Updated 7 June 2018
Leeds Albion Street Clinic is operated by Optical Express. The service opened in September 2013. It is a private clinic in Leeds, West Yorkshire. The clinic primarily serves the communities of the West Yorkshire area. However it also accepts patient referrals from outside this area.
The hospital has had a registered manager in post since September 2013.
Updated 7 June 2018
Leeds Albion Street Clinic is operated by Optical Express. Optical Express is a nationwide company providing general optometric services. The clinic provides laser vision corrective procedures under topical anaesthetic, for adults aged 18 years and above.
The clinic has been operational since September 2013 and is based on the sixth floor of an office block.
Part of the clinic is dedicated to the provision of the optometric service which includes sight tests, eye health screening and examinations, pre and post-operative cataract examinations, pre and post-operative refractive surgery examinations. The remaining part of the clinic accommodates the treatment suite where the regulated activities take place. The clinic provides laser vision correction procedures under topical anaesthetic using Class 4 and Class 3b lasers.
Facilities include a laser treatment room where the surgery is completed, surgeon examination room, consultation room and two rooms where patients receive aftercare advice and medicines following surgery.
The clinic was not operational every day, therefore there was only one staff member based there, which was the surgery manager. The surgery manager was on an extended absence of leave for one year from the clinic and another surgery manager was covering. Treatment lists were staffed by a regional surgery team that travelled and covered the Manchester, Liverpool, Sheffield and Newcastle areas who visited the clinic on surgery days.
We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 23 November 2017, along with 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 services 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:
Staff were aware of how to report incidents. Incidents were discussed across the North region to aid learning.
Staff received level two training for both safeguarding children and adults. A policy was in place and staff were aware of the responsibilities in reporting any safeguarding concerns.
The clinic was visibly clean and monthly cleaning logs were in place. There was accessibility to clean disposable theatre attire and hand washing facilities.
Laser safety was well managed and records were appropriately maintained. Equipment was serviced regularly and all electrical tests had been completed.
Medicines were prescribed and administered to patients appropriately ensuring that they understood how to administer them.
Records were appropriately written and contained all the relevant consultations, health questionnaires and consent forms.
A team brief session took place at the beginning of each surgery day to discuss the patients and any issues. Prior to the patient’s surgery an adaptive ‘five steps to safer surgery’ World Health Organisation (WHO) checklist was completed. WHO audits were completed to ensure that practice was embedded.
Scenario based training sessions were completed on specific surgery days to support staff in managing and dealing with untoward situations.
Staffing was managed by a central schedule and we saw that the appropriate number of staff were present on surgery days.
Care and treatment reflected current legislation and national guidance.
Patients received adequate pain relief and were advised how to manage their pain on discharge.
The surgeon’s statistics were reviewed to identify their establishment rate and safety score and compared against the organisation.
Staff had received an appraisal that reviewed their performance.
We saw evidence of good multidisciplinary working and staff reviewed patients at the beginning of the surgery day.
Patient information could be accessed across all the Optical Express locations; this allowed information to be viewed at any clinic.
Patients consented to the treatment several times prior to their surgery. We looked at seven records and found them all to have consented more than seven days before their surgery.
Staff treated patients with dignity and respect. Feedback from patients was consistently positive. Patient satisfaction surveys identified that patients were satisfied with the treatment and care they received.
Patients were reassured at all times during their treatments and we saw that staff were compassionate.
Patients told us they felt involved in the decision making process and were encouraged to ask questions. We saw that the consultant drew pictures to ensure that patients understood the process.
Services were planned to meet the needs of patients, based on their own choice and preference. They could attend any Optical Express clinic for their post-surgery aftercare.
Extra surgical lists were created to support the demand for surgery. There had been no cancellations for non-clinical reasons.
Patient’s individual needs could be met. These included spacious areas for wheelchair users and adjustable height chairs.
There was a process for the reporting, monitoring and learning from complaints.
The clinic had a clear leadership structure in place from the chief executive office to local leadership. A generic risk register was in place.
Staff were aware of how their role fed in to the vision of the organisation albeit they did not fully understand the overall strategy.
The clinic had a lead for governance and quality monitoring. Staff attended meetings and provided with minutes that they signed to identify they had been read.
Appropriate checks had been completed for staff, these contained references and Disclosure and Barring Service (DBS) record.
The organisation recognised and rewarded staff through their weekly staff reward scheme.
However, we also found the following issues that the service provider needs to improve:
The consent policy did not reflect Royal College of Ophthalmologists 2017 guidance fora seven day cooling off period between the initial consent meeting with the surgeon and the final consent by the surgeon.
The clinic did not have access to any interpreting services and patients were asked to bring their own interpreter. This meant that staff may not be clear if patients had fully understood the risks and benefits of the surgery.
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. Details are at the end of the report.
Ellen Armistead
Deputy Chief Inspector of Hospitals
Updated 7 June 2018
We regulate this service but we do not currently have a legal duty to rate it. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.