Archived: North Wandsworth Dialysis Unit

Updated 3 March 2020

North Wandsworth Dialysis Unit is operated by Fresenius Medical Care Renal Services Limited. The service opened on 16 February 2010 and provides haemodialysis to patients from the local NHS trust. The local NHS trust provides the renal multidisciplinary team (MDT) with two consultant nephrologists visiting the service once at a time on a monthly basis.

The service’s registered manager has been in post since January 2018. The registered manager was available for the unannounced inspections.

The Care Quality Commission previously inspected the unit in June 2017. We did not rate the service in that inspection, however there were requirement notices served to the provider. On this inspection, we noted that previous requirement notices from the 2017 inspection had been addressed by the provider.

Updated 3 March 2020

North Wandsworth Dialysis Unit is operated by Fresenius Medical Care Renal Services Limited. The unit has 16 dialysis stations in the main area and two side rooms with two machines which is 18 stations in total. The service provides dialysis services for people over the age of 18; it does not provide treatment for children.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced part of the inspection on 10 January 2020.

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 rate

We rated it as Good overall.

• Staff kept patients safe from harm and abuse. Risks were assessed, monitored and managed appropriately.

• Care and treatment records were accurate, stored securely and provided comprehensive details of care and treatment.

• Staff recognised incidents and knew how to report them. Managers investigated incidents and made improvements to the service.

• Staff had the appropriate skills, training, knowledge and experience to deliver effective care and treatment.

• Staff delivered care and treatment in line with evidence-based practice.

• Staff involved patients and carers in decisions about their care and treatment.

• Staff cared for patients with compassion, treating them with dignity and respect. Staff truly respected and valued patients as individuals and empowered them as partners in their care, practically and emotionally, by offering an exceptional service.

• The service was proactive in meeting the needs of people from their whole community. The services provided reflected the needs of the population served and ensured flexibility, choice and continuity of care.

• There was an open and transparent culture, with engaged and experienced leadership.

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

• The storage of equipment did not always keep people safe. We found wheelchair stored in toilets and the domestic fridge freezer used for storage of blood samples was not appropriate for its usage.

• Staff did not follow best practice in relation to infection prevention and control. Waste bins were overfilled and falling from its stand in most areas.

• During the inspection, we found there was no process for identifying whether equipment was clean or when it was last cleaned. There was no evidence of the use of “I am clean” green label used at the centre. Following the inspection, the provider told us that any infrequently used equipment was labelled with a “I am clean” green label.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London)

Updated 3 March 2020

North Wandsworth Dialysis Unit was opened by Fresenius in 2010. The unit provides haemodialysis to patients with chronic kidney disease, under the care of a consultant at the local NHS Trust.

The unit is open Monday to Saturday, providing dialysis to adult patients who live in North Wandsworth and surrounding areas.

• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. Staff had access to a robust training and competency programme to ensure they had the skills required to provide good quality care.

• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.

• Staff of different kinds worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.

• The service planned and provided services in a way that met the needs of local people. The services provided reflected the needs of the population served and they ensured flexibility, choice and continuity of care. The facilities and premises were appropriate for the services that were delivered.

• There was compassionate, inclusive and effective leadership at all levels. There was a strategy, and supporting plans, aligned with the wider health economy that were stretching, challenging and innovative, while remaining achievable. There was a demonstrated commitment to system-wide collaboration and leadership.

• Staff felt positive and proud to work in the organisation. The culture centred on the needs and experience of people who used services. Staff told us that they felt pride in the organisation and the work that is carried out to ensure patients received good quality care.