People we spoke to said they were very happy with the treatment they had received at the clinic. This was borne out by written feedback and testimonials on the website. Examples of people's written comments were "a confidence inspiring service", "my consultation was really informative" and "the best."

We looked at evidence from people's records and from information produced by the clinic which demonstrated that people were given detailed information about treatment options and were involved in planning their care and treatment.

We looked at examples of people's medical records and saw that these were well organised, legible and easily located, thus supporting people's continuity of care, as well as providing the basis for audits and clinical decision-making.

We saw that there were effective systems in place to ensure that the equipment, particularly the specialist lasers, were risk- assessed and met government safety standards.

There was evidence that that people were encouraged to give feedback about their experience of the clinic.We saw feedback forms from people who had used the service over the past 6 months which were overwhelmingly positive.

People we spoke with were very satisfied with their care and treatment at Focus Laser Vision. We were able to speak with people at different stages of their treatment – from initial tests, the day of surgery and people coming in for a follow up appointment after surgery. They had been given sufficient information about the service and about proposed surgery and aftercare. They reported that they had been treated considerately by staff and could raise a concern if they had one.

People we spoke with were very satisfied with their care and treatment at this location. They had been given sufficient information about the service, about their treatment and reported that they had been treated considerately by staff and could raise a concern if they had one. All the people we spoke with had used the clinic’s website as a useful source of information and to see what other people who had used the service had experienced.

Focus Clinics is operated by Horizon Medical Limited. Facilities include a laser suite, two pre-screening rooms, five consulting rooms, and a customer lounge. Refractive eye services do not generally treat child and Focus Clinics provides refractive eye surgery for adults only, aged 18 years and above.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced part of the inspection on 24th October 2018, along with an announced visit to the service on 7th November 2018.

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 rate

We rated it as good overall.

We found good practice in relation to outpatient care:

• The service managed staffing effectively. There were enough staff with the appropriate skills, experience and training to keep patients safe and to meet their care needs. Staff had opportunities for personal development and had an annual review with their line manager.

• The service had systems for the reporting, monitoring and learning from incidents. Patient safety was fully considered, and the clinic followed best practice guidelines and measured patient outcomes.

• Medicines were recorded, stored and disposed of safely. Equipment, including lasers were managed safely. Staff had been trained in line with recommendations and evidence of this was kept on their personnel files. Laser machines were maintained in line with manufactures guidance and equipment maintenance was kept up to date.

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

• Staff treated patients with dignity and respect. Care was provided in a respectful way and there was a good system to capture patient feedback which was shared with staff.

• There was a clear organisational structure with clearly defined roles and responsibilities. Line management was clear and staff were approachable and supportive. There was a clear strategy developed with input of all members of staff.

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

• The Medical Advisory Committee (MAC) had not met for a number of months to consider governance matters. Clinic policy stated the MAC meeting should take place every three months but we saw evidence that suggested the MAC had not met for over 9 months.

• Patient information leaflets were not available in different languages or formats.

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. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals