The Care Quality Commission (CQC) has told B. Braun Avitum UK Limited immediate improvements are needed at its haemodialysis services provided at the Gloucester Royal Hospital Renal Units.
Braun Avitum UK Limited provides haemodialysis services to NHS patients over the age of 18 at Gloucestershire Royal Hospital Renal Units. The service operates 50 dialysis bays across three units on the site of Gloucestershire Royal Hospital. Cotswold and Severn units are satellite clinics on the hospital grounds. The service also operates a dialysis bay and side room on ward 7B of the main hospital.
Following the inspection, the service was rated inadequate for being safe and well-led. Inspectors also issued a warning notice to the provider to ensure improvements were made to the governance of the service and the oversight of risks posed by the environment.
Catherine Campbell, CQC head of hospital inspection, said:
“Following our inspection of the Gloucester Royal Hospital Renal Units, I am concerned about the lack of meaningful communication with the host NHS trust. There needs to be an understanding of the urgent need for repairs and the amount of maintenance needed at the site, and more meaningful communication would support this.
“The provider, B. Braun Avitum UK Limited also needs to manage governance of the service more effectively.
“We have issued the service with a warning notice to give focus on the areas we need to see improved. We will re-inspect to assess whether those improvements have been made, and we won’t hesitate to take further action if needed to protect patients.”
Findings from the inspection included:
- The manager provided evidence of good collaborative working between B. Braun and the NHS trust safeguarding teams to protect a patient with a severe learning disability from harm. However, this was not reflected consistently, and incident records indicated challenges with securing safeguarding support from the host trust
- The estates and facilities were provided by and remained the responsibility of the host trust. Clinical areas were visibly dirty in places. Furnishings in many areas were damaged and poorly maintained. The registered manager reported and escalated these concerns to the NHS trust at contract monitoring meetings, and to the hospital estates team, although very little action had resulted
- The registered manager had regular contract review meetings with the host trust. However, there were no minutes from the meetings and there was no system in place to track actions. While the registered manager repeatedly documented concerns about the unsafe condition of the clinical environment to the NHS trust and to B. Braun, there was no evidence the provider had taken more effective escalatory action
- There was a lack of provision for patients with mental health needs.