Bath Kidney Care Centre

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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. We checked that the health and care needs of people and communities 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.

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 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.

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.

Patients understood their condition, care and treatment. Staff educated patients about renal failure and the dialysis treatment options. Patients also had access to the NHS trust and a dialysis charity for further guidance and support. This enabled patients to make informed decisions about the type of dialysis that was best suited to their clinical and social needs.

In the most recent patient satisfaction survey 91% of patients agreed with the statement, “Do you feel you were provided with all the necessary information for your dialysis treatment.” Also, 94% of patients agreed with the statement, “My care team pays attention to my needs.”

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.

The service as commissioned to provide dialysis to NHS patients who lived in the local region. Patients attended the centre 3 times a week for dialysis. This meant staff knew and understood the diverse needs of the patients attending the clinic. Patients confirmed staff understood their individual needs.

Staff at the centre had good working relationships with the NHS clinicians, including the renal physicians and dieticians. There were effective multidisciplinary working processes and clear escalation processes to ensure patients care and treatment between the centre and the NHS was seamless. To support this, the centre hosted NHS consultant appointments, so patient did not have to travel to a different location for NHS consultations.

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

Patients could get information and advice that was accurate and up to date in a way they fully understood and met their communication needs. There was a range of leaflets in the waiting area which included information about renal conditions, dialysis and local support services, including information about accessing dialysis when on holiday.

Information about to raise a concern or complaint was displayed in the waiting area and all patients were given this information when they commenced dialysis at the centre.

The provider website had information about renal failure and the treatment of renal failure, including dialysis. This gave patients an insight into what to expect when commencing dialysis and the impact it would have on their and their family’s lives.

Staff ensured patients were fully informed about their dialysis treatment and the effectiveness of it. Multidisciplinary reviews included the centre staff, the NHS consultant and the patient. This meant the patient was fully informed about their dialysis treatment and any changes required in their treatment. This also enabled the patients to make informed decisions about their treatment. Patients we spoke with were fully informed about their conditions and were experts on their condition and treatment.

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.

Patients, relatives and carers knew how to complain or raise concerns. The service clearly displayed information about how to raise a concern in patient areas. There were posters in the waiting areas telling patients how they could raise concerns if they wished.

Staff had access to a complaints policy. This gave staff clear guidance about the management of complaints, including timescales for responding to complaints. The service had not received any complaints in the 12 months preceding the inspection.

Patients had the opportunity to join a Patient Advisory Board. In this they could use their experiences to bring about improvements to the service and to the patient experience.

All patients we spoke with were happy with their care but knew how to complain if they were not. The complaint procedure outlined the stages of the complaint process.

Staff responded and acted to make improvements following patient feedback. Patient surveys were carried out annually. The most recent survey showed that although 91% of patients felt staff provided all the necessary information for dialysis treatment, there were some that did not feel fully informed. The action plan associated with the patient survey results demonstrated that actions were being taken to address this. Other areas for improvement identified by the patient survey included internet access and comfort of beds and chairs. The action plan demonstrated staff had acted to address those areas for improvement, and this was confirmed in conversations with patients.

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

The service provided renal dialysis to meet the needs people in the local population who required renal dialysis. Staff worked with the NHS renal service to accommodate patients from the local area for dialysis.

The service had aids to support patients with accessibility challenges. Doors were of a width to accommodate wheelchairs. Staff had access to moving and handling aids to support patients who had reduced mobility and staff were trained in the use of the moving and handling aids.

All staff completed training about supporting people with dementia. At the time of our inspection the service was not supporting any patients with dementia. However, staff demonstrated in conversation a good understanding about providing individualised support of people living with dementia.

To ensure patients with a learning disability or who had autism staff completed training about supporting people with a learning disability or autism. Staff could also access support and guidance form the local NHS Learning Disability team.

However, some patients experience delays in the patient transport provision. This was provided by an external provider and was commissioned by NHS England specialist commissioning service. Some patients explained they sometimes had long waits for return journey home after dialysis. They said occasionally dialysis sessions had to be shortened because transport did not arrive in time to get them to the centre on time for their appointment. The registered manager confirmed this sometimes happened and all transport delays were logged and fed back to the NHS England in commissioning review meetings.

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.

All staff had completed training about equality, diversity, inclusion and human rights. Staff demonstrated in conversations a good understanding about meeting people’s diverse needs. They gave examples where they made reasonable adjustments, so patients had equitable experiences.

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.

Patients we spoke with felt the information they were given was clear and accurate and provided in a way they could understand. Patients were supported to make informed choices about their care and plan for the future. Patients had personalised care and treatment plans to suit their needs based on their personal hobbies and lifestyle.

Staff worked well together as an effective multidisciplinary team. There was input from NHS staff, including dietitian and medical staff which ensured patients were fully informed fully informed and supported in their care in line with national guidance.

Although staff were not actively involved in supporting patients with end-of-life decisions they respected patient’s choices about discontinuing dialysis. Throughout the patient renal care treatment, they were advised about the benefits and risks of having and not having dialysis. This meant if they made the decision to discontinue dialysis it was an informed decision and they understood the likely outcomes from the decision.