People using the service said they were very happy with it, satisfied with their treatment and the way it was provided by staff. People said "The service is great, I've had no problems". "From top to bottom everyone is nice and knows their jobs". The procedure for consultation and treatment was fully explained to people and referrals were made through St George's Hospital. One person using the service told us "I've been coming here two years, it's a great team who are really good and kind". They felt treated with dignity, respect and had received very good treatment.

We saw that people using the service had access to information in leaflet form and on the trust and organisation's websites. This included how to access the complaints procedures. Up to date records were kept and people were fully involved in their treatment. There were thorough infection control procedures in place that were followed and regularly audited. The unit was also kept clean and dialysis equipment heat cleaned each daily and after each use. There were suitable numbers of competent, trained and efficient staff available to meet people's needs.

We spoke to a number of the people who use the service. They told us that they were happy with the care and treatment that they received and they thought the staff were kind and caring. Some people told us, ‘the nurses do a fantastic job’, ‘this is a very good service’ and ‘the staff explain everything I need to know’.

We met the regional service manager who demonstrated a good knowledge of the service and treatment provided. The staff told us that they felt supported and equipped to give people the care and treatment they needed.

North Wandsworth Dialysis Unit is operated by Fresenius Medical Care Renal Services Limited. The service is situated on a main high street with surrounding shops and offices.

The service has 18 dialysis stations. Facilities include four isolation rooms located on the ground floor of the unit; three consulting rooms, a meeting room, and the main dialysis area are located on the first floor of the unit.

North Wandsworth Dialysis Unit treats patients with advanced chronic kidney disease. Dialysis is used to provide artificial replacement for lost kidney function.

The service provides dialysis services for patients referred by St George’s University Hospital NHS Foundation Trust. All of patients receiving dialysis at the unit are funded by the NHS.

The Care Quality Commission had received one safeguarding notification from the unit in the previous 12 months.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 13 June 2017, along with an unannounced visit to the centre on 20 June 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.

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 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 areas of good practice:

• There was appropriate management and reporting of incidents and maintenance programmes. All staff were aware of their roles and responsibilities in ensuring patient safety.

• Effective processes were in place for the provision of medicines. These were stored and administered in line with guidance and staff completed competencies annually to ensure they continued to administer medicines correctly.

• Staff stored patients’ medical and nursing records securely. All staff had access to all relevant records ensuring that patients’ care was as planned and not delayed.

• Staffing levels were maintained in line with national guidance to ensure patient safety. Nursing staff had direct access to consultants who were responsible for patient care. In emergencies, patients were referred directly to the local NHS trust and the emergency services called to complete the transfer.

• Staff were aware of their roles and responsibilities to maintain the service in the event of a major incident. Patients were able to continue their treatment at alternative centres or the NHS hospital.

• There was a comprehensive training and induction programme in place to ensure staff competency. Training compliance was 100%.

• There were processes in place to ensure effective multidisciplinary team working, with specialist support provided by the local NHS trust.

• Patients were treated with respect and compassion.

• Staff were familiar with and worked towards the organisational vision and values.

• Quality assurance meetings occurred regularly and included the local NHS trust.

• There was evidence of effective local leadership, with an accessible and responsive registered manager.

• Staff and patients were positive about the service.

However,

• All staff did not adhere to correct aseptic technique at all times.

• There were no clear procedures in place for staff to respond to a patient with sepsis symptoms.

• Staff did not have safeguarding children’s training in accordance with national guidance.

Following this inspection, we told the provider that it must make improvements in regards to safeguarding children’s training in accordance with national guidance, We also told the provider it should make other improvements to help the service improve. Details of the two requirement notices are at the end of the report.

Professor Edward Baker

Chief Inspector of Hospitals