SpaMedica Swindon

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence people were protected from abuse and avoidable harm.

This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

We have not awarded this service a score for Safe.

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

The evidence showed a good standard. The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The service managed patient safety incidents well. The service had a proactive and positive safety culture, based on openness and honesty. Staff were encouraged to report all incidents by management and staff felt safe and supported to do so in line with policy. Staff reported incidents using an online incident reporting system which notified leaders.

Managers investigated incidents and shared lessons learned with the team and the wider service. Following any incident, the hospital manager held a “SWARM” meeting. A SWARM is designed to start as soon as possible after a patient safety incident occurred to identify immediate learning. All managers had completed their Health Services Safety investigation Body (HSSIB) training in line with the patient safety incident framework.

Incidents were monitored at a national and local level to identify any trends and implement any preventive measures. During the period 2025/2026, 47 incidents were reported. There was a wide range, but the slight majority were incidents regarding documentation accuracy. One of the incidents they shared in detail with us, processes identified safety considerations and actions had been implemented across the site to mitigate recurrence. Duty of candour was applied, and learning was put into a quality improvement action plan. Learning from this incident was shared across other SpaMedica sites.

The number of incidents reported at SpaMedica Swindon site was above average, proportionate to the activity. The rate of incidents against activity was 1.4%, the organisational average was less than 1%. SpaMedica Swindon conducted a review and concluded that rather than point to a concern, it instead demonstrated a healthy reporting culture.

Staff understood the duty of candour. Staff apologised and were open and transparent if and when things went wrong. There was a provider level Duty of Candour policy, and all staff had access to this.

The evidence showed a good standard. The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service had a referral and admission process. This ensured all essential information about the patient was received to determine if the patient’s needs could safely be met.

There was an admission criterion for both NHS and private patients. These criteria set out where SpaMedica had limitations in services and minimised risks by appropriately excluding some patients. SpaMedica Swindon was able to provide support to people with bariatric needs and those patients who require sedation for treatment. At the time of our assessment, most patients receiving treatment were NHS funded.

Referrals were sent by ophthalmic providers and patients’ own GPs to the head office. Appointments were made by head office for pre-assessment if the patient was eligible. Once patients had their pre-assessment at SpaMedica Swindon, the patient co-ordinator would book the theatre day and post-operative appointments.

Safety and continuity of care was a priority throughout people’s care pathway. Patients were assessed prior to surgery and findings considered when planning care and treatment. Patient pathway signage was clear throughout the building to inform patients of the pathway of diagnostics, vision measurements, medical history and consultation.

There were systems and processes to ensure the correct patients were treated throughout the patient journey. We observed patients through the treatment stages. We observed handover of patient information. Once in theatre, the World Health Organisation (WHO) surgical safety check list was used to avoid harm and improve team communication. Surgical safety audits were conducted quarterly; the most recent compliance was 99.6%. We observed safety checks being carried out before and during surgery. We reviewed 5 sets of patient records and found the WHO checklist completed correctly.

SpaMedica Swindon offered conscious sedation, they followed the SpaMedica Sedation Operating Procedure. This policy has used guidance from the Academy of Medical Royal Colleges. Conscious sedation is a moderate sedation where verbal contact is maintained throughout the procedure. It is suitable for some patients where ophthalmic surgery performed under local anaesthesia is not appropriate. Reasons can include to reduce procedural discomfort or alleviate for those patients who are very anxious. Suitability for sedation was determined by a pre-assessment process undertaken by a consultant anaesthetist in line with their policy. There was a defined list of contraindications for conscious sedation. Additional safety checks were undertaken and the patient had enhanced monitoring throughout the procedure and post theatre. We observed 2 patients undergoing conscious sedation. A training and competency package had been developed to enable staff to support all patients at all sites that offered conscious sedation.

SpaMedica National Sedation Group oversaw the safety and governance arrangements. Additional audits were completed on all patients who had undergone sedation. An action plan identified improvement actions most of which had been addressed.

Patient records were a combination of electronic and paper and were stored securely.

Clear guidance was displayed in each exam room to guide staff if they were concerned about patients’ capacity to make decisions or vulnerability to abuse.

The provider operated a support line for patients to contact if they had additional questions or concerns. This was available 24 hours a day and advice was provided by ophthalmic clinicians.

The evidence showed a good standard. The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve it. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The service had up-to-date policies and procedures to keep people safe from abuse or improper treatment. Staff followed processes to report concerns. Staff had access to the online policy. There were safeguarding pathways on display in all areas clearly instructing staff how to raise safeguarding concerns.

Staff understood how to protect patients from abuse and provided examples of safeguarding referrals they had raised. One example included staff being proactive following concerns. All staff were trained in Level 2 safeguarding, and the manager was trained in Level 3. The Safeguarding Lead was Level 4 trained and supported staff in escalating concerns. Staff we spoke with confirmed they had attended safeguarding training.

Patients were supported to understand their rights, including their human rights, rights under the Mental Capacity Act 2005 and their rights under the Equality Act 2010. Staff understood the importance of supporting equality and diversity.

Staff followed hospital’s recruitment pathway to ensure relevant recruitment checks had been completed and staff were suitable for their intended roles. These included a disclosure and barring service (DBS) check, occupational health clearance, qualification and professional registration checks.

The evidence showed a good standard. The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff communicated with patients, so they understood their care and treatment, including effectively helping patients with communication difficulties understand their options. Leaders understood their role in supporting all patients and removing barriers to care.

Risk assessments were person centred, proportionate and regularly reviewed with the person. SpaMedica Swindon offers surgery either under local anaesthesia or conscious sedation following assessment. Clinicians undertook detailed assessments to ensure care was provided for the individual. This included additional questions such as medication being taken for diabetes or weight loss. Patients undergoing conscious sedation were provided with a copy of ‘Sedation explained’ by the Royal College of Anaesthetists which gave information on sedation as well as any risks.

Staff worked closely with other clinicians, including opticians and GPs to ensure they understood patient risks. Patients were informed about any risks and how to keep themselves safe. We observed various staff explaining the process and the risks involved with their treatment.

Staff worked together to identify individual needs and risks for patients. Staff took part in a team brief at the start of each shift and in theatres. The service took risks to patients seriously and ensured patients who had surgery were safe. Staff completed safety checks and additional time was given to patients who needed it.

Sepsis posters around the hospital alerted staff and patients to the signs and symptoms of sepsis. Staff sepsis training compliance was at 100% at the time of the assessment.

Staff followed policies and responded promptly to any sudden deterioration in a patient’s health. Staff were aware of the escalation process. Audits to ensure staff were clinically competent in an emergency demonstrated the team coped well. For any patients undergoing sedation, the consultant anaesthetist remained with the patient to manage and monitor until the emergency services arrived.

The evidence showed a good standard. The provider detected and controlled potential risks in the care environment and made sure equipment, facilities and technology supported the delivery of safe care.

Facilities, premises and equipment were purpose-built and met the needs of all patients who used the service. The building was modern and based on the ground floor. The admission area, theatres and recovery area were designed to allow smooth transfer between the different areas.

The service was fully aware of all potential risks in the care environment and controlled them well. Staff made sure equipment, facilities and technology supported the delivery of safe care.

The building was bright, spacious and clean with sufficient ventilation and heating. There were chairs for people with bariatric needs in the waiting area, along the corridors and in some of the rooms. All chairs were easy to clean. Hot and cold drinks were available in the patient waiting area. There was CCTV which was monitored from the main reception desk. The pre theatre ward area had call buzzers and badge access doors. There was ample free parking directly outside.

Prior to the commencement of offering conscious sedation, at the SpaMedica Swindon clinic, risks were assessed and discussed with local health providers.

There was a comprehensive system to proactively manage the safety, maintenance and repair of facilities, premises and equipment. Back-up generators were available in the event of a power failure. Leaders maintained oversight of equipment to ensure it was safe and ready to use. Fire safety equipment was available and had been serviced. Fire exits were clear and free from obstruction.

The site risk register was reviewed monthly in line with the Risk Management Policy. There was a named Laser Protection Advisor and laser safety audits were regularly conducted. The most recent audit was December 2025 which showed 100% compliance. A risk assessment for the use of the laser had been completed. A laminated sign was displayed when the laser was being operated.

Stock was in a secure area and stored off the floor. Stock rotation records were completed monthly. We checked several consumable items, and these were all in date.

Maintenance records showed the hoist and slings were maintained, cleaned and regularly checked.

Staff disposed of clinical waste safely daily and used appropriate systems for the management of sharps. There was a contract for the weekly collection of clinical waste. Staff theatre ‘scrubs’ were laundered twice a week.

Equipment for managing emergency situations were available for staff to use and all were clean and regularly checked.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

There was sufficient qualified, skilled and experienced staff to operate the service. All staff received effective support, supervision and development opportunities. Staff worked together well to provide safe care that met patients’ individual needs.

Staff members included a hospital manager, registered nurses, healthcare technicians, patient coordinator, and optometrists and surgeons. Although it was rare to use agency staff, agency had been used to cover the optometrist role. Staff moved across SpaMedica services in the wider regions. Staffing levels were stable, and sickness rates were low.

The service employed permanent staff who moved between other SpaMedica services in the wider regions to support safe staffing levels. This was aligned with their Clinical Safer Staffing Levels Standard Operating Procedure. Staff were aware this was a necessary requirement to maintain patient safety.

Safe recruitment processes were followed to make sure all staff were suitably experienced, competent and able to carry out their role.

All staff had an induction and had structured progress meetings. Staff in probation had regular progress meetings. All staff were provided with a mid-year review and annual appraisal. All the staff we spoke with confirmed they had received an appraisal. All current appraisal, probation review and mid-year check ins were currently at 100%. All staff competencies were aligned to ensure staff were allocated based on their competency. Managers monitored staff competencies regularly.

Staff received training relevant to their role and had access to mandatory training, which included online and face to face learning. Mandatory training which included use of hoist, sepsis awareness and infection control were 100% compliance. As the site had recently commenced sedation. Experienced additional staff from other sites attended on days where they performed treatment under sedation, as part of their training programme.

Staff received additional training around conscious sedation. To implement sedation a project group of key stakeholders had been implemented. All staff attended a full day training in October 2025 which had input from their leads including governance, anaesthetics and pharmacy.

The evidence showed a good standard. The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Patients were protected as much as possible from infection risks as the premises and equipment were kept clean and hygienic throughout. There was a systematic approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. Patients commented to us how they were impressed by how clean it was.

There were clear roles and responsibilities around infection prevention and control. Staff completed daily cleaning check lists to record compliance with cleaning schedules and standards. Regular clinical audits were completed on a rolling programme. Weekly cleaning audits were completed, average compliance was over 99%. Hand hygiene audits were completed monthly and was 99% compliant over the last 6 months. There was a hoist and sling cleaning record. The hoist was cleaned on a weekly basis.

Staff followed infection control principles including the use of personal protective equipment (PPE). Hand-washing and sanitising facilities were available for staff and visitors and we observed staff practising effective hand hygiene. Posters on handwashing were displayed above sinks. Staff were smart and presentable. Adequate supplies of PPE were available. Staff wiped down equipment after patient contact and between patients. There were multiple large pieces of equipment in the operating room, and these were kept clean, well maintained and dust free.

Staff followed protocols regarding decontamination. Reusable instruments were sent to an external contractor for sterilisation. Where staff used single-use equipment for minor surgery, they documented serial numbers in patient records. This meant items were fully traceable in line with national guidance.

The evidence showed a good standard. The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Staff followed good medicines management in line with national guidance. The service always made sure medicines and treatments were safe and met patients’ needs, capacities and preferences.

Staff who had completed competencies in the management of medicines, dispensed and administered medicines to patients. Staff compliance for medication management was 100%.

Patients were appropriately involved in decisions about their medicines. Patients were involved with assessments and reviews about the level of support they needed to manage their medicines safely and to make sure their preferences were considered. Allergies were clearly recorded.

Medication was securely stored and restricted to appropriate staff. Specialist drugs used for sedation and medical gases were in date and stored correctly.

A resuscitation trolley was available; this was regularly checked by staff. All expiry dates of medicines were listed in the audit record and those expiring soon were highlighted. A ‘grab bag’ was available and the record was regularly checked.