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Optimax Laser Eye Clinics - Reading

Inspection Summary


Overall summary & rating

Updated 3 October 2018

Optimax Laser Eye Clinics - Reading is operated by Optimax Clinics Limited.

The clinic has two floors and consists of a main waiting and reception area, a topography room, three consultation rooms, a preparation room, a recovery room and a laser treatment room. All clinical and other patient areas are fully wheelchair accessible.

The service provides laser correction procedures using class 4 and class 3b lasers carried out by ophthalmologists.

We inspected this service using our comprehensive inspection methodology. We carried out the announced inspection on 3 March 2018 and 10 March 2018.

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.

We regulate refractive eye surgery but we do not currently have a legal duty to rate them when they are provided as a single specialty service. 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:

  • Patients were involved in their care and had the opportunity to ask questions at all stages of their treatment.

  • Staff treated people with kindness and care. The clinic manager maintained consistent local audits and safety and performance monitoring that contributed to the operation of the service.

  • There was a culture of open communication and shared learning in the clinic. This included improvements to the service as a result of learning from incidents, near misses and patient feedback.

  • There had been significant work nationally in the provider, which was reflected in this clinic, to update and improve policies and protocols. This included establishing policies in line with national standards and best practice guidance.

  • Consent procedures were in line with national standards and we saw patients received clear and concise information about their planned treatment and aftercare.

  • The local clinic team used a series of audits to assess compliance with the provider’s corporate standards. These demonstrated consistently good levels of performance.

  • The service was flexible to patients needs and we saw good coordination between surgeons, clinical staff and other clinics in the provider’s group to accommodate patient schedules and preferences.

  • Local leadership was consistent and resulted in a well-established governance and performance management structure.

However we found the following issues that the service provider needs to improve:

  • Clinical staff did not always follow policy in relation to the handling of sterile single-use items. This presented an infection control risk. Procedures in the laser room did not always ensure patients were protected from the risks associated with infection control.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (South East)

Inspection areas

Safe

Updated 3 October 2018

We do not currently have a legal duty to rate refractive eye surgery where these services are provided as an independent healthcare single speciality service.

We found the following areas of good practice:

  • Incidents were investigated and staff understood and adhered to the duty of candour. There was clearly identified learning from incidents and this was communicated to all staff.
  • Maintenance and safety procedures for the laser controlled environment were maintained in line with national standards, including in relation to the role and availability of the laser protection advisor and the laser protection supervisor.
  • Appropriate systems were in place to ensure staff were up to date with mandatory training.

However we also found the following areas that require improvement:

  • Clinical staff did not always follow the provider’s policy in relation to the safe and correct use of sterile single-use items.
  • Staff did not always adhere to best practice in the laser room in relation to infection control. This related to the decontamination of the treatment bed and the use of disposable face masks.

Effective

Updated 3 October 2018

We do not currently have a legal duty to rate refractive eye surgery where these services are provided as an independent healthcare single speciality service.

We found the following areas of good practice:

  • The service planned clinical policies in line with the Royal College of Ophthalmologists Standards for Laser Refractive Surgery.
  • We found consistent practices in pain management.
  • There was a well-defined laser safety leadership structure that included a named supervisor at all times.
  • The consent policy reflected 2016 guidance from the Royal College of Ophthalmology in relation to a seven day cooling off period.
  • Processes were in place to ensure the competency of the staff team. This included through induction, appraisal and ongoing professional training.
  • The clinic manager maintained a system of local audits that ensured care and treatment was in line with national standards and the provider’s policies. Where audits indicated areas for improvement the clinic manager demonstrated a proactive approach to implementing them.

Caring

Updated 3 October 2018

We do not currently have a legal duty to rate refractive eye surgery where these services are provided as an independent healthcare single speciality service.

We found the following areas of good practice:

  • Staff treated patients and their relatives with kindness and respect.
  • All members of staff involved patients in decisions about their care and treatment and offered the chance to ask questions for the duration of their care.
  • There was a demonstrable focus on involving patients in decisions regarding their care and treatment during all stages. This included the use of 3D animations to demonstrate clinical procedures.
  • Staff demonstrated the ability to support patients who experienced anxiety or uncertainty and worked with them to calm their nerves.

Responsive

Updated 3 October 2018

We do not currently have a legal duty to rate refractive eye surgery where these services are provided as an independent healthcare single speciality service.

We found the following areas of good practice:

  • There was no waiting list for treatment and surgery was offered based on demand.

  • The facilities available enabled patients to be treated in a calm and welcoming atmosphere.
  • The Medical Advisory Board (MAB) reviewed national and international clinical guidance on laser eye treatment to ensure policies and practice continued to adapt to people’s needs.
  • The clinic had not cancelled any planned procedures or treatments in the previous 12 months.
  • The compliance manager had recently updated care and treatment guidance for patients living with a learning disability, which reflected the clinic’s approach to ensuring accessibility.

Well-led

Updated 3 October 2018

We do not currently have a legal duty to rate refractive eye surgery where these services are provided as an independent healthcare single speciality service.

We found the following areas of good practice:

  • The local leadership structure was well established and staff spoke positively of it.
  • Governance systems were well structured and involved staff at all levels of the organisation, including the senior leadership team.
  • Staff used quality assurance system outcomes from audits, incidents, complaints and feedback to implement improvements to quality and safety.
  • The culture placed value on openness and positive working relationships.
Checks on specific services

Refractive eye surgery

Updated 3 October 2018

We regulate this service but we do not currently have a legal duty to rate it. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.