We spoke with the registered manager, counsellors, a nurse, eye laser assistants and patients who had received treatment at the clinic. This helped us to gain an overview of what people experienced at Optimax Laser Eye Clinic.

During our inspection we looked at care planning, quality assurance and daily records and undertook a tour of the building. We also looked at ways the service sought views from people who received treatment at the clinic.

Comments we received from patients were positive about the way they were treated by staff and doctors. They were satisfied with the care and support shown to them during the course of their treatment. Comments included, “A brilliant service. They were all so polite and reassuring, I cannot fault them.” Also, “Everything was explained to me throughout the process. I would recommend the clinic.”

Patients told us they were consulted throughout the treatment stages and all options were discussed with them. Patients confirmed they gave their consent to any treatment they received.

We were unable to speak with people using the service because on the day of our inspection visit the service was extremely busy with consultations and treatments taking place and the opportunity did not arise to speak with people directly. We gathered evidence of people's experiences of the service by reviewing completed satisfaction surveys, compliments received and the complaints log. We found that people were very positive about the service they had received and were complimentary about the support received from all the staff. Comments included, "Staff have been fantastic”, “I am very pleased with Optimax and their treatment and other care, can’t fault it”, “A truly professional team” and “You are all professional, efficient and friendly.”

Where people had raised concerns we saw that the manager kept a record of complaints made to the clinic. Complaints were investigated following a structured process that included the nature of the complaint through to the final outcome.

All consultations and follow up appointments were carried out in private rooms to respect the privacy and confidentiality of people using the service.

Cleanliness and infection control were closely monitored and staff had received infection control training within the last twelve months and we saw evidence that the manager had carried out an annual infection control audit in January 2013.

There were enough qualified, skilled and experienced staff to meet the people’s needs.

No treatments were taking place on the day of our visit; therefore we did not obtain any direct comments from people using the service.

Optimax Laser Eye Clinics - Manchester is operated by Optimax Clinics Limited. Facilities include four floors with no disabled access. The reception, main waiting room, topography room and two consultation rooms are located on the ground floor; the first floor has a waiting area, managers’, office, two storerooms, counselling room and doctor’s room. The second floor is a staff only area with kitchen. The basement has public and staff toilets, waiting area, preparation, recovery, laser room and staff changing rooms.

The service provides refractive eye surgery only. If a patient required further care or surgery using anaesthesia or sedation, as an example, lens replacement surgery, patients are referred for private surgery to another Optimax Clinics Limited branch. If patients had lens surgery in another Optimax Clinics Limited branch the Manchester location provided pre and post-operative care. We inspected refractive eye surgery.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 03 August 2017 along with an unannounced visit to the location on 11 August 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 Optimax Clinics Limited 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. 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:

• All areas of the service were tidy and well maintained; they were free from clutter and provided a safe environment for patients, visitors and staff to move around freely.
• There were minimal incidents and complaints. Staff members were aware of how to raise incidents and feedback from patients in relation to their experience was followed up.
• Staff members were positive about their working experience feeling supported to be part of a team and had worked in the service for a number of years.
• A system of risk and quality management was in place that centred on ongoing meetings and communication within the location and the organisation.
• Patients spoken with and feedback to the service were positive about their experience and the outcomes from their surgery.
• A number of audits were in place with action plans that were monitored in order to progress areas of improvement.

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

• The arrangements for dispensing medicines were not sufficient to provide safe management of medicines. As there was no policy or procedure to support staff practice and no competency or training for staff to ensure that they had the correct skills.
• References were not consistently available for employed staff and those working with practicing privileges. Specific qualification information was not available in all personnel files.
• A complaint for a patient allocated to the Manchester branch who received surgery in another Optimax Clinics Limited branch had not been investigated for lessons learnt.
• Policies and procedures were not all up to date or available to consistently deliver a quality and safe service.

Following this inspection, we told Optimax Clinics Limited that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued Optimax Clinics Limited with two requirement notices for regulations breached. Details are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals