RICE - The Research Institute for the Care of Older People

Updated 11 February 2022

RICE - The Research Institute for the Care of Older People is the registered provider. The provider runs the NHS memory clinic for Bath and North East Somerset on behalf of the local Clinical Commissioning Group and Local authority through a sub-contract with Virgin Care.

The clinic is situated at 8, The RICE Centre, Royal United Hospital Bath, Combe Park, Bath BA1 3NG.

This is a limited company incorporated at Companies House. It is also a registered charity founded in 1985 with a Board of Trustees. The Trustees include a geriatrician, a psycho geriatrician, a retired GP, a dementia research professor, a solicitor and a finance expert. The Trustees are also the Directors of the company.

The RICE clinic undertakes clinical research into dementia and provides a Memory Clinic to enable diagnosis of dementia and to identify or supplement treatment options. Referral pathways are for people with milder dementia symptoms and adults 18 years and older. Referrals to RICE are made by the patients GP or by self-referral.

The RICE clinic is registered as the only location with this provider for the following regulated activities:

• Diagnostic and screening procedures
• Treatment of disease, disorder and injury

The clinic is situated in a three storey building, which is owned by the charity, within the grounds of the Royal United Hospital Bath. It has its own car park and level access. There is a passenger lift to all floors, although consultation rooms for patients are mainly on the ground floor and occasionally on the first floor.

The staff team at the RICE clinic consists of a consists of a Consultant Geriatrician, Academic Geriatrician, and Memory Clinic physicians and nurses, a senior psychologist and a number of other psychologists, administrative staff and domestic staff.

The opening hours are 8.30am to 5pm Monday to Friday with appointments between 9am and 4pm.

How we inspected this service

We gathered and reviewed information from a range of sources, including information held by the Care Quality Commission.

We used several methods for the inspection, for example talking to people using the service, their relatives or friends, interviewing staff, observations and review of documents.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 11 February 2022

This service is rated as Outstanding overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Outstanding

Are services responsive? – Good

Are services well-led? – Outstanding

We carried out an announced comprehensive inspection at the Research Institute for the Care of Older People (RICE) on 9 November 2021. This was part of our inspection programme and the first inspection of this service.

The Research Institute for the Care of Older People (RICE) is the registered provider. RICE has two main functions: conducting clinical research into dementia and related conditions and providing Memory Clinic

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. RICE is a research centre conducting a wide range of studies which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

The Nominated Individual is the current Chair of the Trustees, whilst the Registered Manager is the lead clinician and Director of the Charity. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Four people who used the service provided feedback about the service during the inspection. We also reviewed documentation demonstrating RICE engaged with people using the service, their carers and other stakeholders.

Our key findings were:

• The service had clear systems and processes which protected people from abuse and avoidable harm. All staff had received safeguarding training, demonstrated understanding and had escalated concerns. The service assessed patients over 18 years and was reviewing the training provided for clinical staff in line with national guidance.
• Patients experienced an effective holistic and evidence-based needs assessment, care and treatment at the clinic resulting from leading research carried out there.
• The service led quality improvement initiatives at national and international levels with the aim of enhancing the lives of people living with dementia and providing support to their carers.
• Staff were recognised experts in the field of dementia diagnosis, care and treatment.
• RICE initiated and took part in global research studies (commercial and non-commercial) to develop effective treatments for dementia and related conditions including Alzheimer’s disease and Parkinson’s disease.
• The service involved and treated people with compassion, kindness, dignity and respect. We saw they are empowered as partners in their care, practically and emotionally, by an exceptional and distinctive service.
• RICE provides an innovative service tailored to meet the needs of individual people that is delivered in a way to ensure flexibility, choice and continuity of care.
• The leadership, management and governance of the organisation assures the delivery of high-quality and person-centred care, supports learning and innovation, and promotes an open and fair culture.

The areas where the provider should make improvements are:

• Implement the Adult and Child safeguarding training provided for clinical staff as appropriate to their role in line with RCGP Intercollegiate Guidelines.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care