Dearne Valley NHS Dialysis Unit

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we did not rate this key question. At this assessment the rating was Good.

This is the first assessment for this service. This key question has been rated Good.

This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

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

3. The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff made sure patients living with mental health problems, learning disabilities and dementia, received the necessary care to meet all their needs. Patients felt well-supported, cared for and treated with dignity and respect. Staff knew them and their individual needs.

Patient’s care plans fully reflected their physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act. Staff completed individualised care plans for patients. This included 7 routine actions with periodic review to ensure all information was available for multi-disciplinary team (MDT) meetings.

Staff assessed patients’ pain using a recognised tool and gave pain relief in line with individual needs and best practice. They undertook needs-based assessments for patients.

Staff prescribed, administered and recorded pain relief accurately. Patients had timely access to pain management and clinical support. Most patients had prescribed analgesia available on their medication charts, unless contraindicated due to allergies or sensitivities. When patients reported pain, staff undertook a comprehensive assessment to establish its severity, identify potential underlying causes, and determine the most appropriate intervention. Staff closely monitored patients through regular observations and ongoing clinical assessment during treatment. Where a patient's condition deteriorated or they became too unwell to continue dialysis, staff escalated concerns to the renal team and sought specialist advice. Patients were referred for further assessment, transferred to hospital, or prescribed appropriate treatment where clinically indicated.

Clinic environments and services were designed to meet the needs of patients living with dementia. The unit had two isolation rooms for patients who needed calmer, more personalised care. Staff monitored these according to patient needs. They could manage the environment and use privacy screens if patients or their loved ones preferred. Staff told us they reserved patients with dementia the bed nearest their nursing station.

People received the most appropriate care and treatment for them as the service made reasonable adjustments where necessary. All patients on the unit had a consultant and named nurse who oversaw all aspects of their care and treatment. Staff told us this helped them build rapport and receive person-centred care.

Staff talked with patients, families and carers in a way they could understand, using communication aids where necessary. They identified and documented any communication and physical support needs patients had. For example, they adhered to a multiracial visual inspection catheter tool observation record (MR VICTOR). This helped them insert intravenously according to the patient’s skin type and observe any early possible signs of infection.

Staff managed any pain or discomfort patients had. For example, they monitored and recorded all patients with residual 24-hour urine output twice yearly. We saw instructions displayed on how patients could help staff facilitate this in 6 steps.

Managers ensured staff, patients, loved ones and carers could get help from interpreters when needed. Steps to follow were displayed by nursing stations. Staff could provide large print or braille materials. They met the information and communication needs of patients with a disability or sensory loss.

Staff understood and applied the policy on meeting the information and communication needs of patients with a disability or sensory loss. The unit had a patient with learning disabilities who could not retain much information. In response staff informed the patient’s mother and carer. Staff completed specialist care plan templates for patients at risk of falls and diabetic patients to better manage their care.

The RM completed a disability access audit in June 2026. This included suggested environmental improvements and considerations for people with limited mobility. The RM planned to enact two related strategies; one for visitors and another for individual staff risk assessments in the event of an evacuation.

3. The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Managers monitored waiting times and made sure patients could access services when needed, including emergency services. Shifts ran on time and patients were not kept waiting. Staff advised patients of their scheduled dialysis times. They always contacted patients to inform them of any delays prior to or upon arrival. This gave patients a clear understanding of potential waits before commencing treatment on the dialysis machine.

Patients were booked promptly and according to clinical need. They were first transferred from the parent trust. The clinic secretary then booked patients for treatment to be seen by the consultant in clinic within 4-6 weeks. 

The consultant could then request to review patients within 2 weeks. The NHS usually managed treatments of 3-6 months. However, if consultant clinics had capacity, patients could be added to the clinic list by referring to the RM. For urgent clinical needs, clinics could be arranged by referring to the consultant, or for the highest risk patients, to the emergency department.

The service considered the needs and preferences of different people, including those at most risk of a poorer experience of care. If required, staff could add patients ad-hoc to their parent trust hospital’s dialysis list on Sunday when the unit was closed. This could be for patients with extra fluid or who needed isolating when both cubicles were already booked. Occasionally if their parent trust hospital’s dialysis had enough extra patients, staff would consider an extra evening shift. This meant the service had capacity to meet extra patient demand.

Managers worked to keep the number of cancelled or delayed treatments to a minimum. Staff raised or escalated any transport related delays for patients to a contracted ambulance service. They told us patient transport service (PTS) delays were the most common reason patients arrived late.

Staff supported patients to make advanced and informed decisions about their care. They planned care in advance and developed a rapport over time with frequent renal patients to the unit. For example, staff ensured oxygen cylinders were ready alongside the dialysis stations of patients with respiratory conditions.

People understand their condition, care and treatment options (including any associated risks and benefits) and any advice provided. Staff told us patients could attend with overloaded fluids. They encouraged patients to weigh themselves to know how much excess fluid would need removing. They monitored their levels onscreen throughout the dialysis to ensure the machine did not remove too much fluid.

Staff delivered patient’s care and treatment in a way which met their assessed needs. They assessed patients for signs of fluid build-up using body composition monitors (BCMs), checked for swelling, and considered each patient's medical history. Staff recorded patients' weight before and after dialysis to monitor changes accurately and documented any reasons for weight fluctuations, such as routine treatment, low blood pressure, or medical advice.

There was continuity in people’s care and treatment as services were flexible and joined-up. The parent trust offered patients who attended clinics confidential counselling services. Staff could refer patients low in mood, anxious, struggling or depressed who wished to talk and engage with somebody. There was single point access for patients presenting in a crisis or in need of medication.

3. The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff spoke with patients, families and carers in a way they could understand. They communicated effectively and used communication aids where necessary. The clinic secretary had devised a welcome pack for new patients containing all relevant information, including about fistulas. Patients had given positive feedback about this pack.

The service had information leaflets available in languages spoken by the patients and local community. The provider had various leaflets and booklets available, including on fistula care and regional renal dialysis patient transport services. Other patient information leaflets stored online could be tailored or personalised to meet people’s needs. The National Kidney Federation displayed posters giving patients the chance to connect with people who had firsthand experience of a peer support service.

Staff consistently recorded patient’s communication needs within their Electronic Patient Record (EPR). They documented any specific characteristics to ensure these were met and available for reference and review by colleagues.

3. The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Patients and their families gave positive feedback about the service. Staff supported them to do this. We spoke to 6 patients including some complex and their family or carers. All were very satisfied and complimentary.

People, their family, friends and other carers were confident any complaints they made were taken seriously and treated compassionately. Managers dealt with any complaints or concerns thoroughly, openly and gave a timely response, with no repercussions. The RM was keen any complaints or concerns were first managed at clinic level before being escalated. The unit always had a daily point of contact.

Patients and their families knew how to give service feedback about their experiences of care and support. They were kept informed about how their feedback was acted on. We reviewed the service’s latest 2025 patient satisfaction survey. ‘You said, we did’ examples were displayed on the treatment room entrance wall. For example, patients had mentioned the comfort of beds and chairs. In response staff provided all stations with new mattresses and ensured extra pillows were always available. The RM had completed actions in November 2025 based on patient feedback.

Staff saw learning from complaints and concerns as an opportunity for improvement. The provider had a care delivery feedback policy. This ensured patient feedback provided valuable information about what patients thought about the quality of services and care provided.

Staff could give examples of how they incorporated learning into daily practice. We saw positive feedback from 3 patients about the service. One patient thanked staff for always making them feel safe, answering questions and treating them with respect and care at every visit.

Patients could raise any concerns or issues in a range of accessible ways. The service had an app called ‘My companion’ to manage some of their own care. HCAs could help new patients access and manage this app. This allowed patients to check their laboratory results, and find helpful tips.

3. The provider made sure that people could access the care, support and treatment they needed when they needed it.

People can access services when they need to, without physical or digital barriers, including in an emergency. The provider had an in-date standard operating procedure (SOP) for patients under their parent hospital trust who did not attend (DNA) their appointment. This outlined the procedure staff followed for the service’s main and satellite clinics. All the service’s DNAs were escalated to their consultant and discussed at the monthly MDT meetings.

Managers monitored patients did not attend (DNA) rates. They knew their latest DNA rates and the most common underlying reasons.

The service’s onsite trust had a DNA patient advice sheet. Leads planned to roll this out for staff use. During our assessment this was being reviewed at policy meetings. This would better inform patients of processes if they could not attend.

Physical premises and equipment are accessible. All treatment areas and dialysis stations were on the ground floor. Some provision and equipment was available for bariatric patients, for example the weighing scales. These patients could be accommodated by larger beds in two bays.

Services were accessible and timely for patients most likely to have difficulty accessing care. Staff aimed to remove barriers to care. For example, they took action to minimise missed appointments. They followed seven steps for any patient DNAs. This ensured patients who did not attend appointments were contacted. They first called the patient; if they did not answer they rang their next of kin. If a patient’s whereabouts and status were still unknown, staff called 999 for a welfare check. Renal consultants were notified if patients would rather not attend dialysis treatment. Consultants would discuss regular non-attenders in MDT meetings. Staff could usually allocate and accommodate patients’ alternative slots depending on the unit’s capacity. This helped improve their commitment and attendance.

The service was accessible and adaptable to meet patient needs. Staff followed the provider’s in-date patient referral and admission process. This ensured all new patients were accepted as per requirements and allocated a named nurse.

Leads supported wider access to treatment within the local healthcare community. They worked in collaboration with their onsite hospital trust, other provider locations and satellite units and the regional NHS ambulance patient transport service.

3. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The service complied with the Accessible Information Standard (AIS) and Equality Act 2010. The provider had an accessible information policy. This ensured all staff provided a clear, consistent, transparent and fair approach to the provision of accessible information.

The provider had a patient advisory board. This gave patients the opportunity to provide feedback directly to the service.

3. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff could plan patient’s care in advance and provide extra equipment. For example, healthcare and dialysis assistants would move a hoist next to the relevant patient’s dialysis station before their treatment to minimise delays.

Staff supported patients to make informed choices about their care and plan their future care while they had the capacity to do so. Staff safety huddles and meetings considered and planned patients’ care needs. We found multidisciplinary team (MDT) review notes included patient decisions around any do not attempt cardiopulmonary resuscitation (DNACPR) or a recommended summary plan for emergency care and treatment (ReSPECT) orders in place. Staff always kept these on top the patient’s medical records. This meant they could easily access these orders to act in accordance with their wishes.

Managers planned and organised services to meet the local population’s changing needs. The clinic was a satellite location for their parent trust. Most patients who lived in the vicinity of local towns fell into the Doncaster catchment area. The trust’s renal team usually looked after any patients with renal problems when they arose. Staff offered stable patients who needed haemodialysis the choice to dialyse at the satellite clinic nearest to where they live.

People’s decisions and what mattered to them were delivered through personalised care plans. Staff shared these with others who needed to be informed. Staff encouraged shared care across the service. They kept a list of eligible and interested patients in a shared folder. Staff clearly explained the process to relevant patients, along with how to access and competently document their shared care. They could complete a checklist with any patient questions at their initial assessment.

When people’s future care preferences were for greater independence, clinical staff worked together to support them to achieve their goals. The service had shared care tasks of the month. Staff encouraged patients interested in learning how to care for themselves and their dialysis machine during treatment to speak to their nursing team. Shared or self-care guides were available at for staff to complete with patients.