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Inspection Summary


Overall summary & rating

Good

Updated 7 January 2020

The Windsor dialysis unit is part of the Royal Berkshire Hospital NHS Foundation Trust which provides care and treatment for patients with chronic kidney disease needing haemodialysis. Dialysis is used to provide artificial replacement for lost kidney function due to kidney failure. The two main types of dialysis are haemodialysis and peritoneal dialysis.

The unit provides clinics for haemodialysis patients and outpatient clinics for patients requiring peritoneal dialysis. Haemodialysis is a process of blood filtration by pumping the patient’s blood through a special filter and returning the filtered blood to the patient.

Inspection areas

Safe

Good

Updated 7 January 2020

Effective

Good

Updated 7 January 2020

Caring

Good

Updated 7 January 2020

Responsive

Good

Updated 7 January 2020

Well-led

Good

Updated 7 January 2020

Checks on specific services

Medical care (including older people’s care)

Good

Updated 7 January 2020

The unit provides care to patients living in Berkshire and the surrounding areas. The service is delivered from a purpose- built facility situated in Windsor. It consists of 24 treatment stations, including two side rooms, which staff could use for isolation purposes.

The unit also offers holiday dialysis for patients who were holidaying in the area. This is pre- planned to meet demand.

The Windsor dialysis unit does not have any inpatient beds and all patients are treated as day cases and discharged home. Most patients receive dialysis for four hours, three times a week.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

  • The staff looked after the equipment well and infection control procedures were followed to minimise the risks of cross infection.
  • The staff reported incidents, and these were investigated, action plans were developed, and lessons learnt were shared widely to effect learning and practices changed.
  • The service used systems and processes to safely prescribe, administer, record and store medicines. Patients medicines were reviewed, and any changes were discussed with the consultants.
  • Patients received care and treatment in a well- maintained environment. They took into account of patients’ diverse needs, and access for patients with limited mobility and wheelchair were good.
  • The service used monitoring results well to improve safety. Staff collected safety information and shared it with staff, patients and visitors.
  • Staff followed safeguarding policies and procedures to benefit patients. They could recognise and report abuse, and they knew how to apply it. Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.
  • The service provided care and treatment based on national guidance and evidence-based practice.
  • There was effective multi-disciplinary working where staff of different roles such as dieticians and specialist nurses worked cohesively for the benefits of patients. They supported each other to provide good care.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
  • Staff supported and involved patients, families and carers to understand their condition and make decisions about their care and treatment. Families were supported to remain with the patients during their treatment.
  • The staff were focused on the needs of patients receiving care. The service had an open culture where patients, their families and staff could raise concerns without fear.
  • The senior managers and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues. They developed and reviewed action plans to reduce and mitigate their impact.

However:

  • The system for storing empty oxygen cylinders was not safe as these were stored outside the building and may be accessible to unauthorised persons.