DaVita (UK) Ltd - North Poole

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

The service had a leadership structure and governance processes which supported the delivery of high-quality care and an open, fair culture. However, leadership and governance processes had failed to address concerns around medicines management identified at a previous CQC assessment.

We have not awarded this service a score for Well-led.

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

The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The service promoted a positive and inclusive culture underpinned by clear organisational values: service excellence, integrity, teamwork, continuous improvement, accountability, fulfilment and fun. These values underpinned what the organisation called The DaVita Way and were embedded within the service, featuring in the teammate handbook, the clinic environment and in staff newsletters. This created a shared understanding of the organisation’s purpose and expectations. The organisation had also introduced Culture Ambassador roles to strengthen and promote an inclusive culture across clinics. These roles were designed to champion DaVita’s core values and sense of community by sharing success stories and developing opportunities for connection between staff and patients.

Leaders supported a culture where staff felt connected to the organisation’s mission and proud of the care they provided. Feedback from the 2025 staff engagement survey demonstrated that staff were proud to care for patients and valued the strong sense of teamwork within the clinic. Survey findings were used to inform an action plan aimed at strengthening staff engagement through increased opportunities for involvement, collaboration and team activities. During the assessment, staff described how the registered manager and team supported each other and recognised each other’s value and contribution.

Communication promoted a shared direction across the organisation. Regular newsletters kept staff and patients informed about service developments, including new clinic openings, improvements and achievements across different locations. The organisation recognised and celebrated staff contributions using initiatives such as appreciation weeks, employee recognition awards and a Week of Belonging to promote a positive and inclusive culture. The Poole team, for example, had recently been highlighted in DaVita’s Rising Star Awards and Wall of Fame for their work in bringing patients and teammates together through shared activities.

The evidence showed some shortfalls. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. However, leaders had failed to address shortfalls around medicines management identified 5 years ago at a previous CQC assessment.

The service had a clear leadership structure with representation from a range of clinical and corporate disciplines. This structure ensured managers and staff had access to the skills, knowledge and expertise required to support safe, effective and high-quality care in the majority of areas across the service. However, leaders had failed to act upon concerns raised by CQC in March 2021 in relation to a breach of regulation around medicines management. In this specific area, leaders had not taken steps to improve poor practice identified at the previous assessment meaning, despite leadership awareness, practice had continued for the past 5 years.

The clinic was led by a registered manager who was supported by a wider organisational leadership team. Staff consistently described leaders as approachable, responsive and very supportive. They told us they felt listened to when raising concerns or seeking guidance. The registered manager maintained a visible presence within the clinic and was accessible to staff both in person and by telephone. Feedback from a visitor to the clinic also demonstrated confidence in the leadership team and their willingness to respond constructively to concerns or issues raised.

The organisation was committed to developing leadership capability across the service. Managers and senior staff had access to leadership development events, providing opportunities to strengthen safety culture and learn from external experts about developments in dialysis care and treatment. This supported staff to continually develop knowledge and effectiveness in their roles.

The organisation promoted visible and inclusive leadership. We heard how senior leaders from across the organisation had increased their presence within the clinic during a recent period of change through visits, audits and staff engagement. These visits enabled leaders to gain insight into frontline challenges and gave staff additional opportunities to raise concerns and share feedback. This demonstrated a culture of openness, and continuous learning across the service.

The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The service promoted a culture where staff were encouraged to speak up about concerns, incidents, risks or workplace issues. A whistleblowing policy provided clear guidance about raising concerns. There were multiple routes available for staff to use including email, telephone, letter or a Quick Response (QR) code. Staff had access to a confidential reporting tool that could be used from any computer or mobile device. A compliance hotline was available 365 days each year for reporting actual or suspected breaches of policy or legal requirements. Concerns could be raised anonymously which helped ensure staff felt safe and confident in speaking up.

Records demonstrated that staff concerns were reviewed and investigated by the leadership team. We looked at a sample of concerns raised during the last year and found clear evidence of investigation and action. Staff who raised concerns had been signposted for additional support through the organisation’s employee assistance programme.

Staff told us they felt able to raise concerns and would approach the nurse in charge or registered manager in the first instance. They said they were confident that concerns would be listened to and acted upon reflecting a culture where speaking up was encouraged and valued.

The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

The service demonstrated a strong commitment to valuing diversity and promoting an inclusive culture for its workforce. Staff described a positive working environment where diversity was celebrated and respected. The provider organised a range of events throughout the year to promote inclusion and cultural awareness. For example, during the inspection, staff had recently participated in a Week of Belonging, which included an opportunity for staff to share food from their own cultural backgrounds and learn more about each other’s traditions and experiences. Staff spoke positively about these initiatives, highlighting how they fostered understanding, respect and team cohesion. This was reflected in feedback from the 2025 staff engagement survey, where one staff member commented, “I love the staff diversity and cultural differences, it’s a place for all of us to learn about our differences in a positive way, usually through food.”

Leaders supported equality, diversity and inclusion by encouraging staff engagement and creating opportunities for all staff to participate in events and celebrations. The organisation’s engagement calendar recognised a wide range of cultural, religious and awareness events throughout the year, including festivals from different faiths, LGBT+ events, World Menopause Day, International Nurses’ Day and World Patient Safety Day. These activities were promoted through staff newsletters helping to raise awareness and encourage participation across the organisation.

The provider demonstrated a commitment to creating a fair and respectful workplace by taking action to address discrimination and inappropriate behaviour. Where there had been incidents involving discriminatory behaviour from patients towards staff, these had been taken seriously and guidance provided to staff. Information about equality, diversity and inclusion was included within the organisation’s Teammate Handbook together with details of how staff could access support or raise concerns. These arrangements supported staff to have their voices heard and contributed to an inclusive culture where diversity was valued and respected.

The evidence showed significant shortfalls. Although the service had established governance processes, these had failed to address an area of repeated poor practice.

Governance processes were used across the service to review all areas of safety, quality and performance. However, these processes did not always follow the organisation’s policies or identify where improvements were needed. Improvements were not always made in a timely way. For example, action had not been taken to address a breach of regulation identified by CQC in March 2021 in relation to medicines management. No action had been taken to identify new systems and processes to ensure safe practice. Governance processes around medicines had not been reviewed to ensure they aligned with the organisation’s policy and safe practice. Although the service had risk assessments and ongoing audits, these had not been effective in ensuring medicines practice aligned with policy. Governance processes had not ensured timely improvement in response to concerns.

Although staff followed a combination of DaVita policies and local NHS policies there was inconsistency in how policies were communicated and shared with staff. Staff feedback in the 2025 engagement survey indicated uncertainty about which policies should be followed. At the inspection, a policy folder containing 3 NHS policies was available but these were not all in date, relevant or confirmed as having been read by all staff. The service had recognised this as a risk and was working to improve staff access to current policies.

Oversight from the local NHS commissioner provided assurance regarding ongoing quality, safety and performance. Communication was also evident between the service and the NHS about how they could work together to meet future service demand. Regular meetings took place between the service and the NHS which were mostly well attended by the service.

The service had a risk register which reflected the main risks for the service. These were reviewed and discussed within the leadership team and with commissioners. Actions to manage risks in relation to patient safety and business continuity were identified as part of this process. Governance information, risks and service developments were routinely shared with staff through regular teammate meetings helping to promote transparency and effective communication across the organisation.

A business continuity plan provided information about how disruptions to the service such as staffing shortages, utility failures and supply issues would be managed. Staff understood escalation processes and knew who to contact in the event of service disruption. The registered manager described how arrangements had worked well when the service recently encountered an IT failure which affected telephone lines and access to information. Arrangements had ensured patients’ treatment was not interrupted.

The provider demonstrated a commitment to sustainability with a carbon reduction plan published in September 2025. This stated the organisation’s commitment to achieving net zero greenhouse gas emissions by 2045. Staff were encouraged to contribute ideas for implementation across the DaVita community as part of a Green Champions programme.

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The service demonstrated commitment to working in partnership with their local community, charities and health partners to support people affected by kidney disease and contribute to community wellbeing.

Staff engaged in health promotion and awareness activities within their local community. For example, on World Kidney Day, staff organised a stand at a local supermarket where they offered blood pressure checks and spoke with members of the public about kidney health and wellbeing. This helped raise awareness of kidney disease and early identification of health concerns where timely intervention could have the greatest impact.

The provider encouraged staff to strengthen links with their local communities. A volunteering policy had recently been introduced enabling eligible teammates to have protected volunteering time each year. This supported staff in building relationships with local organisations and communities through a shared sense of purpose and social responsibility.

Staff participated in wider charitable initiatives aligned to improving health outcomes. For example, the team had taken part in the DaVita International Walkabout Challenge. Staff used a step-counting initiative to raise awareness of a global healthcare charity which aimed to improve access to kidney care in underserved communities. This demonstrated the provider’s commitment to broader health improvement initiatives.

The service had established partnerships with national kidney charities and renal networks. They regularly participated in conferences and events about patient care, professional development, education and good practice alongside external partners. These partnerships helped keep patients at the heart of service improvement while also raising awareness of developments in the sector.

The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They actively contribute to safe, effective practice and service development.

The provider demonstrated commitment to improvement by identifying opportunities to enhance the quality, safety and effectiveness of their service. For example, following participation in a national multi-professional kidney conference, the service had identified goals to develop points of contact for clinical practice queries, provision of clinical supervision and reflective practice. The culture ambassador programme also had a role in driving service improvement by enhancing patient experience and promoting staff engagement and inclusion.

The service demonstrated commitment to evidence-based practice using data to monitor outcomes for patients and make improvements. For example, they knew that increasing substitution volumes during hemodiafiltration could improve patient mortality outcomes. Action was being taken to implement staff training, achieve optimal pump speeds where clinically appropriate, encourage patients to complete dialysis treatment sessions and escalate concerns promptly to NHS renal teams. This had resulted in substitution volumes increasing between January and May 2026 demonstrating the provider’s commitment to learning and improvement.

The service engaged with professional membership bodies and industry networks which promoted collaboration, shared learning and best practice across the sector. Staff participated in professional conferences and renal network meetings to keep informed about developments in kidney care, policy changes and innovation. DaVita UK further supported staff’s professional development by funding membership of a national nephrology nursing network for all registered nurses, encouraging continuous learning and knowledge sharing.

The Director of Nursing and Quality was a member of a national kidney patient safety committee contributing to the development and dissemination of learning across the kidney care sector. These professional networks and relationships enabled the service to influence and adopt improvements that enhanced quality of care and clinical practice.