Archived: Optical Express - Bluewater Clinic

Optical Express Bluewater Clinic is operated by Optical Express Limited. Optical Express is a nationwide company providing general optometric services. The service provides refractive eye surgery for adults only, aged 18 years and above. The clinic is based on the ground floor within Bluewater shopping complex.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 24 November 2017 and an unannounced visit to the clinic on 8 December 2017.

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.

Services we do not rate

We regulate refractive eye surgery but we do not currently have a legal duty to rate them when they are provided as a single specialty service. We 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:

• There were systems to record and manage incidents. Incidents were investigated and learnings were shared across the business to prevent recurrence.

• We observed a positive approach approach to completion of the safe surgery checklist in line with the world health organisation (WHO) ‘Five steps to safer surgery’. On two separate occasions we observed the checks being made and all staff were present at the time and engaged with the checking process.

• There were good laser safety arrangements. Staff were trained in line with recommendations and evidence of this was kept on their personnel files. Laser machines were maintained in line with manufacturer’s guidance and records of equipment maintenance were kept up to date.

• There was sufficient staff with the skills and experience to manage patients’ care and treatment. The staff worked well together to deliver the service.

• There was a programme of mandatory training . Staff were up to date with this training. All staff had received an appraisal and this formed part of their personnel development plan. This meant staff had the skills and knowledge to do their jobs.

• Patient records were accessible to staff, records were completed fully and were managed securely.

• Patients received care in line with national standards and guidelines. There were systems to measure patient’s and surgeon outcomes. Results were shared and compared across the business.

• Staff treated patients in a caring and respectful way. Staff understood the anxiety of patients and were supportive and patients gave positive feedback about the service. There was a good system to capture patient feedback which was shared with staff.

• The service was planned and delivered to meet the needs of the patient. Patient preference was taken into account when delivering care.

• Complaints were managed in line with corporate policy. Learnings from complaints were shared locally and across the business.

• There was a clear organisational structure with clarity of roles and line management. Staff knew who their line manager was and managers were seen to be approachable and supportive. There was a vision and mission statement that was visible at the clinic which all staff were aware of.

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

• The consent policy should reflect the Royal College of Ophthalmologist 2017 for a 7 day cooling off period between the initial consent meeting with the surgeon and the final consent by the surgeon.

• Flooring in the back corridor had some small breaks in the surface and sinks in the toilets and dirty utility area were corroded and might present an infection risk. This risk was not identified in the local risk register.

• Patient information leaflets were not available in different languages and there was no formal access to translation services or an interpreter.

• There were no systems to formally capture staff feedback.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve.

Amanda Stanford

Deputy Chief Inspector of Hospitals