Lang Riggs House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding. This meant people’s outcomes were consistently better than expected compared to similar services.

This service scored 92 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider was exceptional at assessing, understanding and reviewing young people's health, mental health, wellbeing and communication needs through trauma and autism-informed lenses. Assessments were comprehensive, person-centred and continuously updated to reflect changes in presentation, risks, recovery goals and aspirations, ensuring care remained effective and responsive.

The use of the Care Programme Approach (CPA) provided a structured framework for assessment, care planning and regular review. Through ongoing CPA reviews, young people and professionals worked together to evaluate progress, identify emerging needs and adapt support in a timely manner.

The provider's highly effective multidisciplinary team (MDT) approach ensured assessments were informed by a range of professional expertise, including psychiatry, psychology, occupational therapy, mental health nursing, education and social care. This enabled staff to develop a holistic understanding of each young person's needs and coordinate interventions effectively. Staff were especially skilled at recognising the impact previous trauma and traumatic relationships had on the young people they supported. This focus on relational care resulted in staff and young people building strong relationships, stability and trust to better enable emotional regulation.

The Recovery Star model further enhanced assessment and review processes by helping young people and staff identify strengths, track progress and recognise areas requiring additional support such as emotional wellbeing, relationships, education, independence and self-esteem. Information gathered through Recovery Star reviews directly informed care planning and therapeutic interventions.

Regular placement planning meetings brought together young people, relatives and professionals to review outcomes, discuss future needs and ensure care remained aligned with individual goals. These meetings promoted collaborative decision-making and helped ensure support was tailored to the young person's changing circumstances. As a result, young people received exceptionally personalised, coordinated and recovery-focused care.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

The provider demonstrated a distinctive approach to delivering evidence-based care and treatment. Young people experienced highly personalised, recovery-focused support shaped around their individual goals which promoted their rights and independence and consistently achieved positive outcomes. There was evidence of strong multidisciplinary collaboration and a culture of continuous learning.

Young people were actively involved in planning and reviewing their care and treatment; care plans clearly reflected individual preferences, goals, aspirations, and what mattered most to them.
Care and treatment were delivered in line with current legislation, best practice guidance, and recognised clinical standards. Leaders ensured staff remained up to date with developments in mental health care and therapeutic approaches. Therapeutic interventions, risk management strategies, and recovery-focused approaches were tailored to each young person's specific needs, strengths, and circumstances. This resulted in young people learning coping and emotional regulation strategies which in turn resulted in fewer incidents of harm.

Staff worked collaboratively with psychiatrists, psychologists, community mental health teams, education providers, advocates, and families to ensure coordinated and consistent care. Young people were empowered to make decisions about their lives, develop self-management skills, and work towards greater independence while remaining safe.

Staff demonstrated an understanding of the Mental Health Act Code of Practice and consistently upheld young people's rights, ensuring access to advocacy, reviews, and the least restrictive approaches to care. Care was regularly reviewed with young people and informed by ongoing assessment of progress, outcomes, risks, and changing needs. Clinical oversight and governance systems ensured care remained effective and responsive.

Leaders actively sought and embedded learning from research, professional networks, audits, and quality assurance activities to continually improve practice and outcomes. The registered manager told us, “The home benefits from access to clinical expertise, including psychology, psychiatry or therapeutic input where available, and this informs behaviour support, risk planning and trauma-informed practice. Updates are shared with staff through meetings, supervision, handovers and policy updates.”

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The provider demonstrated an exceptionally effective approach to multidisciplinary and partnership working. The presence of a comprehensive in-house clinical team enabled seamless communication, rapid access to specialist support and highly coordinated care. Young people benefited from a genuinely joined-up service where information was shared effectively, transitions were well managed and care was centred around shared recovery goals. This proactive and collaborative approach consistently achieved positive outcomes, such as young people’s improved insight into their own emotions, building strong and stable relationships and increased participation in activities.

Young people benefited from a highly integrated in-house team consisting of a consultant psychiatrist, specialist mental health nurses, clinical psychologist, psychodynamic therapist and occupational therapist, ensuring specialist expertise was readily available and embedded within daily care. These roles supported the registered manager, deputy manager and support workers.

Clinical staff, care staff and external professionals worked together effectively, sharing information promptly and consistently to deliver joined-up, therapeutic care. Young people only needed to tell their story once; comprehensive assessments and effective information-sharing processes ensured important information followed young people throughout their care journey, reducing distress and repetition.

Detailed transition planning and thorough handovers between services supported smooth admissions, transfers and discharges, helping young people experience stable and consistent support. The in-house MDT enabled timely assessment, treatment reviews, therapeutic support and recovery planning without delays often associated with external referrals. Psychiatric, psychological, nursing, therapeutic and occupational expertise combined to address young people’s emotional, behavioural, social, educational and functional needs in a coordinated way.

The provider maintained highly effective relationships with community mental health teams, social workers, education providers, commissioners, advocacy services and other healthcare professionals to promote the best possible outcomes for young people. Regular multidisciplinary reviews ensured all professionals worked towards agreed objectives, enabling care and treatment to remain responsive to changes in need and recovery progress.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Young people were encouraged and supported to manage their own health and wellbeing, promoting independence, choice and control. Staff ensured young people could access GPs, dentists, mental health professionals and other specialist services when needed, supporting timely intervention and continuity of care.

Young people were supported to make healthy choices through participation in physical activities, meaningful occupations, education and community engagement opportunities. Staff supported young people to build practical skills such as cooking, shopping, meal planning and self-care, helping prepare them for greater independence in the future.

Staff regularly reviewed young people’s physical and mental health needs and responded appropriately when concerns or changes were identified. Staff encouraged young people to develop resilience, improve their wellbeing and achieve personal goals, reducing future reliance on care and support services. Staff worked with relatives, healthcare professionals and other agencies to promote positive health outcomes and ensure support remained coordinated and effective.

The provider routinely monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

The provider had effective systems for monitoring and improving outcomes. A strong MDT approach ensured care and treatment were regularly reviewed, clinically effective and responsive to changing needs. Young people were actively involved in evaluating their progress, and support was adapted to help them achieve their personal goals, improve their wellbeing and develop greater independence.

Care and treatment were routinely reviewed to ensure support remained effective, responsive and focused on achieving positive outcomes for young people. Strong MDT oversight ensured a range of relevant professionals worked together to review young people’s progress and evaluate outcomes from different professional perspectives.

Care reviews considered both clinical outcomes and the goals, aspirations and expectations of young people, ensuring care remained personalised and meaningful. Regular MDT discussions enabled professionals to identify emerging concerns, review treatment effectiveness and make prompt adjustments to care and support. Outcomes were monitored across multiple areas, including mental health, emotional wellbeing, independence, social development, education and daily living skills.

Staff supported young people to set and achieve realistic goals, helping them make meaningful progress towards greater independence and improved wellbeing. Information gathered through reviews, audits and outcome monitoring was used to improve care delivery and maintain positive and consistent outcomes across the service.

The provider used the Recovery Star model as a tool for monitoring and improving outcomes; the model provided a structured and person-centred framework for measuring progress across a range of areas including emotional wellbeing, relationships, education, self-care and independence.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff provided information about consent in a way young people could understand, enabling them to make informed choices about their care and treatment. Consent was embedded in everyday practice; staff routinely sought and respected consent during care delivery, ensuring young people's views, wishes and preferences were central to decision-making.

Young people were encouraged to make decisions about their daily lives, treatment and future goals, helping to build confidence and self-determination. Care plans and reviews reflected young people's preferences, goals and aspirations, ensuring support remained tailored to individual needs.

Staff demonstrated a good knowledge of consent, capacity and least restrictive practice, helping to ensure young people's rights were upheld. Consent was recognised as a continual process and was regularly reviewed as young people's needs, understanding and circumstances changed. Where appropriate, staff worked collaboratively with others to help young people participate in decisions and ensure their voices were heard.

The provider and registered manager understood information sharing about young people was governed by consent and capacity. Upon admission and throughout their placement, young people were supported to make informed decisions regarding who information could be shared with. Where a young person did not consent to information being shared with family members, staff respected their wishes unless there were safeguarding concerns or legal requirements requiring disclosure.