Newmedica Community Ophthalmology Service

We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in most key skills, understood how to protect patients from abuse, and managed safety well. The service had agreed systems and processes in place to safely prescribe, administer, record and store medicines and infection risk. The service had a robust process for safety incidents and lessons learned.
• Staff provided safe care and treatment and made patients comfortable when needed. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to useful information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients and carers.
• The service planned care to meet patients’ individual needs and made it easy for people to give feedback.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Governance processes were in place, however, we found that the audit processes for some areas needed further development. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually.

However:

Surgery:

• Performance meetings were not documented and shared with the respective NHS Trust.
• Two medical staff had not had regular appraisals and the staff competency documentation seen did not contain ticks against each competency completed by staff.
• Not all patients received postoperative follow-up calls and where a patient did not respond another attempt was not made to contact the patient.
• We did not see evidence that a set number of patient records had been audited to confirm whether the records were fully completed, signed, dated and contained all the relevant information pertinent to that patient.
• Shortfalls identified either as a result of audit processes or patient experience exercises were not identified against an action plan.
• Some action plans were not implemented, for example, Legionella risk assessments, and if present, for example, medicines management audits did not confirm all recommendations were completed.
• The business continuity policy was past its review date.

Outpatients:

• Within the storage area we observed some items stored on the floor, which would have made cleaning less effective.
• In the minor operations room, we found some items of equipment were out of date.
• The service did not undertake audits for the completion of consent information.
• Some staff were unfamiliar with the local (Leeds) vision involving the role of ‘patients, people and partners.
• The service had not completed a risk assessment for the use of latex gloves to reflect HSE guidance.