Bullen Head Office

Bullen Healthcare specialises in delivering stoma, urology and wound care products to people's homes. If the patient lives in England and their GP surgery offers the NHS Electronic Prescription Service, then the patient can nominate the service as a preferred supplier for stoma and urology prescriptions.

This was the first inspection of this service. We rated it as good because:

• The service provided safe care. This was reflected in the number of positive comments from patients about the service. Most patients were seen in their own home. The service had no plans to see patients at the clinic in the foreseeable future due to covid minimisation approaches. However, patients were seen, if necessary, at relevant GP surgeries and clinics.
• The number of patients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each patient the time they needed. Patients told us of how easy it was to access staff when needed. Staff assessed and managed risk well and followed good practice with respect to safeguarding. This was observed during a home visit. Staff followed clear personal safety protocols, including for lone working.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment and in collaboration with families and carers. The care plans created by staff related to the service provided and were noted to be personal to each patient. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the patients. Staff engaged in clinical audit to evaluate the quality of care they provided. These audits were used to improve and formulate a high level of care. Staff responded promptly to any sudden deterioration in a patient’s health. All nursing staff carried equipment such as blood pressure monitoring machines in order to assess and monitor the health of a patient during a visit.
• The teams included or had access to the full range of specialists required to meet the needs of the patients. It was reflected by GPs that the staff had more specialised knowledge that could be applied on site. Non-medical prescribers ensured that relevant treatments and appliances were quickly sourced. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. Stakeholders in the service spoke well of the service and their application of agreed goals.
• Staff understood and discharged their roles and responsibilities under the Mental Capacity Act 2005. We saw lots of evidence of consent being sought from patients and carers, reflected accurately in documentation.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. Patients we spoke to, and a visit to a patient’s home, indicated the high level of care and kindness that they received from the service. They actively involved patients and families and carers in care decisions. The products and care provided by the service was led by best practice and supported by different national organisations who assist in the care of stoma, colostomy, urostomy and bladder and bowel problems, all of whom were linked and signposted by the service on their website and in information leaflets.
• The service was easy to access. Staff assessed and treated patients who required urgent care promptly and those who did not require urgent care did not wait too long to start treatment. This was reflected in key performance indicator data. The criteria for referral to the service did not exclude people who would have benefitted from care.
• The service was well-led and the governance processes ensured that procedures relating to the work of the service ran smoothly. All aspects of governance were considered, the service had agreements with clinical commissioning groups that were regularly monitored, with no problems noted during inspection. The culture at the service was clearly open and staff were happy to talk about how much they enjoyed working at the service. Staff we spoke to knew who the most senior managers in the organisation were and stated that, as they were on site, they were a visible presence. Senior management were approachable.