During an assessment under our new approach
Overall Service Commentary
Rotherham Dialysis Unit is operated by Diaverum UK Ltd. The service opened in June 2009. It is a purpose built facility in the grounds of Rotherham District General Hospital. The service is contracted by the Sheffield Teaching Hospitals NHS Foundation Trust to provide renal dialysis to NHS patients. The unit serves the surrounding communities and gives access to treatment for patients for holiday dialysis.
The clinic has had a registered manager in post since July 2016, an experienced renal nurse, who had previously been the unit deputy manager. Diaverum UK Ltd has a nominated individual and the location is registered for the following regulated activities:
- Treatment of disease, disorder or injury.
The facility helps chronic kidney disease patients avoid long journeys to main hospital sites. The unit provides haemodialysis to patients 6 days a week with 2 sessions each day Monday to Friday and additional sessions on Saturdays. The service provides dialysis for patients over the age of 18 years. The service does not provide services to children or young people under 18.
As part of this assessment we reviewed actions we asked the service to take after our last assessment in 2017. In 2017 we identified breaches of regulations 11 – Need for consent, 12 – Safe care and treatment, 13 - Safeguarding, and 17 – Good Governance. These related to making sure safeguarding training was up to date and at the appropriate level, that consent was clear and in line with the organisation’s policy, that interpreting services were used when needed, records were contemporaneous and accurate, policies were reviewed in a timely manner and a detailed duty of candour policy met regulation requirements.
During our unannounced assessment we looked at different areas about how safe, effective, responsive, caring and well-led the service was. We rated the service as Good overall.
In safe, we found a good learning-based culture with an emphasis on patient and staff safety. Safeguarding responsibilities were identified and understood. The unit had enough suitably skilled staff who responded well in an emergency. Staff received meaningful supervision, education and appraisals. Medicines were managed well and the environment was visibly clean. Equipment and premises were well maintained. However, some patients did not have care plans for additional health conditions such as epilepsy.
In effective, we looked for evidence people and communities had their needs assessed and received the best possible outcomes. The service worked well across teams and services to support people. There was input from the local Trust and there was dietetic support for the people who used services. The service monitored people’s care and treatment to continuously improve it.
Blood results and other key performance indicators were regularly monitored and discussed to optimise patient outcomes. This showed patients were receiving effective treatment. Consent was actively sought and checked on an annual basis.
In caring, we found people were supported and treated with dignity and respect; and mostly involved as partners in their care. We looked for evidence people were always treated with kindness, empathy and compassion. We checked people’s privacy and dignity was respected and their experience of how they were treated and supported mattered. We also looked for evidence every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.
In responsive, we found people’s needs were met through good organisation and delivery. We saw people and communities were always at the centre of how care was planned and delivered. We checked the health and care needs of people and communities were understood, and they were mostly involved in planning care that met these needs. We also saw evidence people could access care in ways to meet their personal circumstances and protected equality characteristics.
In well-led, we found service management and leadership was clear, consistent and supportive. Leaders and the culture they created supported the delivery of high-quality, person-centred care. Staff were engaged with the vision of the service and the service had clear responsibilities, roles, systems of accountability and good governance. The service valued diversity in their workforce and worked on an inclusive and fair culture for both patients and staff members. The service understood their duty to collaborate and work in partnership with other units and external stakeholders.