Visualase Laser Eye Clinic

Updated 17 July 2019

Visualase Laser Eye Clinic is operated by Visualase Laser Limited. The clinic primarily served the communities of Bolton in Lancashire; however, patients were accepted from outside of this area for laser refractive eye surgery.

The service provided refractive eye surgery for adult patients who self-funded their care and treatment. No NHS funded work was completed at the clinic.

Regulated activities for the service were diagnostic and screening procedures; surgical procedures and treatment of disease, disorder and injury.

The service had a registered manager in post since 2011 and they had also been employed with the service since 2001.

The service was inspected in 2017 and during this inspection we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We were assured that all the improvements that we told the provider should be completed were actioned.

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)

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.