This service receives referrals from the local NHS Trust and St Georges renal unit and provides community based dialysis for people suitable for such treatment. Patient areas are protected from the general public by key pad entry systems. The treatment areas were divided in four bays of four and eight side rooms with en-suite facilities. We saw television and radio in each bay and reading materials were also provided. The service could be accessed Monday, Wednesday and Friday from 0700 hours until 2300 hours and Tuesday, Thursday and Saturday from 0700 hours until 1800 hours. People that we spoke to told us that the opening hours allowed them to carrying on working and that the dialysis did not interfere with their working lives.

staff told us that the unit had managed to get transplants for 19 patients in the last 2 years and people told us that this was why they wanted to come to this unit. One person told us that she had been given a choice of venues for dialysis but she had chosen this site because of its reputation. She told us that she could always find staff to answer her questions and they were always polite and professional.

People told us that their rate of infections was greatly reduced since coming to this service and that they understood much more of what was going on than before.

Everyone we spoke to commented on the cleanliness and hospitality of the unit.

The people that we spoke with told us that the unit was always very clean and they felt well looked after.

They told us staff took notice of them and listened to what they had to say. Comments included “ they are all so nice here” “they treat you very well” and “they always explain anything you don’t understand”

Colliers Wood Dialysis Unit (the clinic) is operated by Fresenius Medical Care Renal Services Limited under a contract with St George’s University Hospital NHS Foundation Trust. The clinic provides haemodialysis for stable patients with end stage renal disease and failure. Dialysis units offer services which replicate the functions of the kidneys for patients with advanced chronic kidney disease.

The service opened and has been in its present location since February 2011. The facility is a standalone unit within an industrial park operating 24 dialysis stations, 16 stations were provided in four bed bays, eight stations were provided in side rooms with en-suite facilities.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 6 July 2017, along with an unannounced visit to the clinic on 17 July 2017.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

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.

Services we do not rate

We regulate dialysis services but we do not currently have a legal duty to rate them. 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 unit did not have a sepsis policy or pathway to ensure patients with potential sepsis were identified and treated in a timely manner.

• There was an increased risk to patients as a result of not all staff not adhering to aseptic techniques at all times.

• There was a lack of secure storage space with blood samples not being stored securely.

• There was a risk that saline was stored at incorrect temperatures due to being stored in a corridor where temperature was not monitored.

• All staff were not trained to an appropriate level in children’s safeguarding, in accordance with national guidance.

• There were gaps in the daily recording of high and low readings of the blood sugar monitoring boxes.

• A few records relating to staff competence were inconsistent.

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

• All staff had completed infection prevention and control and aseptic non-touch technique, as part of their mandatory training for the year.

• Overall, the unit achieved effective outcomes for their patients.

• Patients who use this service were largely satisfied with their treatment and care.

• Staff were caring and looked after patients with compassion and understanding.

• Overall, feedback from patients was positive about the nursing staff delivering day to day care.

• Policies and procedures were based on national guidance.

• A patient had secured funding from the Kidney Patients 

  Association to create a sensory garden at the unit.

Following this inspection, we told the provider that it must and should make some improvements to help the service improve. Details are at the end of the report.

Professor Edward Baker

Chief Inspector of Hospitals