Diaverum Dialysis Clinic - Rotherham

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

We inspected the service in 2017 but at the time we did not rate dialysis services.

This key question has been rated Good:

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We assessed 6 quality statements for this key question.

We looked for evidence people and communities had the best possible outcomes with their needs assessed. 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 service. 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 reviewed on an annual basis.

We have not awarded this service a score for Effective.

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

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, well being and communication needs with them.

We observed staff asking patients about allergies when administering drugs. We looked at ten sets of patient records, and saw all patient assessments had been completed fully, including good risk assessments, consent processes and personalised care plans.

We saw evidence of referral pathways if people needed additional physical or mental health support, and processes for assessing mental capacity and making ‘best interests’ decisions if required.

If a patient was found unsuitable for dialysis at the unit after arrival, the unit worked with the patient’s consultant to reallocate them, prioritising patient safety and minimising disruption. Additionally, patients were sometimes relocated to a more appropriate setting not only after initial referral but at any time if their clinical condition, needs or circumstances changed. This made sure they were receiving dialysis at the most appropriate place for their health needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. We were assured that current evidence-based good practice and standards were being followed.

Staff were appropriately experienced and qualified and had the right skills and knowledge to meet the needs of the people who used their service. They were able to and encouraged to develop their skills and knowledge to better support patients. Patients said they could get the advice they needed and felt confident in what they were told. An extensive list of staff training was provided, which covered both mandatory training subjects and a range of clinical competencies to ensure that staff were appropriately skilled. We observed treatment being delivered safely and according to individual needs.

People who used service had access to food and drinks whilst undergoing their treatment. The nurses provided patients with light refreshments. Some people choose to bring their own food into the unit to eat during the session.

The service engaged in shared care, encouraging patients to be as involved with their own treatment as much as they were able and wanted to be, which was in line with NICE guidelines.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us that they had good communication links with their NHS partners. NHS consultants and dieticians were readily available to address questions about treatment regimes and make changes to treatment plans. Changes to treatment regimes could be made electronically. If staff had concerns about a patient’s treatment regime or were concerned about a patient deteriorating, they could escalate this and request a consultant review.

Where patient care needed to be escalated, there were clear processes in place. The on-call doctor at the local Trust could be contacted if a patient became unwell. If the situation was more urgent, we saw clear transfer out protocols using emergency services.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The unit promoted the health and well being of patients. Patients had access to additional support should they need it. For example, dieticians were available to give advice about nutrition and hydration outside of the clinic environment. Patients were supported with their wider health conditions to make sure they were as healthy as possible to receive their dialysis and prolong their wellbeing.

Patients were discussed at multi-disciplinary meetings in order to make sure they were in the correct environment to receive their dialysis.

There were posters displayed around the unit which promoted a healthy lifestyle and advised patients how to identify changes in their health and what to do if they were concerned.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Patients were monitored in accordance with best practice guidelines. Individual patient performance score data was used to monitor outcomes on a monthly basis. These outcomes consisted of blood results, vital signs, target weights and nutritional status, as defined by the patient’s consultant. These were used to optimise individual patient treatments.

The service also monitored shortened dialysis times and DNARs (did not attend rates) to ensure there were no barriers preventing patients from accessing services. They proactively worked with patients to make sure they received sufficient dialysis to maintain their well being.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The clinic had a consent policy in place, which outlined the process for ensuring patients were fully informed about the risks and benefits of treatment, and consent was appropriately documented. We reviewed patient clinical records whilst on-site and observed that consent was documented.

Consent was obtained on arrival at the unit and annually but could be revisited if a patient became non-compliant or experienced cognitive decline. If a patient withdrew consent, consultants were immediately involved so discussion around next steps, including Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) could begin.

There was a process in place to support patients who had fluctuating mental capacity and needed support to make decisions about their care and treatment. This process was clearly documented. Patients were assessed on an individual basis to make sure they were safe and suitable for treatment at the unit, with their safety being of paramount importance.