Renal Services (UK) Ltd - Grantham is operated by Renal Services (UK) Limited. The service at Grantham has eight treatment stations including one side room and is open Monday, Wednesday and Friday 7am to 6pm and Tuesday, Thursday and Saturday 7am to 1pm.

There is a Service Level Agreement with University Hospitals of Leicester NHS Trust to provide haemodialysis (HD) to adults over the age of 18. Haemodialysis is a type of renal replacement therapy offered to patients with chronic kidney disease and is the most common form of renal replacement therapy.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 18 May 2017, along with an unannounced visit to the service on 22 May 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?

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

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:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Lessons from incidents were learned and communicated throughout the team.
• Performance showed a consistently good track record in safety, patient outcomes and access to treatment.
• Staffing levels were of an appropriate number for the unit and staff were suitably skilled, including senior managers.
• Patient’s care and treatment was planned and delivered and clinical outcomes monitored in line with evidence-based guidance, standards, best practice and legislation. This included the management of a patient’s pain, nutrition and hydration needs and individual physical health needs.
• There was effective multidisciplinary working. Staff worked well together and there was high morale and staff satisfaction.
• Staff were committed to ‘doing the best’ for their patients and passionate about delivering high quality care, a culture of putting the patient first was evident throughout the unit.
• Feedback from patients was consistently positive about the way staff treated them. The unit had received no complaints in the past year.

However, we also found the following issues that the service provider needs to improve:

• Staff did not fully follow the provider medicine management policy for the positive identification of patients when they were administering medicines.
• On-going competency-based assessments to ensure staff were up to date with using, for example, dialysis machines was undertaken informally but not documented.

• A Workforce Race Equality Standard (WRES) report was not produced at this location.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve.

Heidi Smoult

Deputy Chief Inspector of Hospitals