Langdale House

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

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding.

This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 96 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider was exceptional at making 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 their needs.

Care plans were exceptionally detailed and specific for all people. Care plans were individualised and included information specific to each person including their preferences, history, family relatives’ information, cultural and religious information and dates important to them such as family birthdays. Care plans promoted people’s choice and always involved family members.

The service was extremely inclusive of people. There were pictures of people all around the service. This included pictures they had drawn, images of themselves doing activities, pictures with staff members, pictures on holidays and pictures with loved ones. Staff told us more pictures were incorporated in the service due to person’s request. The dining room had a picture painted by an artist completed in collaboration with people. People were encouraged to choose an animal of any kind and their favourite colour which was painted by the artists. Each animal represented each person.

There were no definite mealtimes for people. They could choose if they wanted to eat separately or together and were supported to prepare their own meals where possible. We observed people baking with staff. On Friday’s, people had a food themed night which celebrated different cultures and people decided which theme they wanted each week.

People had access to regular activities and always chose what they wanted to do. Staff provided people with a detailed activity checklist which included a wide variety of choices. The checklist was given to people in a pictorial format, and they could tick the activities they had interest in.

Staff demonstrated a deep understanding of each person and delivered care and support in a way that was individualised promoting equality and equity. Staff could give clear examples of people’s likes and dislikes, from favourite colours to favourite TV shows. People were at the heart of care at Langdale House, and staff took time to understand individual wishes and needs to ensure they delivered person centred care.

Staff always promoted people’s independence. For example, when cleaning their bedrooms. People were supported to do their own laundry where possible. The provider had a system in place to ensure people’s laundry did not get mixed up. Each person had a laminated picture of themselves which was placed on top of the washing machine to identify whose laundry belonged to whom. This promoted individual independence and made it easy for people to identify their own washing.

People were promoted to lead full lives and were able to put forward their views and opinions. Several people and family members were supported on holidays they had requested. People were supported on local breaks within the country, and some people were taken on foreign holidays. People always chose their holiday destination. All holidays were risk assessed and preplanned to ensure people were safe. People were also supported to plan holidays with other people living at the servicepeople, if they wished.

The provider had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People received care and treatment from services that prioritised and understood their diverse health and social care needs and staff worked closely with relevant professionals. People had access to dietitians, occupational therapists and speech and language therapy (SALT) teams. Staff were able to give clear examples of how they worked closely with the local council to support people with enhanced therapy. For example, a person found it difficult to manage relationships and attachments with others. Staff worked with the local council teams to work together which resulted in the person being successful in maintaining healthier relationships.

We sought feedback from local professionals who worked closely with staff. They told us, “Langdale House truly exemplifies excellence in providing specialist care for individuals with learning disabilities and those who present with challenging behaviours. Staff consistently go above and beyond to meet individual needs, employing innovative and person-centred strategies to engage positively with people, even in situations involving physical or behavioural challenges.”

The provider had implemented a ‘Green Plan’ which was about reducing the carbon footprint. The provider had goals to reduce the carbon footprint and encouraged people to join the global biodiversity framework through litter picking for the local community, encouraging recycling and reducing electricity, gas and water consumption. This helped people to gain a sense of being part of the community. People were part of an environmental meeting which included their voice and as a result people and staff worked together to grow their own vegetables. Staff told us people enjoyed growing their own produce and eating it. Leaders told us their goals in reducing the carbon footprint helped people feel like they were giving back to their communities.

The provider supported work-based projects for people in bakery, gardening and textiles. The projects offered meaningful occupation and skill development. People received monetary compensation for their contribution which enabled them to feel valued for the work they produced. Some items were sold to the public. For example, bread was sold to the bakery. People were accessing these projects which contributed positively to their overall well-being and confidence. The projects offered a transport service for people who struggled to travel independently.

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People were provided with a range of accessible information about their care, treatments and support, how to keep themselves safe, and how to report any issues of concern. This information was easy for them to find. Staff tailored all information in easy read formats for all people. Staff displayed information in communal areas which was in easy read formats. Staff tailored communication to meet individual needs for each person. We saw evidence of this throughout our assessment within the environment and within care and treatment records.

Where people could not communicate verbally, we observed interactions between staff and people that demonstrated relationships were highly caring and compassionate, enabling staff to anticipate and meet the person’s needs quickly, in ways that reduced and mitigated discomfort and distress. For example, a person became distressed. Staff were able to redirect the person using de-escalation methods that worked best for them.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

People and significant others were involved in regular reviews of how complaints were managed. The service held monthly meetings for people giving them the opportunity to raise any concerns or make any requests. People were supported to raise concerns regularly as the manager had an open-door policy and we saw people utilising this on the inspection. Staff used easy read documents to make it accessible for all people. The meeting minutes provided insight into how the meetings were run. People were given the opportunity to add to the standard agenda items which included safety in the service, any ideas for improvements, changes to bedroom decorations, what has been positive in the last month, what has been negative in the last month, food choices and requests for activities. The form also had a list of people’s birthdays to ensure staff were aware of dates special to them.

People were really listened to. The meeting minutes showed evidence of improvements made following people’s requests. For example, one person requested a change of colour in their bedroom. Meeting minutes reflected these changes had taken place and we observed this on inspection.

The provider monitored compliments and complaints and kept a log. In the last 12 months there were minimal complaints made at the service. However, where concerns had been raised, the provider took appropriate action to prevent reoccurrence. Manager’s noted compliments received by staff, from relatives and professionals. There was a compliment from a relative which said, “I am satisfied with [Name’s] outcomes and goals [Name] has achieved following [their] successful move.”

People had access to advocates. The service promoted advocacy and had easy read information available for people. This included information regarding what an advocate was and how to access one. Staff gave examples of working with people’s advocates where necessary.

Relatives were involved in people’s care including risk assessments and capacity assessments. Staff regularly communicated with relatives via phone calls, emails and invited them to face to face meetings. Relatives told us they were included in the care of their loved ones. One relative told us, “I am always consulted with my [loved ones] care.”

The provider was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

Staff worked hard to mitigate barriers and support people to ensure they were not discriminated against due to their disabilities. For example, professionals told us, “When one [person] with partial blindness joined the service, staff undertook additional training to understand the impact of visual impairment from the individual’s perspective. They immediately adapted the environment such as changing room colours from white to more suitable tones, showing flexibility and a deep commitment to personalised care.”

People had access to care which promoted equality, removed barriers or delays and protected their rights. The provider complied with legal equality and human rights requirements, including avoiding discrimination, considering the needs of people with different protected characteristics and making reasonable adjustments. The provider prioritised, allocated resources and opportunities as needed to tackle inequalities and achieve equity of access.

External stakeholders provided positive feedback regarding Langdale House and gave examples of how they removed barriers for people. They said “I have placed someone at Langdale who was discharged from hospital last year. Throughout the time I have worked with them, they have gone above and beyond what I would have expected from a residential home. They made significant alterations to the persons accommodation to meet [their] needs, and have worked together with hospital staff, family and adult social care very well. The communication between managers and myself has been excellent, and any suggestions have been acted upon in a timely manner. Langdale have followed procedures whilst being person centred, in very difficult circumstances at times. I have nothing but positives to feedback.”

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

Leaders and staff prevented discrimination and inequality that could disadvantage different people using their services. They proactively sought out ways to address barriers to improve people’s experience and acted on information about their experiences and outcomes.

Staff demonstrated innovative practice in ensuring people were supported with their individual needs. Staff gave examples of how some people struggled with activities in busier environments. Staff tailored the needs to the individual to ensure they went during quieter times. Staff told us they reviewed environments beforehand to ensure people had positive experiences in the community without any discrimination.

People were supported to access community facilities. The service was located close to a local park. Staff and people told us it was accessed regularly, and people were encouraged to attend events run by the park, for example, fun fairs. The park also had a tennis court which people used. Managers told us they would invite local services to join people.

The service worked closely with local charities and care services. Staff told us people took pride in raising money for charities and gave examples of charities they had raised money for. Some people enjoyed helping older people. Staff supported people to attend care services to engage with people living at people those services.

Staff were experienced in supporting people with inequality. Staff told us they had not been in situation whereby a person was subject to discrimination, but staff were aware on how to deal with it. Staff told us they would support people by always maintaining professional mannerisms, including within the community.

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.

All people had a personal development plan. This was to develop individual goals for each person, giving them the opportunity to make decisions about their future care and support. The goals were reviewed every 12 weeks and included personal goals, how to promote independence, communication and social goals, health and wellbeing, potential risks and reducing restrictions. Plans were specific and person-centred. For example, one person’s goals included improving verbal communication, preparing their own breakfast and reducing one-to-one staffing levels. The plans included people’ voice and were tailored specifically to each person.

People were supported to make informed choices about their care and plan their future care whilst they had the capacity to do so. Where appropriate, people’s plans for the end of their life were in place. The plans documented preferences and gave the person choices under different categories. These were created in a pictorial, easy read format to ensure people could understand them. The plans included specific information regarding if the person wanted to be buried or cremated and their choice of flowers and music. For people who did not have end of life plans in place, managers had plans in place to revisit the subject in the future.