Redditch Kidney Treatment Centre is operated by Diaverum UK Limited. The service has 20 dialysis stations. Facilities include four isolation rooms, three consulting rooms, and a meeting room.

Dialysis units offer services which replicate the functions of the kidneys for patients with advanced chronic kidney disease. Dialysis is used to provide artificial replacement for lost kidney function.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 5 April 2017, along with an unannounced visit to the unit on 11 April 2017.

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? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we do not rate

We regulate dialysis services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following areas of good practice:

• There were effective systems in place to keep patients safe. This included appropriate management and reporting of incidents, effective cleaning schedules and maintenance programmes. All staff were aware of their roles and responsibilities in ensuring patient safety.
• Effective processes were in place for the provision of medicines. These were stored and administered in line with guidance and staff completed competencies annually to ensure they continued to administer medicines correctly.
• Patients’ medical and nursing records were secure. All staff had access to all relevant records ensuring that patients’ care was as planned and not delayed.
• Staff worked collaboratively with the local NHS trust to monitor and assess patients regularly. Patients and their GPs were provided with a minimum of monthly written updates on their condition and treatment plans.
• Staffing levels were maintained in line with national guidance to ensure patient safety. Nursing staff had direct access to a consultant who was responsible for patient care. In emergencies, patients were referred directly to the local NHS trust and the emergency services called to complete the transfer.
• Staff were aware of their roles and responsibilities to maintain the service in the event of a major incident. Patients were able to continue their treatment at alternative centres.
• All policies and procedures were based on national guidance and compliance was monitored through an effective audit programme. Key performance indicators for October to December 2016 showed that the service performed better than all other Diaverum dialysis centres nationally.
• Patients’ pain and nutrition were assessed regularly and patients were referred to appropriate specialists for additional support as necessary.
• There was a comprehensive training and induction programme in place to ensure staff competency. Training compliance was 100%.
• There were processes in place to ensure effective multidisciplinary team working, with specialist support provided by the local NHS trust.
• There were effective processes in place for gaining patient consent for treatment.
• Patients were treated with respect and compassion. Patients reported that staff worked above expectations going the extra mile to ensure their satisfaction.
• Staff were familiar with and worked towards the organisational vision of providing the best possible care for renal patients.
• There were effective processes in place to monitor risks associated with the service and individual patients. Quality assurance meetings occurred regularly and included the local NHS trust and specialists.
• There was evidence of strong national and local leadership, with accessible and responsive managers.
• All staff and patients were positive about the service.
• The service had implemented placements for student nurses.

However:

• The resuscitation trolley was not sealed to assist with the identification of tampering, which was not in line with local policy.
• There was no guidance on the escalation processes for when the medicine fridge temperatures were outside normal range.

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Edward Baker

Deputy Chief Inspector of Hospitals

Central Region