Archived: Diaverum UK Limited (Lewisham)

Updated 17 November 2017

Lewisham Kidney Treatment Centre is operated by Diaverum UK Limited. The service opened in July 2001 and provides haemodialysis to patients from the local area of Lewisham. This was in response to a request from the local NHS trust to provide a dialysis unit within a specified area.

The manager was registered with the CQC in August 2016.

The service is registered for the regulated activity of diagnosis and treatment of disease.

The service has not been previously inspected.

Updated 17 November 2017

Lewisham Kidney Treatment Centre is operated by Diaverum UK Limited. The service has 15 dialysis stations. Facilities include two isolation rooms, one consulting room, and a meeting room.

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

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 6 June 2017, along with an unannounced visit to the hospital on 15 June 2017.

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.

Services we do not rate

We regulate dialysis services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following areas of good practice:

• There were effective systems in place to keep patients safe. This included appropriate management and reporting of incidents, effective cleaning schedules and maintenance programmes. All staff were aware of their roles and responsibilities in ensuring patient safety.

• Effective processes were in place for the provision of medications. These were stored and administered in line with Renal Association guidelines and staff completed competencies annually to ensure they continued to administer medications correctly.

• Patients’ medical and nursing records were secure. All staff had access to all relevant records ensuring that patients’ care was as planned and not delayed.

• Staff worked collaboratively with the local NHS trust to monitor and assess patients regularly. Patients and their GPs were provided with a minimum of monthly written updates on their condition and treatment plans.

• Staffing levels were maintained in line with national guidance to ensure patient safety. Nursing staff had direct access to a consultant who was responsible for patient care. In emergencies, patients were referred directly to the local NHS trust for care or treatment, and an ambulance was called to complete the transfer.

• Staff were aware of their roles and responsibilities to maintain the service in the event of a major incident. Patients were able to continue their treatment at alternative centres.

• Patients’ pain and nutrition needs were assessed regularly and patients were referred to appropriate specialists for additional support as necessary.

• There was a comprehensive training and induction programme in place to ensure staff competency. Training compliance at the time of inspection was 100%.

• There were processes in place to ensure effective multidisciplinary team working, with specialist support provided by the local NHS trust.

• There were effective processes in place for gaining patient consent for treatment.

• Patients were treated with respect and compassion. Patients reported that staff worked above expectations going the extra mile to ensure their satisfaction.

• Staff were familiar with and worked towards the organisational vision of providing the best possible care for renal patients.

• There were effective processes in place to monitor risks associated with the service and individual patients. Quality assurance meetings occurred regularly and included the local NHS trust and specialists. We saw evidence of good outcomes for patients.

• There was evidence of strong national and local leadership, with accessible and responsive managers.

• All staff and patients were positive about the service.

• The service had implemented placements for student nurses.

However, we also found the following areas which required improvement:

• Staff had not received training in the recognition and treatment of sepsis.

• The centre was built prior to the ‘Renal care Health Building Note 07 01: Satellite dialysis unit (2013)’ requirements, as the space between dialysis machines did not meet the 900mm requirement. However, the provider had taken action to mitigate the risks. However, work was in progress on a new Diaverum 20 station dialysis unit at Lewisham Hospital, this would meet the building note requirements.

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Professor Edward Baker

Chief Inspector of Hospitals

Updated 17 November 2017

• There were effective systems in place to keep patients safe. Staffing levels were maintained in line with national guidance to ensure patient safety. Nursing staff had direct access to a consultant who was responsible for patient care. Effective processes were in place for the provision of medications.

• Work was in progress on a new 20 station dialysis centre at Lewisham Hospital.

• There was evidence of strong national and local leadership, with accessible and responsive managers. All staff and patients were positive about the service.