We carried out a review of the data available to us about Rix House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rix House, you can give feedback on this service.
Rix House is registered to provide accommodation for people with learning disabilities or autistic spectrum disorder. It is a purpose-built building with single rooms which have suitable adaptations to meet the needs of the people living in the home. Rix House is registered to care for 20 people and at the time of our inspection 10 people lived at the home.
We found the following examples of good practice.
The registered manager had identified, assessed and mitigated COVID-19 risks to people, staff and visitors.
Staff had received additional training during the pandemic in the correct use of Personal Protective Equipment (PPE), infection prevention and control. Staff were observed to be wearing PPE correctly and had access to this throughout the service.
Visits with relatives and friends were accommodated and adaptations made in response to the changing government guidelines. A visitor pod with microphone had been installed and window visits facilitated.
Professional visitors and relatives were tested before visits took place. Visiting professionals were also asked to provide evidence of their vaccination status prior to entering.
We found the following examples of good practice.
• The home was in a local lockdown and was closed to visitors. Prior to this, the home had amended changes to how visits took place to minimise the risk of the spread of infection. This was meeting in the community or in the enclosed garden.
• Staff at the home have ensured people using the service maintain contact with relatives. This is organised through video calls on mobile devices.
• To ensure the safety of the people living at the home, there are no respite stays taking place. This is to minimise the risk of infection transmission.
• Staff were trained in how to keep people safe and use personal protective equipment (PPE) correctly. Through observations during the inspection and during conversations with staff, it was evident that staff were aware of the responsibilities to manage infection prevention and control.
Further information is in the detailed findings below.
People’s experience of using this service:
At our last inspection in June 2018, we raised concerns about medicines management and quality assurance systems and the service was in breach of Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations. At this inspection we found improvements had been made and the service was no longer in breach of these Regulations.
Medicines were being administered safely and people’s dietary and healthcare needs were met. Infection control procedures were being followed and the service was clean and tidy.
The registered manager provided staff with leadership and was approachable and keen to keep high standards within the service. Audits and checks were carried out and used to drive continuous improvements to the service people received.
The service did not fully apply the principles and values of Registering the Right Support and other best practice guidance, although plans were in place, working with local commissioners, to achieve this in the future. This guidance helps ensure 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. However, the service promoted independence and provided person-centred support within the constraints of an environment where a large number of people shared communal facilities. People were encouraged to access the community and undertake person centred activities. The provider was working with the local authority to alter the environment and move to a supported living model on a different site which would help ensure the principals and values were fully applied.
People told us they felt safe living at the service and appropriate safeguarding referrals had been made. Staff had received safeguarding training and understood how to keep people safe. There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.
Staff were caring, compassionate and knew people well. There was a culture within the home of treating people with respect and dignity. People’s feedback was used to make changes to the service.
A range of meaningful activities were on offer to keep people occupied, according to their individual interests.
Care plans were up to date and detailed the care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to mitigate any risks which had been identified.
Staff were recruited safely and there were enough of them to keep people safe and to meet their care needs. Staff were receiving appropriate training which was relevant to their role and people’s needs. Staff were supported by the registered manager and were receiving formal supervisions where they could discuss their on-going development needs.
The service met the characteristics of Good in all areas; more information is in the full report.
Rating at last inspection: At the last inspection in April 2018, the home was rated requires improvement.
Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection we found improvements had been made and the service is now rated Good overall.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our reinspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rix 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. Rix House provides accommodation and personal care; it does not provide nursing care.
At our last comprehensive inspection in January 2016 Rix House was rated ‘good’ overall. However, due to concerns with the way medicines were managed the safe domain was rated ‘requires improvement’. We completed a focused inspection in June 2016 to check the issues with medicines had been addressed. We saw some improvements had been made to the medicines management system. However, we could not improve the rating for safe from ‘requires improvement’ because we did not see evidence of consistent and sustained good practice. At this comprehensive inspection we found some of the persistent issues around medicines management had still not been addressed. Therefore we have rated the service ‘requires improvement’ in the safe and well led domains. This means the service is now rated ‘requires improvement’ overall.
Rix House accommodates up to 20 people in one adapted building. The service specialises in caring for adults with learning disabilities. At the time of our inspection there were 14 people living at the home and two people who were staying for a short period of respite care.
The service was working in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
A registered manager was in place. A registered manager is a person who has 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.
People received personalised care from staff who were kind, caring and friendly. Staff knew people well and adapted their approach to meet people’s individual needs.
Medicines were not always managed in a safe and consistent way; improvements were still needed to ensure people consistently received the right support with prescribed creams, lotions and drops. This issue has been repeatedly highlighted as requiring improvement by the Commission.
Staff knew how to recognise and report concerns about people’s safety and welfare. Systems were in place to ensure risks were appropriately managed.
Staff received appropriate training to ensure they had the skills to deliver effective care. Before staff could start work appropriate checks were made to ensure they could safely care for vulnerable people.
The home was clean and tidy and the provider ensured the environment was safe and suitable for vulnerable people to live in.
Staff supported people to engage in interests and activities both within the home and in the local community. Staff respected people’s interests and personal pursuits.
People were involved in developing menus which meant they received food and drink which they enjoyed. Nutritional risk was effectively managed.
Staff worked in partnership with other agencies and healthcare professionals to ensure people maintained good health. The registered manager sought local and national initiatives which they could participate in to help improve the quality of care people received.
Staff treated people with compassion, dignity and respect. There was a positive focus on empowering people to be as independent as possible.
There was an open and inclusive culture. People and their relatives were involved in making decisions about their care and how the service operated. Staff respected people’s views and responded to their concerns.
Staff continuously sought new ways to communicate with people and ensure everyone had the opportunity to consent to the care they received and express their views. Staff worked in line with the requirements of relevant legislation such as the Deprivation of Liberty Safeguards (DoLS).
Staff told us they would recommend the service as a place to receive care and as a place to work. Feedback about the registered manager was very positive; people told us they were hands on and led by example.
Systems and checks for monitoring the quality of care were in place however they did not always identify and address areas for improvement. Shortfalls in service delivery were not always promptly addressed and sustained.
We identified one breach of legal requirements. You can see what action we told the provider to take at the back of the full version of the report.
We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk”
Rix House is located in Keighley and is registered to provide accommodation and personal care for up to 20 people who have a learning disability and complex needs. Accommodation is situated over two floors with communal dining and living areas. To the exterior of the building is a small communal garden.
At the time of the inspection there were 17 people living within the home. There were also two respite beds which eight other people used on a periodic basis.
Overall, we found improvements had been made to the safety of the service and it was no longer in breach of regulation. Medicines were managed safely and people received their medicines as prescribed. The process for managing covert (hidden) medicines had been improved. Some improvements had been made to medicines records for topical medicines such as creams, however these improvements needed to be consistently applied.
Medication audits were undertaken, however the frequency of these needed to be increased to help robustly monitor that medicines were consistently managed in a safe way.
We could not improve the rating for Safe from Requires Improvement because to do so requires consistent good practice over time and evidence that the remaining discrepancies on MAR charts for topical medicines were addressed and sustained. We will check this during our next planned comprehensive inspection.”
At the time of the inspection there were 17 people living within the home. There were also two respite beds which eight other people used on a periodic basis.
The inspection was unannounced and took place on 15 and 18 January 2016. The last inspection took place in May 2014 and the provider was compliant with the standards we looked at.
A registered manager was in place. A registered manager is a person who has 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.
People and their relatives we spoke with told us they were highly satisfied with the service. They spoke particularly positive about how kind and caring staff were and how the service listened to people and valued them as individuals.
Some people who used the service were unable to verbally communicate with us, however we extensively observed care and support including people’s gestures and body language. We observed excellent caring interactions between staff and people who used the service. People looked comfortable and relaxed around staff. Creative methods had been used by the service to communicate effectively with people. Staff had an excellent understanding of the individual methods of communication each person used.
People and their relatives said people were safe living in the home. They did not raise any safety related concerns with us. Staff we spoke with had a good understanding of how to identify and act on allegations of abuse and we saw examples where the registered manager had followed safeguarding procedures to keep people safe.
Improvements were needed to some medicine management practices. For example covert medicines were not given in line with recognised guidance. More robust stock monitoring systems were required for boxed medicines.
There were sufficient numbers of staff deployed to ensure safe care and support. Staffing levels were such that people received a high level of interaction and social opportunities. Staff were safely recruited to help ensure they were of suitable character to work with vulnerable people.
Risks to each person were assessed by the service and an individualised plan of support put in place to help keep people safe.
The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act (MCA).
People had access to a range of food within the home based on their choices. People were supported to maintain good nutrition.
Staff received a range of training which was kept up-to-date. Staff received regular supervision and appraisal.
Staff had an excellent understanding of the people they were caring for. This included a high level of understanding of people’s likes, dislikes and preferences. Staff displayed a motivation and passion for providing caring and personalised care to people.
People’s needs were fully assessed and a range of appropriate care plans put in place. Staff had an excellent understanding of people’s plans of care and how to meet their individual needs. The service had worked with people to research and put in place individual solutions to enable people to achieve positive care outcomes.
People participated in a range of activities and social opportunities which met their individual needs. The service owned a minibus which increased the range of opportunities available to people.
A range of audits and checks were undertaken by the service to assess, monitor, and improve the service. We saw these were effective in identifying issues and taking action to resolve them.
Relatives and staff spoke positively about the registered manager and said they were effective in dealing with any concerns or queries.
We saw evidence people’s views were used to making positive changes in the service.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) 2014 Regulations. You can see what action we asked the provider to take at the back of this report.
Is the service caring?
Is the service responsive?
Is the service safe?
Is the service effective?
Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, staff supporting them and from looking at records.
Is the service safe?
During our inspection we looked for the answers to five questions;
Is the service caring?
Is the service responsive?
Is the service safe?
Is the service effective?
Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, staff supporting them and from looking at records.
Is the service safe?
People told us they felt safe. Safeguarding procedures were robust and staff we spoke with understood how to safeguard the people they supported.
Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
Is the service effective?
People's health and care needs were assessed with them, and they were involved in writing their plans of care.
People's needs were taken into account with signage and the layout of the service enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments.
Is the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People completed a range of activities in and outside the service regularly.
People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.
People knew how to make a complaint if they were unhappy. People told us they had never needed to make a complaint but if they did they thought complaints would be investigated and action taken as necessary.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way.
Staff had attended several training courses which took into account the needs of the people who used the service. This ensured that people's needs were met.
We looked at the policy for infection control and inspected all communal and some restricted areas. We found the property to be clean and tidy with cleaning schedules in place.
We looked through the Statement of Purpose (SoP) and found clear aims and objectives for the service. All records requested were brought promptly and stored in a secure and confidential way. We saw evidence that appropriate documents were destroyed when they were no longer needed as recommended by best practice guidelines.
We spoke with four people that used the service and one person said "they enjoyed the food" and another person said "they liked the staff." People we observed indicated that they enjoyed the surroundings of the home and the interaction with others working and living at the home.