DaVita (UK) Ltd - Boston Also known as Renal Services (UK) Ltd

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 good. We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

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 service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them. However, staff did not always keep patient records fully up to date.

Staff followed a clear criterion before admitting patients for treatment. We reviewed 6 patients' records and found that staff completed risk assessments and reviewed these at least annually. Staff completed a comprehensive health assessment of the patient in a timely manner soon after admission. This included foot assessments where the patient was a diabetic. Staff developed care plans were developed with the patient and individualised to their physical needs.

We saw staff did not always keep patient records fully updated. The clinical service specialist carried out monthly audits of records. In March 2026 the unit achieved 98% compliance with the audit tool. However, in the April audit the unit achieved 68% compliance with the audit requirements indicating staff had deteriorated with this task. The clinical service specialist identified areas that staff needed to improve such as missing information, including allergies, signatures or lack of dates on forms. They emailed the unit and assisted with the development of an action plan. The records we reviewed in May 2026 were mainly completed well.

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.

Patients received care, treatment and support that was evidence-based and in line with good practice standards. The service used policies and procedures developed by their provider DaVita (UK) Limited. These were based on national guidance including National Institute for Health and Care Excellence (NICE) Guidance, advice from the British Renal Society and Kidney Care UK. Audits were undertaken by the clinical services specialist to ensure that staff were following policies and therefore national guidance in delivering the best care for their patients.

Staff also followed policies and protocols from the regional renal centre. This was to ensure standardised care in line with national policy.

Renal patients are encouraged to take part in ‘shared care’. This is a programme where patients who want to can take an active role in managing their own haemodialysis treatment within the clinic. Patients can choose which tasks to do with the nursing team. This could range from simple measurements to setting up and programming the machine. This could mean that a patient could undertake home dialysis. Whilst 100% of patients participated in weighing themselves, there were not many patients who, were part of the shared care programme, accessed more advanced options for shared care. At the Boston unit only 19.4% of patients were undertaking any form of shared care, this equates to 3 patients. Staff reported that patients did not want to undertake shared care.

Staff used nationally recognised tools to assess patients holistically. This included national tools such as National Early Warning Score and Waterlow assessments. Patients were offered dialysis 3 times a week in line with the Renal Association guidelines. Dialysis usually took place over a 4-hour period. Staff followed a policy for early disconnections (when patients finished treatment early), kept a record of these along with the reason why the patient had been taken off the machine early.

The service worked well across teams and services to support people. Staff mostly made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff worked collaboratively with the regional NHS renal centre and with their local DaVita sites. All patients were under a named renal consultant from the local NHS trust who undertook monthly ward rounds. A variety of specialist staff discussed patients at monthly multidisciplinary meetings with a variety of specialist input.

The leadership team had effective working relationships with the ambulance service and with national kidney charities. Managers discussed with them how together they could improve services and outcomes for their patients. Leaders met with the regional NHS renal centre to evaluate care and to explore improvement to care provision. They monitored the outcomes for patients through this monthly and quarterly meeting.

The service supported people to manage their health and wellbeing to maximise their independence, choice, and control. Staff supported people to live healthier lives and where possible, reduced their future needs for care and support. The service had many leaflets available in the waiting room on a variety of issues including healthy eating and lifestyles. We saw a poster highlighting potential holiday options encouraging patients on a cruise which could provide dialysis on board. Other leaflets encouraged patients to remain active.

Staff had access to services to support the mental health wellbeing of patients. Staff hand patients had access to help patients who had been newly diagnosed and those who were awaiting a transplant. Specialist social workers and mental health support staff came to the unit to provide support to patients.

The unit had trained vaccinators who offered patients, who met the criteria, flu and covid vaccinations. Patients consented to this formally through a consent form and this could be given on site following dialysis. Staff undertook a foot heath assessment on patients with diabetes. They provided advice on how to care for patients’ feet at home. Staff spoke with patients about their diet and blood results as well as any alcohol consumption. The manager told us they could refer patients for smoking cessation if appropriate.

Dieticians were involved as part of the multidisciplinary team and able to advise patients on their diet and fluid intake. Whilst at the unit, staff offered patients hot and cold drinks and biscuits. Some patients brought in food with them to eat whilst on dialysis. Staff monitored patients’ blood sugar to ensure that they did not suffer a low or high blood sugar whilst on dialysis. This is in line with national guidance.

The service supported people to manage their health and wellbeing to maximise their independence, choice, and control. Staff supported people to live healthier lives and where possible, reduced their future needs for care and support. The service had many leaflets available in the waiting room on a variety of issues including healthy eating and lifestyles. We saw a poster highlighting potential holiday options encouraging patients on a cruise which could provide dialysis on board. Other leaflets encouraged patients to remain active.

Staff had access to services to support the mental health wellbeing of patients. Staff hand patients had access to help patients who had been newly diagnosed and those who were awaiting a transplant. Specialist social workers and mental health support staff came to the unit to provide support to patients.

The unit had trained vaccinators who offered patients, who met the criteria, flu and covid vaccinations. Patients consented to this formally through a consent form and this could be given on site following dialysis. Staff undertook a foot heath assessment on patients with diabetes. They provided advice on how to care for patients’ feet at home. Staff spoke with patients about their diet and blood results as well as any alcohol consumption. The manager told us they could refer patients for smoking cessation if appropriate.

Dieticians were involved as part of the multidisciplinary team and able to advise patients on their diet and fluid intake. Whilst at the unit, staff offered patients hot and cold drinks and biscuits. Some patients brought in food with them to eat whilst on dialysis. Staff monitored patients’ blood sugar to ensure that they did not suffer a low or high blood sugar whilst on dialysis. This is in line with national guidance.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. However, not all staff had a full understanding of how to work with patients who may not be able to consent to treatment. Staff took all practical steps to enable patients to make their own decisions. Formal consent was taken around specific issues such as vaccination or consent to treatment. This consent was formally recorded on an annual basis.

Some staff we spoke with could not articulate what they would do with someone who lacked capacity until presented with a scenario. Then they could explain what had been done previously. At the time of inspection there was one patient who had fluctuating capacity. Staff were aware of the plan for an early disconnection if they became overly restless and non-compliant with treatment. This best interest's decision had been made with the patient's friends, and carers views obtained. A best interest decision is a legal and ethical principle applied when a person lacks the mental capacity to make a specific choice for themselves.

Staff completed training around the mental capacity act 2005 and Deprivation of Liberty Safeguards (DoLS). These both met the service target rates of 90% scoring 100% complaint with level 1 and 2 in the Mental Health Act training.