The Quarter Jack Surgery

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care plans reflected physical, mental, emotional, and social needs of people including those related to protected characteristics under the Equality Act. Our review of clinical records showed people were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

The service held regular multi-disciplinary meetings with other professionals to plan and coordinate care, supporting holistic and person-centred outcomes. People had named GPs, and when booking appointments, they were routinely offered the option to see their preferred clinician.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service had tailored its services to meet the diverse needs of its community, for example, building relationships with community groups to promote the take up of screening programmes. There were established mechanisms for engaging with the community healthcare provider.

The service provided appropriate, accurate, and up-to-date information in formats tailored to individual needs. The service website contained accessible information on a range of topics, including opening times, patient registration, clinics and services, complaints, and prescription ordering.

Reasonable adjustments were made to support communication, including the use of interpreters when necessary.
Leaflets were readily available in the reception area, and posters were displayed to inform people about the service and the various services available to them. People were also provided with clear information on how to access their medical records.
The service was able to demonstrate reasonable adjustments under the Equality Act 2010. The premises had a portable hearing loop in place for people who were hard of hearing. Accessible communication formats such as large print materials and easy read formats were available when required.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service had a clear complaints process, supported by a designated complaints lead and an accompanying policy. Information on how to make a complaint was available on the website. Complaints were managed in line with the service’s policy. Learning from complaints was evident, and staff could identify changes made because of feedback. We reviewed a sample of complaints and found all had been managed appropriately, with apologies provided where necessary and signposting to the Parliamentary and Health Service Ombudsman when required.

Meetings were held to review learning from complaints, and that leaders regularly included this as a standing agenda item to support continuous improvement.

The service ensured people requiring accessible information such as those with learning disabilities, dementia, or those who did not speak English received the support needed to understand their care options. This included access to interpreters and easy‑read materials. For individuals who required additional support, including older people or those with mental health conditions, families were appropriately involved in care planning and decision‑making. The service also supported carers by providing information and guidance to help them manage the care of their loved ones, ensuring they were included in relevant discussions.

Arrangements were in place to promote people’s privacy. Feedback from the 2025 National GP Patient Survey showed 81% of respondents described their overall experience of this GP service as good, which was 6% higher than the national average. The service remained transparent with people using the service by sharing results of the GP patient survey with them and actions they would be taking as a result.

The service made sure that people could access the care, support and treatment they needed when they needed it.

Data from the 2025 National GP Patient Survey showed access to services was below both local and national averages. However, overall experience of the service was above these averages. The service was able to demonstrate how it regularly reviews and analyses feedback and survey data to improve the quality of care. For example, to enhance access, the frailty team was leading work on a new triage criterion for people coded as housebound, frail, or registered as carers, to support more effective care navigation.

The service also offered designated appointment slots for people referred from NHS 111. These were managed by staff, who ensured people were booked appropriately with the correct clinician. In addition, other health and social care providers such as care homes, local schools, and community mental health teams were given access to a dedicated telephone bypass number, enabling timely contact with the service in urgent situations.

It also offered extended access appointments, enabling people to access the service during evening hours on Mondays and Tuesdays. In addition, the service worked collaboratively with the local Primary Care Network (PCN) to enhance care provision.

At the service’s branch site, care is more nurse-led. The booking system allows staff to differentiate between the two sites, ensuring people are booked into the correct clinic through colour-coded scheduling. There is also a safety-netting measure in place where a pop-up alerts the staff making the booking, ensuring clinics such as child and baby immunisations cannot be booked at the branch site, so that a GP is always present when required.

Clinic availability was regularly reviewed on site, ensuring people had timely access to care. The service offered a range of clinic slots within 2 weeks for essential services, including cervical screening, flu clinics, NHS health checks, phlebotomy, and long-term condition reviews.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Feedback from people using the service, both shared with the provider and with CQC, was positive. Staff treated people equally and without discrimination. Leaders proactively sought ways to remove barriers to improving people’s experience and worked with local organisations, including those in the voluntary sector, to address local health inequalities. Staff understood the importance of providing an inclusive approach to care and adjusted support equitable experiences and outcomes.

The provider had processes to ensure people could register at the service, including those in vulnerable circumstances such as people experiencing homelessness and Travellers. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or who lacked internet access.

The service identified the need for carer support and completed an analysis of records to plan for the projected 22% increase in people aged 65 and over living in the area between 2023 and 2033. Feedback was obtained from those registered as carers to understand how they were feeling and the level of support they were receiving. Clinical system data showed 264 people were coded as a carer, 524 as having a carer and 177 people had a specific diagnosis, giving a total of 965 individuals. A survey was created and sent to both care receivers and carers to establish what support they were aware of. In addition, posters and information were shared with people registered at the service or visiting the service or via its website, signposting them to relevant support mechanisms and enabling them to register as a carer. As a result, 5 additional carers had registered with the service, and plans have been made to complete an audit within 6 months to re-evaluate uptake.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Our remote records review showed people were supported to consider their wishes for end‑of‑life care, including decisions relating to do not attempt cardiopulmonary resuscitation (DNACPR). This information was shared with other services when necessary.

The service promoted collaborative working with community teams, including those within the local primary care network (PCN). They worked closely with the community hospice team, where palliative care was effectively managed through regular clinical meetings. All people receiving palliative care were discussed at these meetings to ensure coordinated and consistent support.