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Visualase Laser Eye Clinic Good

Inspection Summary


Overall summary & rating

Good

Updated 17 July 2019

Visualase Laser Eye Clinic is operated by Visualase Laser Limited and provides refractive eye surgery for self-funded patients over the age of 18 years. The clinic was established in September 2001 and uses laser technology to correct refractive errors such as myopia, hyperopia and astigmatism to reduce patients’ need to use visual aids to see clearly.

The facilities included a reception area, two assessment rooms, a consultation room, a theatre suite and recovery room. In addition to these rooms there was an administration office and toilet facilities that were designed for use for people with disabilities. There were no inpatient facilities and no children were treated at the clinic.

We inspected this service using our comprehensive inspection methodology. We carried out a short-announced inspection on 1 and 8 May 2019.

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.

At the previous inspection in 2017, we had a legal duty to regulate refractive eye surgery services, but we did not have a legal duty to rate these services. However, we now have the powers to rate services provided and continue to 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:

  • Staff were 100% compliant with their appraisals and competency checks.
  • The service used the World Health Organisation safer surgery checklist to reduce the risk to patients during refractive eye surgery procedures.
  • Staff spoke to patients throughout their procedures as recommended by the Royal College of Ophthalmology professional standards for refractive eye surgery.
  • Staff kept comprehensive records, and these were stored securely.
  • There were systems in place to ensure that the laser was used safely. Local rules were displayed and adhered to by all staff.
  • There were systems for the maintenance of equipment. Service level agreements were in place and in date with external organisations.
  • Medicines were stored safely, and staff followed infection control protocols when handling cytotoxic medications.
  • All patients were assessed for their suitability for refractive eye surgery.
  • There was a clear procedure for obtaining patient consent.
  • All patients, their families and friends were treated with privacy, dignity and respect. We observed that staff were kind and compassionate whilst delivering care and treatment.
  • Patients we spoke with were happy with the service provided and the care received. Patient feedback was always positive about their experience and patients would recommend friends and family to receive care and treatment at the clinic.

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

  • Hand hygiene was not audited at the time of inspection.
  • Not all theatre staff were trained in the process of aseptic non-touch technique.
  • There was no approval process or review process of the risk register by any other member of the team than the registered nurse.

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.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North)

Inspection areas

Safe

Good

Updated 17 July 2019

We rated it as

good.

We found the following areas of good practice:

  • Staff knew how to report incidents and safeguarding concerns. Incidents were investigated thoroughly.

  • Staff used the five steps to safer surgery outlined by the World Health Organisations safer surgery checklist for all procedures. This was an improvement since the last inspection.

  • Staff followed infection prevention and control guidance. We saw that staff washed their hands and cleaned equipment thoroughly.

  • Staff kept comprehensive records regarding patient care and these were stored securely.

  • Staff followed best practice when handling medications, including cytotoxic medicines. All medicines were stored securely, and the stock managed safely.

  • Patients were assessed for their suitability for treatment using the Royal College of Ophthalmology standards.

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

  • Although we observed staff washing their hands, there was no documented audit to state that this was a continual process.

  • Although theatre staff underwent scrub competencies, there was no training for the process of aseptic non-touch technique for clinical procedures.

Effective

Good

Updated 17 July 2019

We rated it as

good.

We found the following areas of good practice:

  • The service provided care and treatment based on national guidance and evidence-based practice.

  • Staff ensured that patients undergoing laser refractive eye surgery had an appropriate pre-operative assessment and opportunity for discussion regarding their care and treatment as set out in the General Medical Council guidance for doctors who offer cosmetic surgery.

  • Staff participated in appraisals and competency checks.

  • Treatments given, and enhancements carried out by the ophthalmologists were monitored by the registered manager to measure their performance.

  • Staff empowered patients to manage their own health and to take responsibility for their aftercare treatment.

Caring

Good

Updated 17 July 2019

We rated it as 

good.

We found the following areas of good practice:

  • The consultant ophthalmologist and staff spoke to patients throughout the procedures as recommended in the Royal College of Ophthalmology professional standards for refractive eye surgery.

  • We observed that staff were highly motivated to deliver good care to patients and their families consistently. We observed staff talking and listening to patients with dignity and respect.

  • We observed staff explaining treatment options, including benefits and risks to patients. In addition to this, we observed staff ensuring that the patient demonstrated their understanding of the explanations given. This was in line with the Royal College of Ophthalmology professional standards for refractive eye surgery and the National Institute for Health and Care Excellence (NICE) Quality Statement 15, statement five.

Responsive

Good

Updated 17 July 2019

We rated it as good.

We found the following areas of good practice:

  • The service planned and provided care in a way that met the needs of local people and the communities served. The clinic was easily accessible from the town centre and close to public transport links.

  • The waiting areas within the clinic were bright, spacious and comfortable. Treatment areas were arranged so that the patient journey from admission in reception to discharge from the consultant flowed with ease.

  • People could access the service when they needed it and received the right care promptly.

  • It was easy for people to give feedback and raise concerns about care received. Staff learned from complaints and shared this learning via discussion and emails.

Well-led

Good

Updated 17 July 2019

We rated it as 

good.

We found the following areas of good practice:

  • There was a clearly defined leadership structure.

  • Staff we spoke with told us that they felt supported and valued. All staff were proud of the service and many had worked for the service for a long time.

  • The safety and quality of the patient pathway was monitored by the registered manager.

However, we found the following issue that the provider needs to improve:

  • The risk register was reviewed annually by the registered general nurse, but we saw no approval process or review by any other member of the team.
Checks on specific services

Refractive eye surgery

Good

Updated 17 July 2019

Refractive eye surgery was the main activity of the service. We rated the service as good overall because it was safe, effective, caring, responsive and well-led.