We spoke with one person who used the service. They told us they had been provided with information about their treatment options and had been told about the surgery including the benefits, possible risks and the aftercare treatment. Comments included, "I know exactly what to expect as they have explained it all to me."

Staff at the clinic, were given regular training and were given a professional appraisal of their work every year. We observed people were treated respectfully and staff were attentive to maintaining the privacy and dignity of those they cared for.

We saw evidence of feedback from people who used the service, comments seen included, "Wonderful care by all staff", "Thank you for making me feel so comfortable and at ease", “Friendly and helpful staff, great day" and "Fantastic, a brilliant result and fabulous service from all the staff in Leeds."

The provider had a system for checking the quality and safety of the service and records were maintained and held securely.

We spoke with five people who used the service and they said that they were very satisfied with the care and treatment they received. People said that they were fully involved in deciding about the treatments they received. People said that the staff explained to them the treatment options, the risks involved with the treatments and the fees, so that they could make informed decisions

They told us that they were happy to ask staff anything in relation to the treatment and staff were very friendly and helpful.

People we spoke with said the clinic was clean and they had no concerns with the hygiene.

One person said the staff were, "Absolutely brilliant" and another person said, "Absolutely marvellous." One person said that the staff had told them, "Don't hesitate to ring and speak to us."

People that we spoke to told us that their privacy was maintained at all times and that they were given sufficient information about the procedures available in order to make an informed choice.

Optimax Laser Eye Clinic – Leeds, is operated by Optimax Clinics Limited. Optimax hold the lease for part of the building situated on the third floor.  Facilities include reception, a main central waiting area, topography room, three consultation rooms, one treatment room, preparation room and a recovery room. There is in addition, a manager’s office, optometrist room, doctor’s room, staff kitchen / rest room, patient toilets, filing room, laser technician’s room, and electrical cupboard. Loft access was through a small staff only room.

All patient areas / rooms had disabled access and the building benefits from a lift.

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 were referred for private surgery to another Optimax Clinics Limited branch. If patients had lens surgery in another Optimax Clinics Limited branch, the Leeds location provided pre and post-operative care. The clinic recently started to offer Mibo-Thermoflo (a process in which the eye is massaged through ultrasound, as an aid to dry eyes), which is outside of our scope of regulation.

We inspected refractive eye surgery.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 3 and 4 October 2017 along with an unannounced visit to the location on 27 October 2017. This was due to the clinic holding only two surgical days per month.

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:

• There were low numbers of incidents and complaints.
• 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.
• Patients spoken with and feedback to the service were positive about their experience and the outcomes from their surgery.
• All staff at the clinic had received an annual appraisal.
• Medicines were managed and administered in a safe and appropriate manner.
• Most staff were up to date with mandatory training.

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

• There was a lack of consistent registered general nurse cover, during surgical treatment days.
• Maintenance issues were not given priority by senior managers. Some of these issues had the potential to impact on patient care and treatment.
• Risks registers were not reflective of clinic issues and risks were not identified during environmental audits.
• General support for the clinic manager was poor.
• Clinical competencies for the extended role had not been reviewed, to ensure safe clinical practice.

Following this inspection, we issued a letter of concern and told Optimax Clinics Limited that it MUST take some actions to comply with the regulations and that it SHOULD make other improvements. 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