SpaMedica Exeter

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

The evidence showed a good standard. The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The service always made sure patients’ care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Patients were involved in the assessment of their needs, and support was provided, where appropriate, to maximise their involvement. Patients were referred to the service either by their GP or local optometrist. The service had exclusion criterion to determine which patients were appropriate for care. Staff told us about the comprehensive approach to assessing the needs of the patients.

Patients’ needs were assessed and staff updated care plans. We reviewed 10 patient records, and all were comprehensive. Patients had undergone screening checks to ensure they were well enough to proceed with treatment.

Staff had received specific training to support them to engage with patients with additional needs. Mandatory training included supporting patients with dementia as well as patients with learning disabilities and autism. The service had processes to book interpreters if a person required communication support during an appointment.

The evidence showed a good standard. The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff followed up-to-date policies to plan and deliver care and treatment according to best practice and national guidance. There were processes to manage and review policies and procedures to make sure they were up to date. Evidence-based care and treatment was filtered through the governance meetings and shared with staff at regular team meetings and morning huddles.

Staff were able to access policies and processes easily and ensured it contained the most up to date guidance. All policies were centrally uploaded and alerted staff to new policies for them to read. This supported staff to provide consistent care across the service as the policies were identical in all provider locations they may attend to work. Leaders could see who had read the policies and reminded staff who were overdue. We reviewed several policies and saw they were all up to date and referenced national legislation and guidance.

Staff followed established service-wide governance processes to ensure compliance and maintain standards. Staff consistently reviewed performance and compliance using a comprehensive audit schedule. Managers used appraisals and supervision to monitor and improve performance. There were policies to manage conduct and support performance improvements.

The location submits information to the National Ophthalmic database (NOD) records. This audit compares multiple areas to help measure and protect patient safety and professional standards.

The evidence showed a good standard. The provider worked well across teams and services to support people. They recognised the importance of working closely with other services such as optometrists.

When patients received care from a range of different staff, teams or services, it was coordinated effectively. Staff had access to the information they needed to appropriately assess, plan and deliver patients’ care, treatment and support. Staff requested care summaries from the GP where required. All patients who needed surgery attended a pre-operative assessment to ensure they had all the information they needed and were fit to proceed with surgery.

On both days of the assessment, staff were observed to work together well as a team.

On days where surgery was performed, a theatre safety huddle occurs at the start of each operating list. Patients are discussed, highlighting any additional needs. Surgeons and scrub nurses worked together to make sure patients received the correct lens prior to surgery.

For those patients who had any issues with surgery, staff conducted wellness calls with the patient.

All locations for the provider worked closely together to maximise efficiency and reduce waiting times to benefit patients.

The evidence showed a good standard. The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Patient information and leaflets were displayed in large noticeboards throughout the service. There was lots of advice regarding eye health displayed though nothing was available in braille, staff were able to print leaflets in large font.

Staff provided relevant information promoting healthy lifestyles and support to patients on an individual basis where this could improve eye health. This included individualised postoperative advice following surgery.

The evidence showed a good standard. The provider monitored all patients’ care and treatment to continuously improve it. Staff ensured outcomes were positive and met both clinical expectations and the expectations of patients themselves.

Staff monitored and improved quality and outcomes by taking part in regular audits including national clinical audits. Staff provided data to the National Ophthalmology Database Audit, who measured outcomes of cataract surgery. The audit looked at common complications which occurred during cataract surgery. The hospital was within expected limits for two indicators in the audit for the avoidance of vision loss and the posterior capsule rupture rate (a complication that may occur during surgery when the capsular bag holding the lens breaks).

Audits were conducted for each surgeon to monitor the outcomes monthly to check for effectiveness of treatments. These were reviewed and monitored by the medical director. If any deviation was found, the surgeon would be closely monitored. Throughout 2025 the provider reports they have only had to support 7 patients who required readmission. Readmissions would go to either the local NHS provider or one of the providers specialist sites.

Post-operatively, patients spent time under observation until clinical staff were satisfied it was safe for them to leave, and the patient felt comfortable doing so. Staff provided post-operative instructions to each patient to make sure they recovered quickly and safely. They spent time with each patient in recovery to answer questions about how to look after themselves at home and what to do if they had unexpected side effects.

Patients reported on the outcomes of their surgery. The service gathered information postoperatively to see if patients were happy with their outcomes. A patient survey in September – December 2025 demonstrated that patients were overall happy with their outcomes following surgery. Thank you cards from patients sharing their positive experience were shared with the team.

The evidence showed a good standard. The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to enable patients to make their own decisions. Patients received information about care and treatment in a way they could understand and had appropriate support and time to make decisions. All patients were given both written and verbal information about their treatment, in advance, to support making decisions and informed consent.

Staff understood the importance of ensuring patients fully understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. Staff clearly recorded consent in the patients’ records. Staff had the appropriate skills and knowledge to seek verbal and written informed consent before providing care and treatment to their patients. We reviewed 10 sets of patient records and found consent had been clearly recorded in each.

The provider, as part of their clinical audits, completes a consent audit every 3 months. At the last audit we reviewed, correct consent was 100%.