Paxton Medical Group Also known as Claughton Medical Centre

Updated 13 December 2016

Claughton Medical Centre is situated in a deprived area of Wirral. There were 10,489 patients on the practice register at the time of our inspection.

The practice has 11 GP partners, five male and six female, one male GP registrar, five nurse practitioners, four practice nurses, a research nurse, a practice manager and a number of administration and reception staff. There is patient parking available and access to local transport links.

The practice is a teaching/training practice for medical student and trainee GPs.

The practice is open between 8.30am and 8pm Monday to Friday. Appointments are from 8.30am to 11am every morning and 2.30pm to 5.30pm daily. Extended hours appointments are offered at the following times Monday to Thursday from 6.30pm to 7.30pm. There are also arrangements to ensure patients receive urgent medical assistance when the practice is closed. Out of hours patients are asked to contact the NHS 111 service to obtain healthcare advice or treatment.

The practice has a General Medical Services (GMS) contract and has enhanced services contracts which include childhood vaccinations.

Updated 13 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Claughton Medical Centre on 13 October 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. We discussed with the practice the need to review how information was disseminated to the practice staff.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. We discussed with the practice the need to ensure there was information about how to complain available on their website. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Review the new systems in place with regard to safeguarding to ensure they are embedded and effective.

• Review the new system in place with regard to the issuing of repeat prescriptions to ensure it is embedded and effective.

• Ensure information about how to complain is available on the practice website.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 December 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• The practice employed nurse practitioners to support the effective management of patients with long term conditions.

Updated 13 December 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 13 December 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice in partnership with the CCG was involved in the alternative to hospital scheme to support patients to receive appropriate care and treatment at home rather than be admitted to hospital.

Updated 13 December 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 13 December 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• The practice worked hard to ensure patients with dementia were reviewed every six months to monitor the impact dementia was having on their lives and so that timely referrals were made for social care intervention.

Updated 13 December 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.