Bull Point House & Annex

Updated 31 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

One inspector completed the inspection.

Service and service type

Bull Point House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch, and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and four relatives about their experience of the care provided. We spoke with three members of staff including the registered manager, deputy manager, and a senior care worker during the site visit.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We requested feedback from professionals and staff and received it from four professionals and four further staff.

Updated 31 January 2020

About the service

Bull Point House & Annex (hereafter referred to as Bull Point House) is a residential care home providing personal and nursing care to five younger adults at the time of the inspection. The service can support up to five people. Bull Point House is a detached property in its own grounds set over two floors with views over the Tamar river. There is a separate self-contained building called “the annex” that has ground floor accommodation for one person in close proximity to the main building.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

People were supported by exceptionally kind and caring staff. Staff went out of their way to ensure people were happy and could recognise their own goals and start to take steps towards achieving them. People were treated with dignity and respect by staff who were supported to reflect on their practice.

People had choices about what they did in a day, what they ate, and who supported them. People’s living skills were developed, and we saw clear evidence of the service encouraging people to become more independent. People were involved in the day to day running of the service, helping with cooking, shopping, admin tasks and environmental checks.

There were enough staff to meet people’s needs. Staff were recruited safely and given bespoke training, so they could develop the skills to meet people’s unique needs. Medicines were managed safely. Risks were assessed and reviewed regularly by staff who knew people well.

The service linked in with key health professionals to ensure people’s needs were being met. There was a positive behavioural support approach where interactions and behaviours were recorded and observed closely to look for themes and trends.

The service adapted the property around people to meet their individual needs. People’s rooms were highly personalised and comfortable. People enjoyed the food and could choose what they wanted to eat.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff understood consent and asked people how they would like support.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People went out when they wished to and took part in individual and community activities.

The service was well-led, by a management team that were respected and invested their time effort and resources of the provider into creating a balanced, happy life for the people living in the service. Staff told us they felt supported and the ethos of the service was person-focussed and open.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 23 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.