03 August 2021
During a routine inspection
Sparkhill Dialysis Unit is operated by Fresenius Medical Care Renal Services Limited. The service has 24 dialysis stations including four isolation rooms. There are three rooms for consultations and one meeting room. Dialysis units offer services which replicate the functions of the kidneys for patients with advanced chronic kidney disease. Dialysis provides artificial replacement for lost kidney function.
We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit to the unit on 3 August 2021.
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.
We rated it as requires improvement because:
- Staff did not complete risk assessments when using bed rails with patients. Not all staff were fully compliant with infection prevention and control processes. Staff did not respond to one dialysis machine alarm, although they could see the patient from their location. We observed once instance where medicine administration was not done safely.
- Staff did not support patients who did not speak English to give informed consent to treatment.
- Staff did not always follow provider policies when delivering care and treatment.
However:
- 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 kept good care records. 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. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and advised them on how to lead healthier lives. Key services were available to suit patients’ needs.
- Staff treated patients with compassion and kindness, mostly 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. People could access the service when they needed it and did not have to wait too long for treatment.
- Leaders ran services well using reliable information systems. 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.