Gloucester Royal Hospital Renal Units

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This service was previously inspected and rated under a previous provider but has not yet been rated under the new provider.

At this inspection we rated caring as Good.

We found people were supported and treated with dignity and respect; and 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, they understood their experience of how they were treated and supported mattered. We also found evidence every effort was made to take people’s wishes into account and respected their choices, to achieve the best possible outcomes for them.

We have not awarded this service a score for Caring.

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

The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect. Despite the lack of privacy screens, staff ensured patient’s dignity was maintained whilst being connected to the dialysis station by using screens for any personal care when needed.

Patients said staff treated them well and behaved appropriately towards them. We observed interactions between nursing staff and patients. Staff remained courteous and polite during all interactions with patients.

Results from the patient survey in 2024 reported issues with late transport, patients being put onto the machines late and access to support groups. All three units had a clear combined action plan with many actions already completed.

The service carried out 2 surveys, one of its own and one on behalf of the trust. For the patient Perception of Care (PPC) survey, the units had achieved an 84% response rate which resulted in numerous improvements including the replacement of all the dialysis machines, although plans were already in place to do this.

The service treated people as individuals and made sure people’s care, support and treatment met their needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

We observed all staff treating people in a respectful manner from booking in at reception to the end of the dialysis session. We observed staff engaging with patients and checking patient’s wellbeing.

The service made adjustments for patients and tried to accommodate specific requests for appointment times.

Information leaflets were available in a number of languages.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. Two patients were scheduled to begin home dialysis, and there was a shared care program which empowered patients to be involved in their care as much or a little as they chose.

On both Severn and Cotswold units, shared care was promoted. The service used a patient questionnaire to assess involvement and goals. This was managed by link nurses and reviewed every three months or upon patient request. Data was tracked in a spreadsheet, and the process was evolving to improve data quality and responsiveness.

The service had a phone app which would allow patients to view and manage their outcome data, blood results and view medications. Information around their dry weight, fluid intake and diet and education could also be accessed through the app. At the time of our inspection the app had not yet been rolled out and was awaiting approval from the NHS Trust's information governance team.

Patients who used services had access to television screens and the internet whilst they were having treatment.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff identified and responded to changing risks to patients. We witnessed a patient who required emergency transfer by ambulance to the host NHS trust’s nearby emergency department. A review of this incident showed staff followed procedures by phoning the consultant and the emergency services and this happened in a timely manner. Staff had identified learning from the incident as mentioned in ‘learning culture’.

The service cared about and promoted the wellbeing of their staff and staff were always supported to deliver safe, person-centered care.

The service had enough staff. Cotswold and Severn units utilised health care assistants (HCA) and once Diaverum had taken over the service, HCA ratios were increased to 1:8 to offer more support. The service also introduced HCAs to ward 7b. Staff told us they felt less pressure and were able to attend to people who required closer supervision or if any issues with venous access arose.

Staff felt supported by their senior management team. We saw staff appraisals documented meaningful conversations about career development and how it could be supported.