Newmedica Community Ophthalmology Service

Updated 9 September 2022

Newmedica Community Ophthalmology Service in Leeds is an independent provider registered with CQC since 2019 and this is the first inspection since registration. The registered manager is registered across two locations in Leeds and Wakefield.

The inspection was announced on the Thursday before the inspection on the following Tuesday. The inspection was announced to ensure that we could inspect both the surgical and outpatients’ services as we were aware that surgical sessions took place on specific days. The surgical sessions took place every weekend, Tuesdays and alternate Wednesdays. Outpatient activity took place throughout the week.

The service provides a range of ophthalmic treatments for NHS and other funded (insured and self-pay) adults. The services provided include:

• General ophthalmology and cataract surgery including pre- and post-operative assessment.
• Yttrium aluminium garnet (YAG) laser treatment. YAG laser capsulotomy is a type of laser treatment that is used to make a hole in the capsule to allow light to pass through to the back of the eye to improve vision. The YAG laser is used as the final part of the cataract surgery.
• Ocular hypertension and glaucoma treatment and monitoring
• Eyelid and tear duct surgery
• Medical retina services – for conditions that affect the back of the eye
• Oculoplastic, (which is a broad term for several surgical procedures on the eye and the surrounding structures, including the eye socket, eyelids, tear ducts, and parts of the face) and medical retina.

The hospital is registered to provide the following regulated activities:

• Diagnostic and screening procedures

• Treatment of disease, disorder or injury

• Surgical procedures

Updated 9 September 2022

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.

Updated 9 September 2022

See the summary above for details.

We rated this service as good overall and good for being safe, caring, responsive and well-led. Effective is not rated in outpatients.

Updated 9 September 2022

See the summary above for details.

We rated this service as good overall and good for being safe, caring, effective, responsive and well-led.