treatment. This included (but was not limited to), training in order to safely administer blood transfusions, practical manual handling and prevention of medicine errors training.

Updated 24 May 2023

Worcester Dialysis Unit is operated by Fresenius Medical Care Renal Services Limited. The service opened in 2009 and provides haemodialysis to patients from the local area of Worcestershire. This is a satellite dialysis service.

The service is located away from an acute hospital site. Facilities included 20 dialysis stations (four of which were in isolation rooms), 4 consulting rooms, and a meeting room. Dialysis units offer services that replicate the functions of the kidneys for patients with advanced chronic kidney disease. Dialysis is used to provide artificial replacement for lost kidney function.

This was the first rated inspection of the service.

We rated the service as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service-controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, gave patients advice around nutrition. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available to suit patients' needs.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families, and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported, and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually.

Updated 24 May 2023

We rated this service as good because it was safe, effective, caring, and responsive, and well led.

See summary above for details.