Sheffield Dialysis Unit

Updated 9 June 2016

The renal team provided haemodialysis care for approximately 580 patients in South Yorkshire and North Trent. There were two dialysis units at the Northern General Hospital site and four satellite units in Sheffield, Barnsley, Chesterfield and Rotherham.

During this inspection we visited the satellite unit in Sheffield. The unit was located on an industrial and leisure type complex in Sheffield. The unit had eighteen dialysis stations including four side rooms. Two of the stations could accommodate bariatric patients. There were also clinic rooms available where medical and nursing staff saw patients. A private company maintained the unit; they provided equipment, but staff working in the unit were employed by the trust.

We looked at the environment including the main dialysis suite, the side rooms and the clinic rooms. We spoke with seven members of staff including the renal consultant, the matron, the senior sister, a band 6 registered nurse, two band 5 registered nurses and a care support worker. We also spoke with five patients who were having dialysis and looked at the care records of six patients.     

Updated 9 June 2016

We inspected the Sheffield Dialysis Unit as part of the inspection of Sheffield Teaching Hospitals NHS Foundation Trust from 7 to 11 December 2015. We carried out this inspection as part of the Care Quality Commission (CQC) comprehensive inspection programme.

Overall, we rated the Sheffield Dialysis Unit as good. We rated safe, effective, caring and responsive and well-led as good.

Our key findings were as follows:

• The unit was visibly clean and well maintained. There was evidence of when equipment had been cleaned. Records were fully completed and medicines were stored appropriately.
• We found that the service was effective because the renal pathway and other documentation were in line with current national guidance.
• We saw that staff involved and treated people with compassion, kindness, dignity and respect. The patients we spoke with gave consistently positive feedback about the care and treatment they received at the unit. The unit had not received any complaints from January 2015 up until the time of our inspection.
• The service was organised so that it met the needs of local people. Dialysis was available six days per week on a morning and afternoon.
• There was a vision and strategy based on the trust values. The leadership, management and governance of the organisation ensured high-quality person-centred care and supported learning and innovation.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 9 June 2016

We rated the Sheffield dialysis unit as good overall because we found that the unit delivered safe, effective, caring, responsive and well led healthcare.

We found that people were protected from avoidable harm and abuse. The unit used a recognised electronic reporting system. All staff we spoke with were aware of the system and told us they used it to report incidents and near misses. Staff were aware of the Duty of Candour. All staff of all grades we spoke to were aware of their responsibilities and felt confident and competent to raise a safeguarding alert. The unit was visibly clean and well maintained. There was evidence of when equipment had been cleaned. Records were fully completed and medicines were stored appropriately. All staff were up to date with mandatory training and staffing levels were consistent with recommended guidelines.

We found that the service was effective because the renal pathway and other documentation were in line with current national guidance. All trust policies and procedures reflected current guidelines and staff told us they were easily accessible via the hospital’s intranet. There was a comprehensive induction for new staff and all staff had an up to date appraisal. Staff development including renal-based competencies and postgraduate education was seen as a priority by senior staff. There was evidence of good multidisciplinary working however, some essential services e.g. dietetic support was limited. We saw documented and verbal consent being sought from patients.

We rated caring as good because we saw that staff involved and treated people with compassion, kindness, dignity and respect. The patients we spoke with gave consistently positive feedback about the care and treatment they received at the unit. There was a good range of patient and carer information available and we found that patients were supported psychologically and emotionally.

We found that the unit was good in terms of responsiveness because the service was organised so that it met the needs of local people. Dialysis was available six days per week on a morning and afternoon. A bespoke taxi service brought patients to the unit and the drivers transporting the patients to the unit undertook a basic first aid and a moving and handling course. Staff were responsive to the needs of vulnerable patients and told us about a number of situations when they had successfully supported these patients. The unit had not received any complaints from January 2015 up until the time of our inspection.

We rated well led as good because there was a vision and strategy based on the trust values. The leadership, management and governance of the organisation ensured high-quality person-centred care and supported learning and innovation. The senior staff promoted an open and fair culture. Senior staff had actively shaped the culture through effective engagement with staff, people who use services and their representatives and stakeholders. The unit identified their own issues and ensured these were assessed to mitigate the risk as far as they were able to. They also had close working relationships with other units at the trust and positive networks had been developed with wider organisations. There was a strong focus on continuous learning and improvement for all staff grades.