During an assessment under our new approach
Date of assessment 27 May to 28 May 2026. This inspection was undertaken due to the age of the existing rating.
Lang Riggs House is a small residential care home located in a quiet suburb of Bolton. The service offers specialist transitional therapeutic and rehabilitative residential placements for young people young adults with complex and distressed presentation in the context of mental health and neurodevelopmental conditions. At the time of this inspection, 4 young people were being supported. Lang Riggs House is part of Nestlings Care Ltd.
There were exceptionally robust and well-embedded systems in place to promote safety and manage risk. Staff demonstrated an understanding of their responsibilities in identifying, preventing and escalating concerns. Safety incidents were consistently well documented, analysed in depth and used as opportunities for reflective learning. Learning was shared proactively across the team and embedded into practice. Staff received high-quality, role-specific training in safeguarding and safety processes, which was regularly refreshed and enhanced to reflect emerging best practice.
Risk assessments were highly person-centred, dynamic and completed to an excellent standard by skilled and knowledgeable staff. These were subject to frequent review and adapted promptly in response to any change in needs or presentation. Staff anticipated and responded swiftly and effectively to changing risks, including deterioration in mental or physical health, medical emergencies and behaviours of distress. Staff were well supported by experienced leaders when managing complex or high-risk situations, leading to consistently safe outcomes.
Staffing levels were carefully planned, consistently responsive and based on a thorough understanding of individuals’ needs. Rotas were managed flexibly to ensure continuity, stability and strong therapeutic relationships. There was a strong focus on staff wellbeing, and staff did not work excessive hours. Medicines were managed to a good standard, with robust governance systems ensuring safe administration and ongoing monitoring in line with best practice.
Young people’s physical, mental and social needs were comprehensively and holistically assessed. Care and treatment were consistently delivered in line with current evidence-based best practice and reflected innovative, recovery-focused approaches. There was strong multidisciplinary collaboration, ensuring seamless and coordinated care across services. Staff systematically collected, analysed and used care data to drive continuous improvement and consistently achieve positive and meaningful outcomes for young people.
Care was delivered with a highly compassionate, person-centred approach. Staff demonstrated a deep understanding of each young person’s preferences, strengths and aspirations, and consistently treated them with dignity and respect. Independence was actively promoted, with young people empowered to make informed choices and take control of their lives. The environment was thoughtfully designed and adapted to support autonomy, privacy and emotional wellbeing, enabling young people to thrive.
The service was led by a highly effective, visible and inspirational registered manager, supported by a skilled leadership team. Leaders consistently demonstrated a strong commitment to delivering outstanding, person-centred care and fostering a culture of continuous learning and improvement. Staff described a highly positive, open and inclusive culture, where they felt valued, confident to speak up and actively involved in service development.
Governance and quality assurance systems were highly effective, driving innovation and sustained excellence. Feedback was actively sought from young people, relatives and professionals, and was systematically reviewed, analysed and used to inform service improvements. Complaints were welcomed as opportunities for learning and were managed with openness and transparency.
We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider ensured people with a learning disability and autistic people were supported with respect, equality, dignity, choice, independence and inclusive access to their communities.
Right Support:
Young people led rich and meaningful lives, with consistent support to pursue their interests, goals and aspirations. Staff worked proactively with young people to develop personalised strategies to manage periods of distress, enabling them to remain safe while maintaining independence. Young people were supported to have maximum choice and control over their lives, with staff consistently applying the least restrictive approaches in line with best interests' decision-making. Systems, policies and leadership oversight strongly reinforced and sustained this practice.
Right Care:
Young people received exceptionally kind, compassionate and responsive care. Staff demonstrated a detailed understanding of individual needs, preferences and communication styles, ensuring care was consistently tailored and effective. Privacy and dignity were consistently upheld to a high standard. Staff were skilled in safeguarding practices and demonstrated confidence in recognising, preventing and responding to potential abuse. There were consistently enough skilled staff to meet young people’s needs safely. Communication with young people was a particular strength, with staff using innovative and consistent approaches to ensure young people could fully understand information and express themselves.
Right Culture:
The service had a strong, values-driven and inclusive culture, with a clear and sustained focus on achieving outstanding outcomes for young people. Leaders promoted openness, transparency and accountability at all levels. Young people and those important to them were actively and meaningfully involved in all aspects of care planning and service development. Leadership presence, strong partnership working and effective communication significantly reduced the risk of closed cultures.