KC Dialysis Centre

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

At our last assessment we rated this key question good. At this assessment the rating has remained the same.

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

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 evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed five patient records and found that comprehensive patient information was obtained from patients' home dialysis units before treatment commenced. Records contained detailed medical histories, prescribed medicines and treatment plans, enabling staff to understand and respond to each person's individual clinical needs. Consent forms were completed, signed and dated, and where applicable, additional information such as DNACPR documentation was included within the clinical record.

Patients also underwent routine screening processes, including MRSA screening, and relevant pathway results were available to inform care delivery. A discharge summary was completed following each attendance to support continuity of care between the holiday dialysis unit and the patient's usual care providers.

The nursing care plan demonstrated a comprehensive approach to assessing and responding to people's physical and emotional health needs. Staff assessed risks associated with unstable blood glucose levels, medication management, diabetic neuropathy and foot health, and the potential impact of receiving treatment in an unfamiliar environment. Care plans included monitoring blood glucose levels before and after dialysis, identifying previous complications, assessing patients' understanding of their condition and treatment, and evaluating psychological wellbeing. Patients were encouraged to discuss concerns, report symptoms promptly and participate in decisions regarding their care, ensuring assessments remained person-centred and responsive to individual needs.

The service sought to make reasonable adjustments to ensure people could access treatment according to their individual needs. Staff described supporting a patient with a learning disability who attended with two carers and accommodating a request from the care home for treatment to be provided in a separate isolation room. This demonstrated flexibility in responding to individual circumstances and reducing barriers to accessing care.

The evidence showed a good standard. The service 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 and current evidence-based good practice and standards.

The service delivered care and treatment in line with established policies, national guidance and recognised best practice for haemodialysis services. Clinical staff followed evidence-based procedures for patient assessment, dialysis treatment, medicines management, infection prevention and control, and the recognition and management of deteriorating patients, including sepsis. Patients were assessed prior to treatment and care was delivered in accordance with dialysis prescriptions and clinical information provided by their referring renal unit.

Staff delivered care and treatment in line with evidence-based guidance and established clinical protocols. Care records demonstrated that patients’ treatment requirements were clearly documented and reviewed. Staff maintained accurate fluid input and output records throughout treatment, which enabled them to monitor fluid balance effectively and ensure prescribed fluid removal targets were achieved. This supported compliance with clinical requirements, informed treatment decisions, and helped reduce the risk of complications associated with over or under fluid removal.

The evidence showed a good standard. The service 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.

The service worked closely with patients’ GPs, home renal units, consultants, pharmacists and other healthcare professionals to ensure care was coordinated and information was shared effectively throughout the patient journey. Prior to treatment, referral information, dialysis prescriptions, medicines information, allergies and individual care needs were reviewed to ensure patients received treatment that met their needs.

Staff maintained regular communication with referring renal units to discuss any treatment variations, clinical concerns or changes in a patient's condition. Where patients had complex clinical requirements, the service worked collaboratively with external healthcare providers to obtain specialist advice, medicines and support to enable the safe delivery of dialysis treatment.

Staff demonstrated effective multidisciplinary and cross-organisational work to support positive patient outcomes. For example, during a holiday haemodialysis session, nurses identified prolonged bleeding from a patient's venous needle site and recognised this as a potential indicator of vascular access dysfunction. With the patient's consent, staff shared their observations with the patient's home renal unit and recommended further assessment which meant the patient received the treatment they required.

Within the unit, the nursing team worked closely to deliver care, monitor patient wellbeing and respond to changing needs. Staff shared information through day-to-day communication, clinical documentation and governance systems. Regular audits, incident reviews and governance meetings supported shared learning and continuous improvement across the service.

The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

The service supported people to manage their health independently and maintain their wellbeing while on holiday. Patients were provided with education about managing diabetes alongside dialysis, including recognising and responding to hypo- and hyperglycaemia, medication administration, dietary management and maintaining good foot care. Hyperglycemia is high blood sugar (usually above 10.0 mmol/L or 180 mg/dL), while hypoglycemia is low blood sugar (usually below 3.9 mmol/L or 70 mg/dL)

Staff reinforced self-management strategies during treatment sessions and encouraged patients to ask questions and raise concerns. The care plan also recognised the importance of emotional wellbeing, providing reassurance, promoting participation in care decision-making and creating a supportive environment to reduce anxiety associated with managing long-term conditions away from home. These measures helped patients maintain control of their health, prevent avoidable complications and enjoy a positive holiday experience with ongoing essential treatment.

The service also recognised the importance of supporting patients’ mental health and emotional wellbeing. Although specialist mental health services were not provided on site, staff were trained to identify signs of psychological distress, anxiety, depression and other mental health concerns. Where concerns were identified, patients were offered support from a registered nurse, and, with consent, relevant information was communicated to their usual renal team or GP to ensure appropriate follow-up and continuity of care.

The evidence showed a good standard. The service 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.

Due to the nature of the service as a holiday dialysis provider, most patients had 1-3 sessions of dialysis therefore its ability to routinely collect and monitor longer-term patient outcomes was limited. Patients remained under the clinical oversight of their home renal units, and the service did not have formal processes to routinely receive follow-up outcome data once patients had completed treatment and returned to their usual place of residence.

The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service had a consent to treatment policy which outlined the standards and procedures required to ensure staff complied with relevant legislation and guidance on obtaining consent.

Staff sought and recorded consent before commencing treatment and ensured patients were involved in decisions about their care. During observations, staff consistently sought verbal consent before undertaking routine procedures, such as taking blood pressure measurements and carrying out clinical assessments. This demonstrated a respectful approach to patient autonomy and ensured patients were informed and willing participants in their care and treatment.

All patients attending the unit were required to complete a written consent form before commencing treatment. Managers routinely reviewed consent documentation before patient records were filed to ensure forms had been completed accurately and in full. Any omissions or discrepancies identified were addressed promptly before records were closed.

Staff told us patients attending the service had capacity to consent to treatment and that consent processes were completed before care was delivered. The service worked with carers and support networks where required to ensure individuals understood their care and treatment arrangements and their wishes and preferences were considered throughout their treatment experience.

Following the inspection, the service informed us it planned to introduce an annual consent audit as part of its clinical audit programme, providing additional documented assurance alongside the existing record review process.