Lang Riggs House

• Staff wore appropriate PPE and followed the current guidance. All visitors and staff were asked to complete a health declaration stating they were free from any COVID-19 symptoms. Hand sanitiser was provided in the entrance area and visitors were required to wear a mask.

• Staff helped people keep in touch with their family and friends through the use of technology.

• Up to date infection control policies and procedures were in place and adhered to.

• Daily management briefings about COVID ensured information was shared with staff.

Further information is in the detailed findings below.

Lang Riggs House is a residential care home providing personal and nursing care to four people aged 16 to 25 years old at the time of the inspection. The service can accommodate a maximum of four people in one adapted 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 received an exemplary standard of effective mental health rehabilitation because they were supported by an in house, highly skilled staff team. Staff received bespoke training which focused on how best to support people in an individualised way. 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.

People experienced positive outcomes because of the excellent standard of person-centred support staff provided. People had exceeded expectations and goals set by clinical professionals. People engaged in education, volunteer work and community projects. Staff understood the importance of positive risk taking and how to develop people’s confidence and life skills.

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 received safe care. Staff protected them from the risk of abuse and avoidable harm. People’s medicines were managed in a safe way. Staff monitored, analysed and learnt from accidents and incidents. Staff maintained accurate records. There was a very high standard of effective communication with people, staff and other stakeholders.

People told us they felt involved in decisions made about their care and treatment. Staff supported people in a kind and respectful way. Staff had built trusting relationships with people and understood the best way to communicate with them. The service effectively used Positive Behaviour Support (PBS), this approach is a person-centred framework for providing long-term support to people with a learning disability, and/or autism, including those with mental health conditions, who have, or may be at risk of developing, behaviours that challenge.

The service was well-led. The registered manager had left their role before the inspection and an interim manager was deployed by the provider immediately. The interim manager had a good understanding of the service and people they supported. Governance systems were robust and all staff were involved in the running of the service. The provider and senior management team had identified some shortfalls before the inspection and had an improvement plan which showed clear timelines and action planning.

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 18 July 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.

Lang Riggs House is a residential home providing high quality accommodation and personal care for young men and young women between the ages of 16-25 years. The home is in a residential area on the Bolton/Atherton border. The detached property has been built to an exceptionally good standard and is set in extensive mature gardens. The ground floor comprises of lounge/dining area, games room, kitchen, toilet, treatment room, laundry, stores rooms and an office. Upstairs, all bedrooms are single occupancy and there were two bathrooms and a staff bedroom.

At the time of the inspection there were three people living at the home. There was one vacancy and during the inspection a person came to look at the home and speak with staff with a view to moving in.

The home specialises in the care of people who are diagnosed as, recovering from mental health problems, who may require help through talking therapy, taking medications, regulating their emotions and to manage risks to themselves or others due to which they are not ready or not able to live with family or independently.

This was the first inspection of Langs Riggs house since registering with the Care Quality Commission (CQC) in 2015.

The registered manager had recently left the service. The registered manager from the company’s other home was in the process of adding Lang Riggs as a second location to their registration. The registered manager had worked across both locations and was based at Lang Riggs. The registered manager was experienced, highly motivated and had extensive knowledge about the service.

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 and associated Regulations about how the service is run.

All staff at the home were dedicated to providing care to a very high standard of care. They strived for excellence through consultation, they were passionate and dedicated to the young people they were supporting in assisting them to achieve goals and aspirations. The provider’s visions and values were understood and shared across the team, and they were fully supportive of development plans. The culture of the service was open and transparent.

People’s care records were person centred and tailored for them as individuals and where appropriate families were included. People were supported by staff who knew them well and understood their complex needs.

People at the home told us they were happy and felt safe. They were encouraged and supported to follow their own interests and hobbies. Each person planned discussed activities on a weekly basis with staff.

People were encouraged to maintain a healthy and nutritious diet and were including in shopping and meal preparation.

Staffing levels were high to meets people’s needs. Rotas were flexible to ensure that enough staff were available to accompany people on activities or appointments as required.

People lived in a safe environment and risk assessments were carried out to minimise risks without taking away people’s right to make decisions.

Staff spoken with demonstrated an in-depth awareness of the principles of the Mental Capacity Act (MCA) 2005 and associated Deprivation of Liberty Safeguards (DoLS).

New staff were recruited with the involvement of people who used the service. All checks were in place before they started work and they received a comprehensive induction. The aims and objectives of the induction were specific to the service, to meet the staff team and people who used the service and to understand day to day information.

We found the system for managing medicines was safe and we saw how the staff worked in cooperation with other health and social care professionals.

The provider had quality assurance systems in place, which helped to monitor and assess the quality of care and services delivered. Results of surveys were shared and actions they had taken in response to questionnaires.

There was a complaints policy and procedure in place to deal with and respond to any complaints/concerns in a timely manner if required.