The Care Quality Commission
  • Hospital
  • Independent hospital

Aston Kidney Treatment Centre

Overall: Good read more about inspection ratings

Aqueous One, Aston Cross Business Centre, Aston, Birmingham, West midlands, B6 5RQ (0121) 359 8427

Provided and run by:
Diaverum Facilities Management Limited

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Aston Kidney Treatment Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Aston Kidney Treatment Centre, you can give feedback on this service.

11 March 2020

During a routine inspection

Aston Kidney Treatment Centre is operated by Diaverum Facilities Management Limited. The service has 24 dialysis stations which comprise of two bays with eight stations, one bay with four stations and four side rooms. Facilities include a waiting room with 18 chairs, including seating for patients who required bariatric seating, two private consultation rooms for outpatient appointments, a meeting room. a patient kitchen and patient parking.

The service provides haemodialysis to patients aged 18 and over.

We inspected this service using our comprehensive inspection methodology. We carried out the inspection on 11 March 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 have not previously rated this service. We rated it as Good overall.

We found the following areas of good practice:

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service mostly controlled infection risk well. Staff assessed risks to patients and mostly acted on them. They mostly managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
  • Staff provided good care and treatment and gave patients pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

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

  • Staff did not always manage clinical waste well; lids on sharps bins were left open.
  • Staff did not respond when patients’ dialysis machines alarmed.
  • Vital sign recording sheets showed that on two instances out of 13 checked, patents did not have their vital signs checked frequently enough.
  • Staff did not always check prescriptions when administering one specific medicine.
  • One policy reviewed did not reference all available guidelines and the service did not have access to a policy about the Accessible Information Standard.
  • Within the first half of 2019, the patient satisfaction survey results were low compared to other Diaverum clinics. Managers created action plans to address this, and the results improved as a result.
  • Most of the written literature available to patients was in English.
  • Patient transport delays impacted on patients undertaking their full treatment or being delayed at the clinic. However, we acknowledged that the clinic manager took action to address this where possible.

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. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals (Midlands)

28 June and 3 July 2017

During a routine inspection

Aston Kidney Treatment Centre (the centre) is operated by Diaverum Facilities Management Limited. The service has 24 dialysis stations. Facilities include four isolation rooms, two consulting rooms, two meeting rooms and an office room.

Diaverum was awarded the contract as part of a partnership agreement with a local NHS trust to provide haemodialysis adults over 18 years living with chronic kidney failure.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 28 June 2017, along with an unannounced visit to the centre on 3 July 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.

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

We found the following issues that the service provider needs to improve:

  • The process of incident reporting, investigation, and learning from incidents was poor with a lack of understanding of good governance processes.
  • Staff did not have the required level of knowledge and understanding to meet the duty of candour requirements.
  • We found several safety concerns with medicines management, which were not in line with safe medicine standards. This included issues with storage, prescription, administration and documentation of medicines.
  • The centre could not evidence annual competency records including aseptic non-touch technique. Training records were not up-to-date.
  • Overall, compliance with aseptic non-touch technique and hand hygiene was variable. We found that not all staff followed correct infection prevention and control policies.
  • There were issues with access to the centre building including access to parking facilities.
  • Staff at the centre were in the process of receiving mental capacity awareness training. The practice development nurse confirmed this training did not include deprivation of liberty safeguards.
  • The manager did not recognise the risks we observed during the inspection or escalate them appropriately.
  • Safeguarding knowledge and awareness was not sufficient to provide assurance that staff were aware of actions to take.
  • The centre did not adequately support patients who did not speak fluent English. We were concerned patients would not be able to communicate if they felt unwell or give informed consent.
  • Staff did not adequately maintain patient dignity.
  • Most records we viewed did not contain suitable and adequate risk assessments to ensure the health and safety of patients receiving care or treatment.
  • The centre was experiencing issues with some patients accessing dietitian support. This had not been identified as an issue by the centre,
  • The centre was not labelling clinical waste bags in line with regulations.
  • We saw staff breach information governance requirements and did not adequately protect patient information from non-authorised access.
  • Effective processes were not in place for identifying, recording and managing risks. Concerns identified by the inspection team had not been identified on the risk register. We raised our concerns with the centre manager who did not respond appropriately to concerns raised at the announced visit.
  • The overall leadership and governance of the centre needed strengthening.There was no evidence of a learning culture.The centre did not proactively seek patient safety and care quality improvements.

However, we also found the following areas of good practice:

  • 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.
  • Overall, the unit achieved effective outcomes for their patients.
  • The centre delivered high flux dialysis to all patients and haemodiafiltration to 99% of patients. These are the most effective forms of treatment for kidney failure.
  • Staff worked flexibly, working over their hours when needed for the interests of patients.
  • Staff were caring and friendly. They knew their patients well and looked after them with compassion and understanding.
  • Overall, feedback from patients was consistently positive about the nursing staff delivering day-to-day care. The service had received three complaints in the 12 months preceding our inspection.
  • There was effective multidisciplinary working between centre staff and the referring NHS trust.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with two requirement notices. Details are at the end of the report.

Full information about our regulatory response to the concerns we have described in this report will be added to a final version of this report that we will publish in due course.

Heidi Smoult

Deputy Chief Inspector of Hospitals