Midland Eye

Updated 28 March 2018

Midland Eye is operated by Aspen Healthcare. The service was established in 2003 and owned by four consultant ophthalmic surgeons. Aspen Healthcare acquired part of the business in 2012 and it remains jointly owned at present. Midland Eye is an ambulatory day surgery clinic and is located in Solihull, West Midlands. The clinic offers specialist consultation rooms, on-site diagnostic testing and operating facilities for ophthalmic eye conditions, which includes refractive eye surgery. The clinic provided NHS and private procedures of which a large proportion was NHS. The clinic primarily serves the communities of the Solihull and also accepts patient referrals from outside this area. The clinic did not treat patients under the age of 18.

The clinic had a registered manager in post since August 2011. A new manager had recently been appointed and was registered with the CQC in February 2017.

The clinic had been inspected in December 2012 and December 2013 using a previous inspection methodology. This inspection was the clinic’s first inspection under our current methodology. In the 2012 inspection, the service was found to be compliant in the five outcomes that were inspected. In the 2013 inspection, the service was found to be compliant in four of the five outcomes that were inspected. They were found not compliant in outcome 14, suitability of staffing, support for workers. The provider had since implemented a staff training and competency database.

Updated 28 March 2018

Midland Eye is operated by Aspen Healthcare. Aspen Healthcare is a group healthcare provider that provides independent services across the UK. The Midland Eye clinic is an ambulatory day surgery clinic with no inpatient beds or wards. Facilities include an operating theatre, an anaesthetic room, a small recovery area, a pre-assessment room, a diagnostic room, three consultation rooms and two patient waiting areas.

The service provides surgery, and outpatients and diagnostic imaging. We inspected both of these core services. We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 26 and 27 September 2017, along with an unannounced visit to the hospital on 11 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 clinic was surgery. Where our findings on surgery – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery core service.

Services we rate

We rated Midland Eye as good overall.

We found good practice in relation to surgery and outpatients:

• Patients were protected by a strong comprehensive safety system, and a focus on openness, transparency and learning when things went wrong.

• The safety systems in place kept patients safe from avoidable harm, which was reflected in an excellent track record in safety.

• Staffing levels were appropriate to keep people safe at all times.

• The clinic invested in staff training, skills and competence. Competence of staff was integral to achieving the service’s aim of providing first class healthcare.

• There was a comprehensive suite of policies and procedures that supported staff in providing high quality, safe and effective care. The policies and procedures were reviewed regularly and were in line with current best practice guidelines and legislation.

• Patients had good outcomes because they received effective care and treatment that met their needs. Outcomes were routinely monitored and reviewed alongside patient experience to assess quality of care.

• Staff treated patients with compassion, kindness, dignity and respect. Patients were respected and valued as individuals and were empowered as partners in their care.

• The clinic provided patient centredcare and treatment. Services were organised and tailored to meet the needs of the individual patients. The clinic delivered services in a way that ensured flexibility, choice and continuity of care.

• The leadership, management and governance of the clinic assured the delivery of a high-quality person-centred care, supported learning and innovation, and promoted an open and fair culture.

• Governance and performance management arrangements were proactively reviewed and reflected current best practice.

• Risks were clearly identified and monitored effectively. Performance issues were escalated to the relevant committees and the board through clear structures and processes.

• Patients and staff were highly respected and valued. A full and diverse range of patients’ views and concerns were encouraged, heard and acted on.

• Information on patient experience was reported and integrated with performance data to give a clear and accurate all round picture of quality and safety.

We found areas of practice that require improvement in relation to surgery and outpatients:

• We found that patient identifiable information was not always present on all pages within the paper notes and the authorised signature sheet at the front of the notes were not always completed. Correspondence letters to other health professionals did not always have a penned signature present. On our return visit, the clinic had put things in place to ensure that these issues were rectified

• The clinic did not have a designated area for recovery and patients had to recover in the shared waiting area. Although no patients raised this as an issue, staff recognised that the shared waiting and recovery area was not ideal for patients privacy.

• The clinic was not currently submitting data to the Private Healthcare Information Network (PHIN).

Following this inspection, we told the provider 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

Deputy Chief Inspector of Hospitals

Updated 28 March 2018

The outpatients’ service was small and compact and the management team, governance systems and staffing were the same across the surgery and outpatients service.

We do not repeat information throughout the report but cross-reference to the relevant section of the surgery section.

We rated this service as good because it was safe, caring and responsive. Well-led was outstanding. There is currently not enough evidence nationally to give a rating for effectiveness of outpatient services.

Updated 28 March 2018

Surgery was the main activity at the clinic. Where our findings on surgery also apply to other services, we do not repeat the information but cross-refer to the surgery section.

All management and governance systems, along with staffing were managed jointly with outpatients’ services.

We rated this service as good as it was safe, effective, caring and responsive. Well-led was outstanding.