Clifton 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

This is the first time we have rated this service. We rated responsive as good. The service planned care and treatment to meet the needs of local people, took account of people’s individual needs and future care plans, and made it easy for people to give feedback about their experiences. Care and treatment was centred around people and their needs. People could access the service when they needed it, in a way that promoted equality, removed barriers or delays and protected their rights.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People who use the service told us their needs and preferences were taken into account. They told us their care and treatment was person-centred and focussed on their needs.

Staff told us people referred to the service already had an established dialysis treatment plan in place from the commissioning trust. Staff told us people’s care plans were regularly reviewed and discussed with them along with vital observations and blood results to enable improvements or changes to their plan of care. The renal dietitian told us they assessed people’s nutritional needs and care plans and fluid monitoring charts were regularly reviewed.

We observed positive interactions between staff and people with specific needs, including a person with diabetes and another with hearing difficulties. We saw staff understood their needs and provided appropriate care and treatment. Care records showed person-centred care plans that reflected what people told us. People receiving dialysis treatment had individual identification documents used to programme the individualised treatment on dialysis machines.

People told us their care was coordinated well and staff planned and delivered their care and treatment in a way that met their needs. People told us their care was reviewed by the nurses, consultants and dietitians at least monthly and this included discussions about their ongoing care and treatment.

Staff told us they received all the information they required to plan people’s care and treatment as part of the referral from the commissioning trust. Staff told us they prepared the equipment, consumable items and medicines for each person in advance of their scheduled dialysis treatment. Managers told us they had daily discussions with staff across the service and the commissioning trust to plan and deliver people’s care and treatment.

The renal matron from the commissioning trust told us they held regular discussions with staff at the service to plan and organise people’s care and treatment. The dietitian and consultant told us the monthly multidisciplinary reviews enabled continuity of care as they assessed each person’s treatment plans and allowed staff to make changes based on clinical needs and preferences.

The service was a nurse-led satellite dialysis unit and the commissioning trust maintained clinical oversight and responsibility for people who use the service. People were referred to the service once assessed as stable by the commissioning trust. Staff reviewed people’s care plans and risk assessments routinely and multidisciplinary clinical reviews took place monthly to assess people’s treatment plans. Staff planned and delivered services in a way that met the needs of people who use the service. The unit operated 6 days per week. Dialysis treatment appointments were scheduled in advance, enabling staff to plan and deliver people’s care and treatment. Facilities and were appropriate for the services being delivered. The design and layout of the unit adhered to national guidelines for satellite dialysis units. Access to the unit was secure and all areas had wheelchair and disability access.

People who use the service told us staff provided them with the necessary information about their care and treatment verbally and in writing. They also answered any questions they had.

Staff told us they had regular discussions with and provided people with relevant information so they were well informed about their care and treatment. Staff told us they received training in information governance and confidentiality and they could easily access information such as care records and policies and guidance.

Information leaflets about dialysis services were readily available and could be provided in different languages or easy to read formats, if requested. Staff knew how to access interpreters or signers when needed. Each service user had a named nurse as a point of contact for information. People were given emergency contact information so they were able to access guidance and support when they needed it. People could access information on electronic platforms and applications about their treatment including appointment dates and laboratory and test results. Managers produced an integrated performance dashboard which included information around performance, risk and outcomes. Key risks were discussed as part of daily safety huddles. Staff could access support and advice from the commissioning trust when needed. Information such as policies and guidance was available on the provider’s intranet. Electronic records were kept secure with password-protected access. There had been no data breaches relating to the service in the past 12 months.

People who use the service told us they knew how to raise a complaint or concern and felt confident their concerns would be listened to and addressed.

Staff told us they encouraged people to provide feedback about the care and treatment they received. Staff understood the policy on complaints and knew how to handle them. They told us information about complaints was discussed during daily huddles and routine staff meetings. Managers told us complaints, compliments and feedback from surveys informed learning and improvement.

The provider’s care delivery feedback policy provided guidance on how staff should handle complaints. People were given information on how to complain or raise concerns, including how to escalate their concerns within the organisation or externally. Managers investigated complaints and identified themes. Records showed the service received 12 complaints in the past 12 months and these were investigated appropriately and responded to in a timely manner. The service routinely obtained feedback from people during their treatment and annual surveys. The 2023 annual survey showed most people were positive about their experience using the service.

People who used the service told us they received treatment in a prompt and timely manner and did not experience long waits when they arrived for their dialysis treatment. They told us they were given clear information on their appointment times. People spoke positively about the transport service and told us this helped them to get to and from the service in a timely manner. People spoke positively about being able to access treatment within their local area and told us this was convenient and reduced travelling times.

Staff told us they were able to plan people’s care and treatment in advance so they did not experience delays in their treatment. Staff told us they monitored and followed up any people who did not attend their appointments and rescheduled their appointments promptly to ensure their treatment schedules were not disrupted. Managers told us the service had sufficient capacity to meet peoples’ needs and performance around access and flow was monitored daily to minimise any delays to people’s care and treatment.

Dialysis treatment was provided for people over 18 years of age who resided in the local area and met the service’s inclusion criteria. People who did not meet the inclusion criteria continued their treatment at the commissioning trust. The service had sufficient capacity to provide safe and treatment. A transport service was available for people unable to make their own journey. Managers monitored waiting times and made sure people could access services promptly when needed. People did not experience delays when referred to the service or on the day of their dialysis treatment. There had not been any treatments cancelled for non-clinical reasons in the past 12 months.

People told us their needs and preferences were assessed and understood by staff. They told us they were treated with equality and in a non-discriminatory way.

Staff told us they treated people equally and without discrimination. They were able to give examples of how they respected the individual wishes of people with protected characteristics, such as those identifying as transgender and people with communication or language difficulties.

The provider’s equality and diversity policy outlined the processes for equal opportunities including how staff ensured they did not discriminate on the grounds of protected characteristics under the Equality Act, when making care and treatment decisions. Protected characteristics were taken into account when planning for people’s care and treatment and this was regularly reviewed with input from people and their relatives. Managers collated and analysed data relating to treatments provided for people with protected characteristics and those with specific health conditions such as asthma and diabetes. The nature of the dialysis treatment meant it was difficult to differentiate outcomes for people with protected characteristics. However, we looked at data for incidents, complaints and treatment outcomes and this did not identify any disparity in care or adverse outcomes or inequalities for people with protected characteristics.

People who use the service told us the staff routinely discussed their long-term care and treatment plans with them and their preferences were taken into account.

Staff told us people’s long-term care plans were discussed on admission and routinely reviewed with their involvement. This included arrangements for discharge, transfer and end of life care planning.

Most people who use the service had been diagnosed with kidney failure or end stage renal disease that required regular and long-term dialysis treatment. People’s long-term treatment plans, objectives and outcomes were discussed as part of their initial assessments and then reviewed at least monthly as part of multidisciplinary reviews. Staff identified people eligible for a kidney transplant and facilitated transplants through the commissioning trust. Staff routinely held discussions around end of life care planning with people and their relatives and liaised with community palliative care teams to plan care in accordance with their wishes. People’s DNACPR status was discussed as part of their initial assessment.