27 November and 5 December 2017
During a routine inspection
Optical Express Reading is operated by Optical Express Limited ,which is a nationwide company offering general optometric services. The clinic provides laser vision correction procedures for adults aged 18 years and above.
The clinic is situated in the basement floor with a passenger lift and level access from the small car park for people with limited mobility and wheelchair users. The clinic had a laser treatment room, surgeon’s examination room, two screening rooms and two post care/discharge rooms.
We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 27 November 2017 and an unannounced visit to the service on 5 December 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 refractive eye surgery 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:
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The service had a process to review incidents, and investigations were shared with staff to assist learning and improve patients’ care.
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Patients received care in visibly clean and suitably maintained premises, and their care was supported with the right equipment.
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The staffing levels and skills mix was sufficient to meet patients’ needs and staff appropriately assessed and responded to patients’ risks.
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Patients' records were detailed with clear plans of the patients' pathway of care.
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Patient consent was obtained prior to commencing treatment. Patients were provided with information to enable them to make an informed decision.
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All staff their mandatory training and annual appraisals. Care and treatment was provided by suitably trained staff, who worked well as part of a multidisciplinary team.
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There was clear visible leadership within the services. Staff were positive about the culture within the service and the level of support they received.
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There was appropriate management of quality and governance and managers were aware of the risks and challenges they needed to address.
However, we also found the following issues that the service provider needs to improve:
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The consent policy did not reflect the Royal College of Ophthalmologists 2017 for a 7 day cooling off period between the initial consent meeting with the surgeon and the final consent by the surgeon.
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The process for the administration of a cytotoxic drug did not meet with current guidelines and practices. Staff did not follow single use policy for Mitomycin.
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There was inconsistency about the interpretation and management of the checklist for laser surgery.
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Patient information leaflets, documents, and consent forms were only available in English.
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There was no interpreter service available for patients. Patients were advised to bring their own interpreter to the clinic, or use a family member.
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There was no staff’s survey to gain staff’s feedback regarding the service in order to make improvements as necessary.
Following this inspection, we told the provider that it must take action to meet the requirement. We have told the provider they should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report
Amanda Stanford
Interim Deputy Chief Inspector of Hospitals