People who attended the clinic were given appropriate information regarding their care or treatment. People were given time to consider options so that they could make an informed decision about their planned treatment.

Care and treatment records were up-to date and reflected each time a person had attended the clinic for treatment.

Safeguarding policies to protect vulnerable adults from harm or abuse were in place and staff had undertaken training.

There were regular on-going training sessions and clinical competency assessments in place to ensure that staff safely delivered care and support to people.

The provider had processes and procedures in place to monitor the quality of service provision.

The clinic had an effective system in place to deal with complaints that people might raise. Information was available for people who attended the clinic which informed them of how to raise a concern and also how they could comment on the service they had received

Optical Express Cambridge is operated by Optical Express Limited. Optical Express is a nationwide company offering general optometric services. The clinic provides laser vision correction procedures for adults aged 18 and over.

The clinic has pre-screening amenities, consultation rooms, and a laser treatment suite, which consists of a laser treatment room and surgeon’s treatment room.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 18 December 2017, along with an unannounced visit to the clinic on 3 January 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 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:

• Patient safety was monitored and reviewed and incidents were reported and investigated and learning shared.
• Staffing numbers and staff skill mix were appropriate to deliver safe care and to assess and respond to patient risk.
• Patient records were complete and contained information about assessment, consent and treatment.
• Medicines were stored safely and administered to patients appropriately.
• All staff were up date with mandatory training and all had completed annual appraisals. Care was delivered by a suitably trained, multidisciplinary team that worked well together.

• Audits were regularly carried out to monitor the delivery of safe, effective care and treatment.
• The surgery team and the optometry team showed compassion towards patients. Staff listened to patients and showed respect for patients’ dignity.

• There was a clear leadership structure and a positive working culture.

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

• The consent policy did not reflect Royal College of Ophthalmologists guidance 2017 for a seven day cooling off period between the initial consent meeting with the surgeon and the final consent by the surgeon.
• There was no formal interpreter service available and patients were advised to bring family or friends to act as translators.
• All patient documentation was only available in English
• The service did not carry out a staff survey to engage with staff and gain 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. Details are at the end of the report.

Heidi Smoult

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Deputy Chief Inspector of Hospitals