Havant Renal Unit

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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. At our last assessment we rated this key question as 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.

Staff treated patients with kindness, compassion and respect. During the assessment we observed staff respond compassionately to a patient whose condition deteriorated. Staff maintained the person's dignity and privacy while providing prompt clinical support. Although the unit did not use curtains between treatment stations, staff had access to 4 mobile privacy screens and used them when required. Staff explained many patients preferred the open-plan environment because it allowed them to socialise with other patients during treatment while still having access to privacy when needed. The design of the unit also supported dignity, as patients could see out of the windows while preventing members of the public from seeing into treatment areas.

We observed several examples of caring interactions during the inspection. Staff responded promptly to patients' needs and treated them with consideration and respect. For example, we observed a member of staff opening a door for a patient using a walking aid. Staff interacted warmly with patients and appeared familiar with their individual needs and preferences.

Patients told us staff were friendly, approachable and kind. Many patients had attended the service for several years and said they knew the staff well. They reported they were often cared for by the same named nurse, which helped them build trusting relationships and feel reassured during treatment. Patients said staff listened to them, involved them in discussions about their care and provided support when needed.

Patient feedback demonstrated positive experiences of care and treatment. Survey results showed improvements across several areas of patient experience, including support, communication, sharing decisions about care, the environment, scheduling and planning, and privacy and dignity. Privacy and dignity scores had improved over time since 2024, indicating patients felt their dignity and respect were maintained during their care.

Staff treated people as individuals and tailored care to their specific needs, preferences and circumstances. They completed an admission assessment for every patient, which included information about communication needs such as language, speech and hearing requirements. This enabled staff to adapt their approach and provide personalised care that reflected each person's circumstances.

Staff gathered detailed information about patients' social histories, including family relationships, employment and lifestyle. This helped them understand what mattered to people and plan care around their individual needs and priorities. For example, staff described how they worked flexibly with a patient to arrange dialysis sessions around their employment commitments. This enabled the person to continue working while receiving safe and effective dialysis treatment.

Staff adapted care and treatment to meet individual preferences wherever possible. During the inspection, we observed a patient receiving dialysis in a hospital bed rather than a dialysis chair. Staff explained they had arranged this at the patient's request to improve their comfort during treatment. This demonstrated how staff listened to patients and made reasonable adjustments to meet their needs.

The building was fully accessible for people with reduced mobility, including wheelchair users. Staff had access to moving and handling equipment and had received training in its safe use. Each dialysis station included an adjustable chair, television with headphones and Wi-Fi access, allowing patients to remain comfortable and choose how they spent their treatment time. Patients told us they were satisfied with the facilities and had no concerns about their comfort during dialysis sessions.

Staff recognised and supported people with additional needs, including those living with dementia, learning disabilities, autism and mental health conditions. Training compliance was high, with all staff completing Dementia Awareness training and almost all staff completing Learning Disability and Autism training. This helped staff understand individual needs, adapt communication and provide person-centred care.

Staff could access additional support when required. They could refer patients to specialist mental health services through the local NHS trust and signpost people to kidney care charities for practical and emotional support. This helped ensure patients received support that extended beyond their immediate clinical needs.

The service recognised patients as individuals rather than focusing solely on their treatment needs. Staff celebrated patients' birthdays and had developed positive relationships with many people who attended the unit regularly. This helped create a welcoming and supportive environment and contributed to a positive patient experience.

The service recognised the importance of family and social support. Patients were encouraged to have family members or friends accompany them wherever possible, and any restrictions were only introduced in exceptional circumstances following a risk assessment. This helped patients maintain important relationships and support networks while receiving treatment.

Patient feedback reflected this personalised approach to care. Experience scores remained consistently high across all domains, with particularly positive feedback about information provision, appointment scheduling and how staff treated people. Patients described feeling valued, respected and well supported throughout their care and treatment.

The service supported patients to remain as independent as possible and encouraged them to take an active role in their care and treatment. Staff provided information, education and practical support to help patients understand their condition and make informed decisions about their care.

A shared care programme gave patients the opportunity to become more involved in their dialysis treatment if they wished. Following appropriate training and assessment, patients could take part in tasks such as recording observations, setting up equipment and carrying out parts of their treatment. Participation was based on individual choice and ability, and staff used shared care records to support learning, build confidence and develop self-management skills.

Patients and their families had access to a range of information and support resources from Kidney Care UK. These covered topics such as treatment options, nutrition, fluid management, emotional wellbeing and living with kidney disease. Together with the shared care programme, this helped patients develop the knowledge, skills and confidence to manage their condition and make informed choices about their care.

Patients were encouraged to be actively involved in monitoring their treatment. They weighed themselves before and after dialysis using wheelchair-accessible scales and entered the results directly onto the electronic system. Nurses checked the information for accuracy as dialysis prescriptions and some medication doses relied on patient weight. Patients could also access an electronic application to view their blood test results, helping them better understand their condition and take ownership of their treatment.

The service provided patients with personalised information about their blood test results and dialysis treatment each month. This included explanations of target ranges, what the results meant and how medicines, diet and treatment could affect them. This helped patients understand their health and take part in decisions about their care.

Staff respected patients' choices and supported them to make informed decisions. Patients were given information about the risks of ending dialysis treatment early and staff ensured they understood the possible consequences before making a decision. Where patients chose to finish treatment early, this was documented appropriately and reviewed to ensure their safety and wellbeing.

The service also helped patients maintain independence in other areas of their lives. Staff worked flexibly with patients who were employed and adjusted dialysis schedules where possible to support them to remain in work. Evening dialysis sessions provided additional choice and flexibility for people balancing treatment with work and other commitments.

Staff remained attentive to patients throughout their dialysis treatment. On arrival, staff took time to speak with patients, assess their condition and identify any immediate concerns, allowing them to respond quickly when additional support was needed.

During the inspection, staff explained that each nurse was responsible for up to 4 patients at a time. We observed nurses working in close proximity to their allocated patients, with all dialysis machines and monitoring equipment clearly visible. Staff told us this arrangement was deliberate and helped them maintain continuous oversight of patients throughout treatment.

We observed similar levels of vigilance across the unit, with staff closely monitoring patients and equipment throughout treatment. When asked how they would identify deterioration in a patient who was unable to verbally communicate concerns, a nurse explained that dialysis machines were programmed with individual alarm limits based on each patient's expected observations. If a patient's observations moved outside these limits, the machine would alert staff immediately. The nurse confidently demonstrated how alarm guards had been set for a patient, showing how the system supported the early identification of concerns and a rapid response when required.

The layout of the treatment area supported safe and effective monitoring. Staff were able to maintain clear sight of patients, dialysis machines and access sites at all times, enabling them to quickly identify any changes in a patient's condition or problems with dialysis lines and connections.

Staff also used the National Early Warning Score (NEWS2) before and during dialysis sessions to monitor patients' condition. This helped staff identify signs of deterioration early and escalate concerns promptly when needed.

Staff spoke positively about working at the service and described a supportive and respectful team culture. A healthcare support worker told us they enjoyed their role and had good job satisfaction. During the inspection, we observed positive interactions between colleagues. Staff treated each other with kindness and respect, checked on one another throughout the day and worked well together to support patients. Staff also had access to a well-equipped staff room and a comfortable space to take breaks away from clinical areas.

The service regularly sought feedback from staff through the annual My Opinion Counts survey and used the results to identify areas for improvement. The 2025 survey showed positive levels of staff engagement, with an overall engagement score of 79%. Staff engagement was a particular strength, scoring 87%, while teamwork also scored highly at 85%. These results showed that staff generally enjoyed their work and valued the support they received from colleagues.

Leaders recognised there were opportunities to improve some areas of staff experience, particularly around perceptions of management support and the wider organisation. Relationships with managers was the lowest-scoring area and had fallen compared with the previous year. In response, leaders had developed action plans to improve communication, staff recognition, engagement and involvement in service development.

The service was committed to staff learning, development and career progression. Staff were supported to attend external courses, conferences and practical training events, alongside in-house learning opportunities. Recent training included dialysis machine training, vascular access training, independent prescribing education and clinical training provided by equipment manufacturers. Junior staff were encouraged to learn from experienced nurses, consultants, dietitians and other specialist professionals to develop their skills and knowledge.

Leaders also invested in the future development of the workforce. Senior nurses were supported to undertake advanced renal nursing qualifications, and additional development opportunities were being planned for healthcare assistants. Staff were encouraged to take on extra responsibilities, including audit work, quality improvement projects and link roles, helping them develop professionally and become more involved in improving the service.

Staff had access to support for their health and wellbeing, including occupational health services when needed. Leaders promoted a culture of learning, reflection and continuous professional development, helping staff maintain their skills, confidence and competence in their roles.