Community Health and Eyecare Limited (CHEC - Watford)

Updated 3 September 2021

Community Health and Eyecare Limited is operated by Community Health and Eyecare Limited. It is a company built by optometrists and ophthalmologists to deliver eyecare services to adults in the community. The Watford surgical centre was purpose built and opened in January 2020. It is a private clinic in Watford and primarily serves the communities of Hertfordshire. The service operates six days per week, Monday to Saturday.

The clinic offers day case surgical services and outpatient appointments to NHS patients under local clinical commissioning group (CCG) contracts. Most of their activity is carried out at the Watford surgical centre. They also deliver some of their services locally at GP practices and other clinics in the local area.

The service is managed from a central referral and booking centre directing patients through choice to various clinics in the UK. The surgical site is managed by a registered manager supported by an ophthalmic team which consists of:

• Ophthalmology Consultants
• Optometrists
• Registered Nurses
• Ophthalmic Technicians
• Administration Staff

Services provided at this location include:

• Outpatient appointments
• Cataract surgery
• YAG (laser procedure)
• Wet AMD (treatment for macular degeneration)
• Minor eye procedures

The clinic has approximately 34,000 appointments annually.

The clinic has a registered manager in post and is registered to provide the following regulated activities:

• Surgical procedures
• Diagnostic and screening procedures
• Treatment of disease, disorder or injury

This is the first time we have inspected and rated this service. We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection on 29 June 2021. To get to the heart of patients’ experiences of care, we ask the same five questions of all services: are they safe, effective, caring, responsive to people’s needs, and well led.

The main service provided was surgery. Where our findings on surgery also apply to other services, we do not repeat the information but cross-refer to the surgery service level.

Updated 3 September 2021

This is the first time we have rated this service. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink if necessary, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and supported them to make decisions about their care and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• Although there was good compliance with completing the WHO safer surgery checklist, we noted there was not always verbal communication, as per instructions on the checklist. The checklist states each item to be read out loud, however, we noted verbal communication had not always taken place. This had already been identified by the service and safer surgery workforce training workshops had been arranged to address the issue.
• Patients sometimes waited unattended for a short period (few minutes) for their post-operative checks outside theatre following surgery. We raised this with leaders following our inspection who told us there was usually a member of staff waiting with patients and would ensure staff always remain with patient’s post-surgery going forward.
• The notes trolley located near the theatre was occasionally unlocked and the room where this was located was left unattended on some occasions. This meant that notes could potentially be accessed by unauthorised persons.

Updated 3 September 2021

This is the first time we have rated this service. We rated it as good overall.

The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.

We rated this service as good because it was safe, caring, responsive and well led. We do not rate effective for outpatient services.

Updated 3 September 2021

This is the first time we have rated this service. We rated it as good overall.

We rated this service as good because it was safe, effective, caring, responsive and well led.

Please refer to overall summary above.