We spoke with two patients who were visiting the provider’s Leeds clinic for treatment. One told us the staff had been, “Really helpful” and they had they no concerns about the service. The other said the staff were, “Very good, polite and professional.”

Patients said they were not put under any pressure to undergo treatment. Their treatment options were explained to them and they were given information and a consent form to take away and given time to think about the risks and benefits before deciding whether to return for treatment.

Patients were assessed to determine their suitability for treatment. They were asked to provide a personal and medical history, their reasons for seeking treatment and expectations of the results of the treatment.

Patients were protected from unsafe or unsuitable equipment because the provider carried out regular checks to ensure equipment was working correctly.

We spoke with the registered manager and six other members of staff. They told us they enjoyed their jobs. They were able to access advice at any time to enable them to carry out their role and were supported to, “Act in the best interests of patients”.

The provider had put in place a programme of audits to assess the quality of the service. The audits included assessments of the physical environment, health and safety, infection control, adverse incidents and the outcome of surgical treatments.

Patients and staff were asked for their views about the service. There was a high level of patient satisfaction with the service, the staff and the information provided.

The provider took care to ensure that people who used the service understood the choices available to them and involve them in decisions about their treatment. People who had used the service told us that they had been very happy with the treatment they had received at the Leeds Clinic. They said that the staff had taken time to fully explain their treatment options to them. One said “The staff have been marvellous.”

People’s care and treatment was planned according to their particular needs. The provider acted to ensure the safety and welfare of people who used the service. We saw that each person had an individual treatment plan which took account of personal factors, such as their medical history and occupation, which might affect their treatment options and after care.

We found that the clinic was clean, well equipped and furnished to a high standard. There were effective arrangements for the prevention and control of healthcare associated infections.

New staff were required to undergo an induction period and participate in an annual appraisal. The staff we spoke with were knowledgeable about their roles and understood the importance of accurately assessing and meeting the needs of people who used the service. They told us that they were well supported and had opportunities for professional development.

The provider had a process for dealing with complaints, however, information about the complaints process was not always readily accessible.

We spoke with one person who uses the service. They said they were very satisfied with the service received and had been treated well. They said they could not fault the service and would recommend it to others. They said they were very impressed with the after care received.

Optegra Leeds is a private clinic operated by Optegra UK Limited. Facilities include an operating theatre, assessment and consultation rooms and a patient waiting area. The service is accessible from Leeds train station and car parking is available.

The service provides refractive (laser) eye surgery only. The service is provided to adults. All patients are privately funded, referring and paying for their refractive (laser) eye surgery themselves.

We inspected this refractive (laser) eye surgery service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 10 October 2017 along with an unannounced visit to the hospital on 12 October 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.

The main service provided by this hospital was refractive (laser) eye surgery.

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:

• There were low levels of incidents and complaints.
• Patients were consistently positive about their experience and the outcomes from their surgery.
• Effective governance and risk management processes were in place.
• Suitable numbers of competent, trained staff were available.
• Staff worked well as a team and were engaged with the local vision to expand the service.
• Staff were up to date with mandatory training and most staff had received an annual appraisal.
• Patients told us they felt involved in decisions about their care because staff took time to listen and explain.
• Medicines were managed and administered in a safe and appropriate manner.
• A surgical checklist was effectively used to ensure safe treatment for patients.
• Laser safety was well managed and records were appropriately maintained.
• Surgical outcomes were benchmarked internationally, to contribute to continuing improvement.

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

• Although we saw evidence incidents were addressed and actions taken to minimise patient safety risks, we found not all low or no-harm incidents were recorded as per Optegra policy. This meant some incidents or themes could be missed.
• Although an observational audit and training were in place to support nursing staff in infection prevention and control, this did not include optometrists.
• The optometrist-led pathway meant patients were not being seen by the surgeon carrying out treatment until the day of the procedure, which is best practice. However patients were seen by the consultant prior to undergoing surgery on the treatment day.
• Arrangements for managing emergencies did not include a service level agreement with the local NHS hospital or a written policy for managing ophthalmic emergencies, which are best practice. However, the service had not had any emergencies in the last 12 months.
• Patient information was not routinely available in easy read format, to assist people with impaired sight.

Following this inspection, we told the provider that it should make some 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