Clacton-on-Sea Dialysis Unit

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• 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

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

We looked for evidence that people were always at the centre of how care was planned and delivered. We checked that the health and care needs of people were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

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.

We scored the service as 3. The evidence showed a good standard. The service 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.

We saw evidence of shared care documentation in the 5 care records that we reviewed. All patients receiving care at the unit were given the opportunity to be as active in their treatment as they wished.

Patients we spoke to told us that they were involved in their care and treatment and had regular opportunities to meet with their consultant to discuss any changes. One patient told us that he was offered a twilight session as they had been away.

We saw how the unit stored supplement drinks for some patients as they did not wish to store them at home and these were offered to them during their dialysis sessions.

Staff adapted care to individual needs using the Individual Patient Performance Scores (IPPS). For example, nurses do monitor machine parameters and vascular access to identify access flow issues. Where clinically indicated, appropriate interventions such as using thrombolytic agents dwell to maintain effective access flow and dialysis treatment.

There were policies and processes in place to manage missed appointments. All missed appointments were followed up with a telephone call and if contact was not made a welfare visit was requested to ensure that the patient was safe. Staff offered additional dialysis slots to try and compensate for missed sessions and maintain treatment adequacy. Where possible staff facilitated alternative treatment times that suited the patient if they had other appointments or was their preference.

We saw individual personal emergency evacuation plans were in place for patients and they were reviewed regularly.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Each patient had a named nurse who was responsible for reviewing blood results and updating patient records which enabled continuity of care and familiarity for patients. The unit had 18 permanent staff and had not used any bank staff in the last 12 months. Patients told us that they were familiar with all the staff that cared for them and supported them with their care and future session bookings.

The provider had a clear admission and discharge policy which ensured staff managed admission, transfer and discharge processes appropriately.

Staff told us that they had close working relationships with their manager and the NHS renal team through regular meetings and communication via telephone and emails as needed to support joined-up care. The unit used the same electronic system as the local NHS trust who commissioned the service which enabled staff to access patient records in real time to tailor care for patients who had been recently discharged.

If a patient was admitted to hospital staff shared the dialysis and medication prescriptions with the ward to ensure continuity of care and treatment for the patient.

Senior leaders used the IPPS scores to monitor the diverse health and care needs regionally to identify areas of improvement.

The unit was supported by the local trust volunteers who enhanced patient well-being and undertook non-medical duties such as serving refreshments and sitting with patients who were awaiting patient transport.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

We saw notice boards and patient information leaflets displayed in the waiting area. There was a wide range of information available on treatments, local services, patients’ rights, and how to provide feedback.

Information leaflets were available in large fonts and other languages spoken by patients upon request.

The unit promoted the use of the secure, free digital patient portal used by the local NHS trust which allowed patients to view their blood test results, appointments and letters digitally.

Staff provided education and support to patients who missed their appointments to inform them of risk associated with non-attendance. This was also shared with the patient’s GP.

Staff told us that they had used google translate and the local NHS trust’s language line to access translation support for 2 patients who did not speak English as their preferred language.

The service submitted notifications to the Care Quality Commission in line with the conditions of registration. There had been submissions for death of a service user and injury to a person using the service in the last 12 months from June 2025 to June 2026.

Staff were 100% compliant with accessible information standards training.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Information on how to make a complaint or raise a concern was displayed in the waiting area. Patients we spoke to told us that they felt comfortable to raise a concern but had not needed to.

The service had received 8 complaints in last 12 months; these all related to delayed patient transport. Complaints were responded to in line with policy and we saw duty of candour applied to the last 3 complaints received. The service monitored the number of complaints received and shared these as part of their key performance indicators with the NHS trust and monitored them for themes. All staff we spoke to were aware of themes of complaints and told us these were discussed at monthly team meetings.

We observed the ‘You said, we did’ board in the waiting area which demonstrated action taken in response to feedback. This included the use of cold spray for discomfort during needle placement.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff made reasonable adjustments for patients. For example, people with mobility issues were provided with walking aids or a wheelchair after their dialysis if they were tired.

Staff could access medical support via telephone during their shift and senior support in an emergency.

The service had an admission and discharge criteria to ensure that stable haemodialysis patients were treated at the unit. This was a consult led decision and as reviewed at the weekly MDT meeting to ensure patients were receiving care at the most appropriate site.

There were a range of session times available for patients and staff worked with patients to try and give them choice of sessions available where possible. Staff told us that they always tried to support changes when requested.

The waiting list was managed by the local NHS trust. At the time of the assessment, there was 1 patient that was awaiting a slot at Clacton dialysis unit. This was being reviewed regularly to facilitate a transfer close to their home once a slot became available.

Patients told us they were supported to access dialysis services whilst on holiday. This was facilitated by the service to ensure that care and treatment was accessed whilst away. This service was not commissioned by the local NHS trust to provide dialysis for people on vacation within the Clacton area.

The service had a business continuity plan outlining clear actions to be taken to ensure the uninterrupted running of the service in the event of a disruption. The service had not needed to close or implement this in the last 12 months. The service worked closely with other sites offering regional support if required.

Many patients were reliant on ambulance transport to get to and from the unit. Both staff and patients told us that there were frequent delays in treatment resulting in shortened treatment. The service had raised this with the NHS trust and the ambulance provider and would submit incident reports to record the frequency of delays and its impact. The transport contract was held by the local NHS trust. However, the service had established monthly meetings with the ambulance provider to try and establish effective communication to improve care and service delivery. There was an action log created in June 2026 to support this. The effectiveness of these meetings is yet to be evaluated by the service.

The unit was on the ground floor and wheelchair accessible. At the time of our assessment Clacton-On-Sea dialysis unit was a chair-only facility. Senior leaders told us they were undertaking a project to introduce hoists and 2 beds, which would enable them to expand the range of patients they could safely accommodate within the clinic. This development would support a more inclusive service for the local population, many of whom were frail and older adults.

We scored the service as 3. The evidence showed a good standard. 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.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Patients were able to provide feedback on the care they received through a variety of ways such as raising a concern or complaint. The provider also carried out a global quality of life survey to compare the experience of patients across all Diaverum sites. However, of the 5 care records we reviewed, none had documented feedback from the patient at their monthly reviews within the care plan proforma to capture their feedback and experience at regular intervals.

Staff had access to the local NHS trust’s translation services for more complex discussions and used online translation for more simple communication.

Where treatment sessions were missed or shortened staff told us that they offered alternative sessions to maintain treatment adequacy.

The service has strong links with charities such as the Kidney Patient Association and encouraged patients to communicate with them to access care and support. We were told that there were plans for a representative to attend the clinic to speak to patients about accessing financial support such as benefits.

We did not see equality impact assessments for policies and procedures we reviewed to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff were trained in equality, diversity, inclusion and human rights and compliance was 100%.

We scored the service as 3. The evidence showed a good standard. 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.

We saw evidence of close links with charities such as Kidney Patient Association and the renal consultants to support patients to make decisions about their care and treatment and their future. The named nurse had access to the NHS patient records for advanced decision-making records such resuscitation status. This was communicated to all staff at the morning huddle and a copy of the proforma was found at the front of care records.

Each patient had a personalised care plan which details the patient’s needs, wishes and feelings. This was completed prior to commencing the first session at the unit so that choice was supported.

A multidisciplinary approach to patient care was supported through weekly meetings. This ensured that key information was shared and discussed. The named nurse was responsible for referring to dieticians and other health professionals between the monthly visits.