• Staff knew how to protect patients from abuse and the service worked with other agencies to do so, staff had received training on how to recognise and report abuse and were able to give examples of when they had done this.
• The service controlled infection risk well. Equipment and premises were kept clean and there were systems and processes in place to prevent the spread of infection. The hospital measured its infection rates and there had been no reportable infection since October 2017.
• Managers monitored the effectiveness of care and treatment and used the findings to improve them. Outcomes were reviewed every month so that changes could be implemented quickly. They compared their results with other services to try to improve them. Rates of posterior capsular rupture were low. The hospital was a national trainer for a new technique for some glaucoma patients.
• The service made sure that staff were competent for their roles. There was a culture of continuous learning and development at the hospital and protected time for research. New roles had been developed with appropriate training, education and competency assessments. There was oversight of training and development at a senior level.
• Care was holistic at the eye hospital and staff were very aware that a diagnosis of sight loss would dramatically affect people’s lives. Patient feedback about their care was very positive and people felt comfortable at the hospital.
• There was strong emotional support at the hospital and patients could access psychological support. Staff supported patients to access services in their own communities to try to prevent social isolation. There was specific support for children and their families and feedback about this service was extremely positive.
• The service met the individual needs of patients who needed additional support. There were examples of the individual support to patients with a learning disability or autism so that the best outcomes for the patients could be achieved.
• The hospital was working to support children and young people and their transition to adult services. There was senior clinical support for this and an audit was in place to identify those patients who were in the transition phase of their treatment. Patients saw the same medical consultant through into the adult clinics.
• Leadership from all professions working in the eye hospital was effective and robust. Managers were capable, experienced, clinically knowledgeable and competent and staff told us that they had confidence in them. Many of the managers were leaders in their own professions both nationally and internationally.
• There was a strong culture of risk management and service improvement at the hospital with systems in place to escalate issues of risk and patient safety up and down the organisation. The hospital were aware of their financial situation and this was part of the accountability oversight framework.
• Staff worked collaboratively to develop new models of care, innovation was encouraged and there was protected time for research among health professionals in the department.
• However; Not all patient records were fully completed and there were issues around the availability of patient records for out-patient clinics.
• The safer steps to safer surgery including the World Health Organisation checklist were not

always fully completed.