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Provider: Moorfields Eye Hospital NHS Foundation Trust Good

Listen to sound recordings of the inspection report on Moorfields Eye Hospital NHS Foundation Trust that we published on 06 January 2017:

Inspection Summary


Overall summary & rating

Good

Updated 12 March 2019

Our rating of the trust stayed the same. We rated it as good because:

  • We rated safe, responsive and caring as good and effective was rated outstanding. In rating the trust, we took into account the current ratings of the services not inspected this time.

Inspection areas

Safe

Good

Updated 12 March 2019

Our rating of safe improved. We rated it as good because:

  • Actions taken by the trust since the previous inspection had improved the safety of care and treatment provided.
  • Good progress had been made with implementation and compliance with the World Health Organisation (WHO) surgical safety checklist.
  • Staff understood how to protect patients from abuse; they had training on how to recognise and report abuse. Staff working with children and young people had been trained to safeguarding level three.
  • There were sufficient staff with the right skills and training to care for patients.
  • Staff adhered to infection prevention and control policies.
  • Services followed best practice when prescribing, giving, recording and storing medicines.
  • Records were clear, up-to-date and available to staff providing care.
  • Services had systems to report incidents and the majority of the services we inspected were able to provide examples of learning from incidents.

However;

  • Although services deployed sufficient nursing staff to care for patients the vacancy rate for unregistered staff was above the trust target.
  • In outpatients at Moorfields at Bedford the children’s waiting and clinical areas were not separated from the adults.

Effective

Outstanding

Updated 12 March 2019

Our rating of effective improved. We rated it as outstanding because:

  • Services provided care and treatment in line with national guidance and evidence of its effectiveness.
  • Services monitored the effectiveness of care and treatment and used the findings to improve them.
  • Patient outcomes in many specialties were better than the national targets. They compared local results with those of other services, nationally and internationally, to learn from them
  • Services participated in research projects, many with other ophthalmology providers, in order to drive improvement and identify best practice in care and treatment for patients.
  • There was good multidisciplinary working across all services we inspected.
  • Managers appraised staff’s work performance to provide support and monitor the effectiveness of the service.
  • Staff understood how and when to assess if patients had the capacity to make decisions about their treatment.
  • Although the new to follow up rate in outpatients at Moorfields City Road was higher than the England average the trust told us this was due to patients having complex and chronic conditions.

Caring

Good

Updated 12 March 2019

Our rating of caring stayed the same. We rated it as good because:

  • Staff cared for patients with compassion. Feedback from patients confirmed that staff were caring and treated them with kindness. They said that staff went out of their way to make their visit as comfortable and smooth-running as possible.
  • Staff provided emotional support to patients to minimise their distress and cope emotionally with their care and treatment.
  • Responses from the trust’s family and friends test were consistently good and many included comments about individual staff giving exceptional care.
  • Patients we spoke with told us they were involved in decisions about their care and treatment and staff took time to answer their questions.

However:

  • In outpatients at Moorfields City Road we observed some staff not acknowledging patients and being abrupt when answering their questions.

Responsive

Good

Updated 12 March 2019

Our rating of responsive improved. We rated it as good because:

  • Services were planned and delivery to meet the needs of local people.
  • Services took account of patients’ individual and diverse needs such as disability, gender, religion and belief. Accessible information for patients living with learning disabilities and dementia was available. This was an improvement since the previous inspection.
  • Hostel accommodation was available for patients who did not want to travel home on the same day of surgery and overseas patients who could not fly due to their surgery.
  • The trust’s referral to treatment time (RTT) for non-admitted pathways was consistently better than the England overall performance.
  • In surgery at Moorfields City Road people could access the service when they needed it. The patient journey was planned to ensure maximum efficiency with the effect that the average length of stay for both elective and non-elective patients was significantly below the England average.
  • In surgery at Moorfields City Road patient’s follow-up appointments were planned and scheduled at pre-assessment. This reduced the likelihood of them being unable to attend the appointments.

However:

  • The environment in outpatients at both Moorfields City Road and Moorfields at St George’s was limited, although some work had been undertaken to improve this since the last inspection.
  • The ‘did not attend’ rate for outpatients at Moorfields City Road and Moorfields at St George’s was higher than the England average and the trust was working to try and change this.

  • There was limited capacity in some of the clinics at Moorfields at Bedford. Some patients experienced delays and long waiting times due to capacity issues and clinics over booking.

Well-led

Good

Updated 12 March 2019

Our rating of well-led remained the same. We rated well-led as good because: