The Care Quality Commission

Archived: CESP (Gloucestershire) @ Tetbury Community Hospital

Malmesbury Road, Tetbury, Gloucestershire, GL8 8XB (01242) 521919

Provided and run by:
Consultant Eye Surgeons Partnership (Gloucestershire) LLP

All Inspections

4 September 2013

During a routine inspection

We previously visited this provider in February 2013. At that time we had concerns about arrangements for dealing with complaints. We were also concerned that there were inadequate systems in place to monitor quality and safety. We returned to check whether improvements had been made in these areas. We also looked at how the service cooperated with other providers, arrangements for obtaining the consent of patients in relation to treatment and arrangements to ensure that people were cared for by people with appropriate skills, qualifications and experience.

We visited the provider's headquarters (Lansdowne Lodge) and looked at records. We found that the provider had improved its arrangements for dealing with complaints and systems to monitor quality and safety.

We spoke over the telephone with patients who had undergone eye surgery at Tetbury Hospital and looked at their records held at Tetbury Hospital. We saw that consent had been appropriately obtained and was recorded. Records also showed that CESP liaised with other healthcare professionals involved in people's care. Referring GPs and opticians were kept informed about people's treatment and any ongoing care required.

We looked at records of training and supervision for the surgeons working at CESP. The provider had assurance from the surgeons' NHS employer that they had maintained the necessary skills and qualifications to undertake their role, although records held by CESP were not all up to date.

20 February 2013

During a routine inspection

We visited CESP's Gloucestershire headquarters in Cheltenham. We looked at records relating to services at Tetbury Hospital. We had recently visited Tetbury Hospital. CESP were not operating on that day but we looked at the premises and spoke with the hospital's manager and staff who supported CESP consultants when they visited.

We spoke over the telephone with four patients who had undergone eye surgery at Tetbury Hospital. Their feedback was very positive. The said they were well informed about their treatment. They told us that staff were friendly and put them at their ease. They had confidence in the surgeons who performed their surgery.

Patients were assessed and screened to ensure that they were suitable for day surgery and there were arrangements in place to deal with medical emergencies. Patients were given information about after effects of surgery and how to care for themselves at home.

Eye surgeons were subject to performance appraisal by their NHS employer and assurance was provided to CESP that their practice had been reviewed and that they had accessed regular training. There were systems in place to capture patient feedback and clinical outcome data. However this information was not routinely reported to or considered by the registered manager or the medical advisory committee. The complaints procedure was not well publicised and there was insufficient evidence that complaints were investigated and resolved to people's satisfaction.