Runcorn Road Dialysis Unit

On this page

• 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

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. 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 people could access care in ways that met their personal circumstances and protected equality characteristics.

This is the first assessment for this service. This key question has been rated outstanding. This meant people’s needs were met through good organisation and delivery.

People were at the centre of their care and actively involved in decisions about their care. The service provided information people could understand, and staff had gone the extra mile to understand different cultures and ways to communicate. They used a variety of tools to communicate with people according to their needs and found creative ways to communicate with each person using the service. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

This service scored 86 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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. Staff went beyond what was expected of them to create a warm, friendly environment where people were at the centre of their care.

Care plans were holistic and included physical, psychological, emotional and social aspects of care. Care plans were regularly reviewed with involvement of the patient and their named nurse. Changes in needs were discussed at the multidisciplinary meetings and outside of these when necessary. Where people had additional needs or protected characteristics, their hospital passports were used to ensure consistency in care being delivered in line with their preferences and wishes.

There were examples where staff had taken additional action to support people. For example, to ensure a vulnerable patient was supported over a bank holiday, staff from the dialysis centre visited the patient at home and maintained links for them to access support should they need it.

Staff kept a record of changes in people’s circumstances that might impact their dialysis schedule. For example, if they had important events such as weddings or funerals to attend. This helped staff to work reschedule dialysis so as to safely allow the patient to attend events that were important to them.

Leaders had changed the schedule of twilight dialysis sessions to allow people more freedom and family time over the weekend, moving the twilight schedule from a weekend day to midweek.

Staff took time to get to know people. They helped them to celebrate life occasions. This included celebrating people’s birthdays. The manager kept a stock of musical instruments and balloons, and staff serenaded people when it was their birthday. This was seen to bring joy to the unit and contributed to a warm, friendly atmosphere. In addition, we were told of occasions where staff had been invited to write and deliver the eulogy for people at their funeral. This was because the staff were seen as playing a significant role in people’s lives.

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 operated in a way to ensure continuity of care. Local haemodialysis services were integrated and managed within the trust, with shared operating procedures, integrated leadership and shared learning.

We saw there was continuity of care. For example, there were shared management systems that enabled information to be shared across services when people transitioned from one service to another. We saw an example of a patient who transitioned from child services who was supported to visit the service prior to receiving care. In addition, staff from the service worked closely with the children’s service staff, to ensure a smooth transition and that the patient’s needs were met.

The service worked closely with both local and national services to ensure high standards of care. This included services in the local community organisations and networks, including the Midlands Kidney Network, to ensure capacity and services met the needs of the local community.

The service was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Staff use a variety of tools to communicate with people according to their needs and found creative ways to communicate with each person using the service.

Information was available in different formats and languages to ensure people received and understood information relevant to their care needs. Leaders told us staff had attended workshops in learning conversational Urdu to ensure they could communicate basic phrases. This included asking for consent, checking comfort and phrases relevant to dialysis.

Written information was available in different languages that were commonly spoken by people attending the unit. A video was running on the television screen in the waiting area where staff were on screen greeting people and providing information, including in Urdu.

Easy read information was available for people with a learning disability. Feedback from a relative of a patient with learning disability included that staff were mindful of using simple language and checking the patient understood the information shared with them.

A communication box was available to assist people with hearing or visual impairments, ensuring everyone could communicate their needs and feel included in their care.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

There were effective systems for people to provide feedback on the service. This included people being greeted by the senior nurse on arrival and providing them with an opportunity to discuss any concerns informally. The trust took part in the UK Kidney Association Patient Reported Experience Measures (PREMS). They scored similar to or higher than the national average in all areas. In the 2024 PREM, 70 out of 110 people receiving treatment and care at Runcorn Road provided feedback. The service had identified transport, shared decision making and self needling as areas for improvement. Action had been taken to improve transport issues which included involvement of the trust transport lead and regular meetings with service leads to ensure improvements were implemented. Staff and patients told us they had experienced minimal transport issues in recent months.

The service had effective systems for dealing with patient concerns. Staff we spoke with understood complaints and feedback were useful in helping the service to improve. People we spoke with understood how to provide feedback and how to make a complaint. There had been no formal complaints within the service in the last year.

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

The service met the needs of people in terms of access. There were 26 dialysis stations across 3 bays and 2 side rooms. The service provided dialysis to 110 people at the time of our assessment. Two sessions, morning and afternoon, were provided Monday to Saturday, with an additional twilight session on a Monday, Wednesday and Friday. The service provided 15,786 dialysis sessions in the last year which was at 78% capacity.

All people had access to dialysis 3 times a week, usually for 4 hours a session, in line with national guidelines. The exception to this was people starting dialysis who may only have 2 sessions a week as clinically indicated. People were required to meet agreed criteria for receiving dialysis treatment at a satellite centre of through a home dialysis programme.

Staff ensured the service was flexible in meeting the needs of people. For example, where their schedule needed to be altered due to important personal events. We saw that staff took on additional shifts or worked extra hours when necessary to ensure people had access to meet their needs. For example, when a power failure delayed treatment for people, staff worked with other dialysis centres and provided additional sessions to ensure all people requiring dialysis received it. This included staff going into work on their day off and working until late into the evening to ensure all patients had access to their dialysis. Staff recognised the additional needs due to this occurring on the day after their Muslim cohort of patients had been attending Eid celebrations. Therefore, there was a greater risk of patients experiencing complications if their dialysis was delayed as dietary fluctuations may have an impact. There was capacity across the trust to provide additional dialysis sessions in the event of visitors to the area requiring treatment, or in the event of an emergency.

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.

Staff worked closely within the multidisciplinary team to provide appropriate tailored support where this was needed. They worked with the vulnerabilities team to support people with protected characteristics and additional needs. They also worked closely with supportive care nurses where people required additional support at home.

Staff had a good understanding of the needs of the local community and how to support people based on their cultural and social needs in order to achieve the best outcomes and experience for people. We observed staff checking in with people during their treatment and giving them the opportunity to share details of their experience. There were processes for staff to follow up on individual issues and we observed staff working closely with people to ensure their experience was positive.

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.

Staff had identified people who were likely to be in the last year of life. They worked closely with the multidisciplinary team to provide additional support. This included visits from the supportive care nurse in the community.

The named nursing structure of the service enabled continuity and open discussions about planning for the future. Staff had a good understanding of people who were particularly vulnerable and required additional support and future needs were discussed regularly with people, family and as part of multidisciplinary meetings.