Lang Riggs House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Young people benefited from an environment where concerns about safety were encouraged, listened to and acted upon. Staff understood their responsibility to report incidents, near misses and emerging risks, and were confident concerns would be taken seriously and addressed appropriately. This supported an open culture where safety was viewed as everyone's responsibility.

There were effective systems in place to investigate incidents and safety events. Records showed managers reviewed incidents promptly, identified contributory factors and implemented actions to reduce the likelihood of recurrence. Learning from incidents was shared with staff through team meetings, handovers and supervision sessions, ensuring good practice was consistently embedded across the service.

Leaders recognised the importance of understanding the unique risks associated with supporting young people who may experience periods of emotional distress, self-harm, anxiety or behavioural crisis. Staff demonstrated a reflective approach to managing these risks and worked collaboratively to review support strategies when incidents occurred. This ensured care remained responsive, person-centred and focused on achieving positive outcomes.

Staff told us they felt supported to raise concerns and were encouraged to contribute ideas for improving safety and quality. They described an open management culture where mistakes were viewed as opportunities for learning rather than blame. This promoted psychological safety and helped managers identify areas for improvement at an early stage.

The provider used information from incidents, complaints, safeguarding concerns and quality assurance activities to identify themes and trends. Where learning was identified, changes were made to practice, risk management arrangements and staff training.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Detailed transition timelines were in place for young people when they were moving into the service which were individually tailored. If young people found the transition into Lang Riggs House emotionally overwhelming, staff followed trauma informed practices to provide a high level of emotional reassurance and relational support.

Any new referrals were screened to ensure the young person’s needs could be met by the provider. The provider met with the young person and supported them to be involved in discussions around their care pathway and transition. The registered manager told us, “Referrals are considered carefully and are not accepted unless we are satisfied that we can meet the person’s needs safely. We review the referral information, risk history, health needs, behaviour support needs, safeguarding information, medication, education, family contact, legal status, staffing requirements and any known trauma or triggers. We consider compatibility with the current young people living at the home, including age, gender, vulnerability, risk presentation, known triggers, peer dynamics, environmental risks and whether the staff team has the right skills.”

Professionals, such as the registered mental health nurse and psychologist prepared and completed presentations for staff about new people entering the service. The information was detailed and included the person’s background, presenting concerns and advised staff on how best to support them.

The provider managed transitions and referrals out of the service very well. The provider shared information or escalated concerns to external services and appropriate bodies as necessary. The registered manager told us, “Moves out of the service are planned with the placing authority, family where appropriate, health professionals, education, advocacy and the receiving placement. We share current care plans, risk assessments, medication information, health information, communication needs, routines, likes and dislikes, behaviour support strategies and key learning from the placement. Young people are supported to understand the move in a way that is meaningful to them, with visits, social stories, transition work or keyworker sessions where appropriate. We aim to reduce anxiety, avoid abrupt endings, maintain dignity and ensure the next placement has accurate information to support continuity of care.”

The provider ensured professionals such as hospital staff had all the relevant information about a young person if they were transferred to them.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff recognised young people with mental health needs often faced complex vulnerabilities and ensured safeguarding arrangements reflected their individual experiences, risks and preferences. The registered manager told us, “Safeguarding is everyone’s responsibility and is embedded through safer staff recruitment, induction, training, supervision, clear reporting routes, whistleblowing, an open culture and daily oversight. Staff are expected to recognise and report abuse, neglect, exploitation, peer-on-peer concerns, professional boundaries, self-harm, missing episodes and any allegation against staff.”

Young people were supported in an environment where their wellbeing, dignity and rights were promoted. Staff demonstrated a good understanding of safeguarding responsibilities and were committed to protecting young people from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Care and support were delivered in a way which balanced safety with people's rights to make choices and develop greater independence.

Staff worked collaboratively with external partners when safeguarding concerns arose, helping to ensure young people received coordinated support and protection. Safeguarding concerns were recognised, reported and escalated promptly. Leaders promoted open communication, professional curiosity and partnership working to ensure young people remained safe while being supported to achieve their goals and live fulfilling lives.

Staff understood the potential indicators of abuse, exploitation, self-neglect and emotional harm and received training and ongoing guidance which enabled them to respond appropriately to concerns. Staff considered safeguarding as part of their everyday practice and remained alert to changes in young people's presentation, behaviour and emotional wellbeing. Young people were encouraged to express their views and discuss any worries or concerns.

Staff developed positive and trusting relationships which helped young people feel comfortable sharing information and seeking support when needed. This person-centred approach enabled staff to identify risks early and respond in meaningful ways to the individual.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff recognised young people had individual strengths, aspirations and vulnerabilities, and tailored support to balance safety with independence, choice and recovery. Young people were actively involved in understanding and managing risks which affected their lives, with support which was proportionate and person-centred.

Risk assessments and care plans were developed with young people and reflected their physical health, mental health, emotional wellbeing and social circumstances. Staff considered risks holistically, including those associated with self-harm, emotional distress, relationships, community access, education and developing independence. Rather than focusing solely on risk avoidance, staff worked alongside young people to understand what mattered most to them and how these goals could be achieved safely. This approach enabled young people to maintain control over their lives while receiving appropriate support and protection.

Staff demonstrated a good understanding of each young person's individual needs and the strategies required to support them safely; this was clearly demonstrated in the daily morning staff shift handover meeting, which we attended. Support plans provided clear guidance on managing identified risks while promoting positive outcomes and personal development. Staff used least restrictive approaches and adapted support in response to changes in young people's circumstances, emotional wellbeing and mental health needs. This helped ensure care remained responsive and proportionate to the level of risk.

Young people were encouraged to participate in discussions about their care, support and risk management arrangements. Staff took time to explain risks and explore options with young people, helping them to make informed decisions and develop confidence in managing their own wellbeing. Young people either had a positive behaviour support plan or distress management plan which aided the staff team to manage risk; these identified strategies to use to reduce distress such as distraction techniques and coping skills and identified early warning signs for each young person.

The provider regularly reviewed risks in partnership with young people, their relatives and external professionals, where appropriate. Changes to support arrangements were informed by ongoing assessment, professional advice, incidents and feedback from young people. This collaborative approach helped ensure risk management remained dynamic, relevant and focused on achieving the best possible outcomes for young people.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider had effective arrangements for monitoring and maintaining the safety of the premises. Safety checks and servicing schedules in place ensured the environment remained safe and suitable for its intended purpose. Equipment used by staff and young people was maintained appropriately, and any defects or concerns were addressed without delay which reduced the likelihood of equipment failures affecting the safety or quality of care provided. Premises and equipment safety certificates were in place and up to date.

Leaders understood the importance of creating an environment which balanced safety with the need for young people to feel comfortable, respected and at home. Environmental risk assessments considered both general health and safety risks and those associated with supporting young people experiencing emotional distress, self-harm or periods of crisis.

Risks were reviewed regularly and responded to promptly when changes were identified. The registered manager told us, “Premises and equipment are overseen through daily health and safety checks, monthly audits, fire safety checks, maintenance reporting, infection control checks, equipment checks, environmental risk assessments and manager walkarounds. Staff are expected to report defects immediately and urgent risks are escalated to senior management, maintenance contractors or emergency services if needed.” Our review of records confirmed this.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff were recruited safely, with appropriate pre-employment checks carried out before staff started working with the service which included Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff had opportunities to learn, and any poor performance was managed appropriately.

Staffing arrangements were planned around the individual needs, risks and preferences of young people, helping to ensure care was delivered safely, consistently and in a way which promoted positive outcomes.

Some young people required enhanced emotional support and responsive interventions during periods of distress; leaders maintained oversight of staffing levels and adjusted deployment where necessary to ensure young people received timely support. Staff were available to provide individualised care, build positive relationships and respond effectively to changing needs and risks.

Staff possessed the skills and experience required for their roles and received training and relevant to supporting young people with mental health needs. Training covered key areas including safeguarding, risk management, mental health awareness, de-escalation and promoting positive outcomes. This helped staff develop the knowledge and confidence needed to provide safe and effective care.

Staff received regular supervision, appraisal and ongoing support from leaders; this provided opportunities for reflection, learning and professional development, enabling staff to continually improve their practice. Staff told us they felt well supported and were able to seek guidance when required. Leaders monitored staff performance and competency to ensure standards of care remained high. A staff member told us, I enjoy working at Lang Riggs House, I get good support and supervision monthly with the deputy manager or registered manager.”

There was evidence of effective teamwork across the service. Staff communicated well with one another through handovers, team meetings, supervision sessions and daily discussions. Information about young people's needs, risks and progress was shared appropriately, helping to ensure consistent care and support.

Staff demonstrated a good understanding of the young people they supported and tailored care to meet individual needs. Leaders promoted a culture of learning and continuous improvement. Training needs were identified and addressed promptly, and learning from incidents, safeguarding concerns and feedback was shared with staff to strengthen practice. The provider recognised maintaining a competent and confident workforce was essential to delivering safe, high-quality care.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Systems and processes supported the early identification of infection risks, and appropriate action was taken to reduce the likelihood of transmission within the home. Infection prevention and control formed part of the provider's wider approach to safety and quality assurance.

The environment was clean, safe and well-maintained. Staff understood their responsibilities for preventing and controlling infections and followed policies and procedures designed to minimise risks. Environmental hygiene was monitored to ensure communal areas, bedrooms and shared facilities remained safe and suitable for use. Young people were encouraged to clean their own personal rooms, with staff assistance, if necessary.

Risks associated with infection were assessed and managed appropriately. The provider considered individual health needs, potential vulnerabilities and emerging infection risks when planning care and support. Staff remained vigilant to signs of illness and took prompt action when concerns were identified, which helped protect young people while maintaining a supportive and homely environment.

Staff received training and guidance in infection prevention and control and demonstrated an understanding of good hygiene practices, the use of personal protective equipment where required, and measures to reduce the spread of infection. The provider had arrangements in place to identify and respond to outbreaks or significant infection concerns.

Measures taken by the provider supported both safety and wellbeing, enabling young people to continue participating in education, social activities and therapeutic interventions wherever possible.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were managed in as safe way. We inspected documents from the provider remotely including Medicine Administration Records (MAR), ‘when required’ (PRN) protocols, medicines audits and Controlled Drug (CD) records.

MAR charts reviewed for multiple people showed consistent and complete entries, with allergy statuses recorded and minimal missed doses, although isolated issues were noted such as unclear signatures and a small number of missed administrations. PRN protocols were present and generally detailed, but some inconsistencies were identified such as guidance on desired outcomes.

Medication error reporting was thorough overall, with most incidents clearly described, investigated, and followed up with appropriate actions, demonstrating a positive learning culture.
CD registers showed good practice with regular stock checks and dual signatures, but some corrections were unclear, with no guidance in the policy on how to do it properly and adherence to policy when amending entries.

Medicines management audits were consistently completed with appropriate documentation, including summaries or action plans where applicable. The medicines policy was up to date and comprehensive, covering key areas including self-administration risk assessments and CD procedures, although it lacked a clearly named responsible individual.

Overall, the service demonstrated effective medicines governance with some minor areas for clarification and improvement. The provider responded promptly to our feedback about medicines management.