Silverthorn Medical Centre

Updated 26 June 2023

We inspected this service as part of our ongoing independent health inspection programme.

The service is provided by Complete Community Eyecare. They are a diagnostic service providing eye care in the community rather than in hospital. The main activity of the service is the running of the community glaucoma and retinal monitoring service. The service manages low risk stable glaucoma patients or patients who are at risk of developing glaucoma.

The registered manager of the service was the consultant ophthalmologist who originally set the service up. They also work at the local NHS hospital seeing patients who need eye surgery. The service manager was involved in the day to day running of the service.

The service was registered with the CQC at the current location in 2022 to provide diagnostic and screening procedures and treatment of disease, disorder or injury. Prior to that it was registered at a nearby address. This service has not been inspected before.

The service operates over three satellite sites, in the London borough of Waltham Forest. These are Silverthorn Medical Centre, Comely Bank Medical Centre and Langthorne Health Centre. We inspected the Silverthorn location only, where the service’s location was registered to provide a weekly clinic.

Updated 26 June 2023

Silverthorn Medical Practice is a community-based service supporting low risk, stable glaucoma patients or patients who are at risk of developing glaucoma. We had not inspected this service before.

We rated this service as good because:

• There was a good standard of cleanliness, and the provider had undertaken appropriate actions for infection control. There were measures in place to manage and minimise anticipated risks for patients and staff.
• The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. The community glaucoma and retinal monitoring clinics were consultant led.
• The service provided care and treatment based on national guidance and evidence-based practice.
• The service aimed to provide patients with a local service to keep them out of hospital and easier to access. There was a waiting lists for the service, but this was small. The service aimed to see new referrals within 6 weeks. For January 2023 the average time to be seen was nearly 7 weeks. The NHS target timeframe is 3 months.
• The staff were passionate about eye care and providing a good service for the community and felt well supported within the service. Staff demonstrated a kind, patient and professional service to patients. They actively involved patients in their assessment and treatment.
• Ophthalmologists and optometrists sought patient consent before treatment and recorded this as appropriate.
• Staff said that they were provided with extra support and supervision in their first few months at work in the service. Staff were clear about their roles and accountabilities.
• Patients received surveys by text after every consultation, to provide feedback about the service.
• Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff.

However:

• Whilst staff were provided with mandatory training, not all staff had received all the appropriate training. Not all staff had completed basic life support training.
• Staff described regular supervision and opportunities to meet, discuss and learn from their performance within the service. However, these informal discussions were not recorded as supervision sessions. The provider did not have a supervision policy.
• Despite developing formal governance systems for the service, we found gaps in recording and monitoring of risk and performance. The service did not have a risk register or equivalent to document the main risks to the service and to reduce the risk. Managers did not keep minutes of their governance team meetings.