Bath Kidney Care Centre

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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

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.

Staff showed kindness and compassion to all patients. Their attitudes and behaviours when interacting with patients showed that they were discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it.

Staff protected patients’ privacy and dignity when carrying out clinical tasks. All dialysis stations had curtaining that staff used to protect patients’ privacy and dignity.

Patients said staff treated them well and behaved appropriately towards them. They said staff were friendly, happy and kind. Results from the most recent patient survey showed patients responded positively to the statements, “My care team treat me with respect” and “My care team treat me with kindness.”

The representative from a kidney charity that visited the centre to support patients shared information that all patients they spoke with had positive experiences and said staff were kind, caring and supportive.

Patient information was held securely. Paper records were stored securely in locked cabinets. Electronic records were held on computers. All computers were locked when not being used and each member of staff had an individual password to access the computers.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences. The said they would feel comfortable raising any concerns about behaviour toward patients with their manager.

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

Staff completed an admission document for all patients that detailed communication needs including language, speech and hearing ability and if any communication needs were required. Staff supported all patients by completing detailed records of patient social history including family relationships and working life. This enabled them to deliver individualised care.

In the most recent patient satisfaction survey patients responded positively to the statement “My care team paid attention to my needs”.

The building was accessible to patients with reduced mobility. All areas were accessible to wheelchair users. Staff had access to moving and handling equipment to support patients and staff had training in the use of moving and handling equipment.

Each dialysis station had a bed or chair which was adjustable for patient comfort. Patients also had a television in their dialysis station which they could use headphones to watch and there was access to Wi-Fi. In the most recent patient satisfaction survey carried out by the service internet access and comfort of treatment chairs and beds was identified as an area for improvement. Staff had worked with an action plan to make improvements in these areas. Patients we spoke with had no concerns about the comfort of the dialysis stations or internet provision.

Staff made sure patients living with mental health needs or dementia, received the necessary care to meet all their needs. The service had access to specialist mental health support. Staff could refer patients to a counselling service at the local NHS trust. There were also helplines and support materials for a kidney care charity.

Staff completed specific mandatory training on supporting patients living with dementia. Due to the setup of the clinic, it was not suitable for patients who needed significant extra support, this was outlined in the patient admission criteria. Patients needing significant extra support received their dialysis at the NHS trust site.

The service had information leaflets available in languages spoken by the patients and local community. Patient information such as the fistula care booklet or the patient guide could be produced on request in a range of languages spoken by the local community.

Managers made sure staff, and patients, loved ones and carers could get help from language and British Sign Language interpreters when needed.

The service promoted people’s independence, so people knew their rights and had choice and

The service and staff were committed to supporting patients’ choice and independence. The service had introduced twilight dialysis sessions 3 times a week. As well as increasing the capacity for dialysis to meet the needs of the local population, this also gave patients who worked the choice to dialyse in the evening after work rather than having to take time off work 3 times a week.

Staff supported patients’ choices by educating them about their condition and dialysis. For example, staff ensured patients understood the risks to health if they decided to terminate a dialysis session early. There were examples in patient records where a patient requested to terminate a dialysis session. The records detailed that patients understood the risks associated with terminating the session before it had completed.

Staff supported patients to be as independent as possible with their dialysis treatment. All patients weighed themselves before and after a dialysis session and this record was automatically transferred onto the patients’ electronic record. If patients wished to explore home dialysis, this was done by the NHS trust, including any assessment or training. Staff at Bath Kidney Care Centre continued the support and training for these patients, a process called shared care. Through the shared care approach staff supported patients to carry out some or all their dialysis, some with the ambition to eventually dialyse independently at home. At the time of our inspection staff were supporting 6 patients who were at varying stages of their journey towards home dialysis.

Staff supported patients with choices about holidays. This included the practicalities of holidaying while receiving dialysis and sourcing centres where they could receive dialysis while on holiday.

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 were alert to patient’s needs and took the time to observe, communicate and engage people in discussions about their immediate needs what they arrived for dialysis. Staff could quickly recognise when people needed urgent help or support and used appropriate tools and technology to assist.

Staff now assessed patients using the National Early Warning Score (NEWS2) at the beginning and during their dialysis session. This meant staff were alerted to any changes in patients’ conditions that needed immediate attention. There were emergency buzzers in each patient area and CCTV throughout the service areas. This allowed staff to see patients when they were not with them and act promptly if there was urgent assistance needed.

The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff felt respected, supported and valued. We heard how they enjoyed their jobs and were well supported to give good patient care and experience. There was a culture of kindness and respect between colleagues. All conversations we observed were positive and warm, with staff checking on each other.

All staff spoke positively about the support they received from the manager. In the most recent staff survey staff comments included, “The manager is very supportive with the staff. “Staff felt positive about working at Bath Kidney Care Centre. In the most recent staff survey 88% agreed with the statement, “I would recommend our company to people I know us as a great place to work.” Also 88% of staff agreed with the statement, “our company inspires me to do my best work.”

Staff could access support for their own physical and emotional health needs through an occupational health service.

The service recognised staff success. Staff and patients could nominate a member of staff for an award to recognise those who worked above and beyond their role.