The Langford Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality person-centred care, supported learning and innovation, and promoted an open, fair culture.

At our last assessment we rated this key question Requires improvement. At this assessment the rating has remained Requires improvement.

The service was in breach of regulation for the governance at the service. This is because governance processes did not always operate effectively. The service did not always have robust governance processes in place to ensure that issues were promptly identified and actioned. For example, the environmental checks and audits staff completed were not always sufficient to provide assurance. We found some issues with medicines governance and oversight. Issues raised by patients in community meetings were not always followed up.

However, leaders had the skills, knowledge and experience to perform their roles. Staff knew and understood the provider’s vision and values and how they applied to the work of their team. Staff felt respected, supported and valued, and had access to the information they needed to provide safe and effective care.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff knew and understood the provider’s vision and values and how they were applied in the work of their team. The staff members we spoke with told us that they were confident that the patients were receiving good care.

The provider’s senior leadership team had communicated the organisation’s vision and values to the frontline staff in this service. Eighty six percent of the staff members who participated in the 2026 staff survey felt that their work for the provider was very and moderately meaningful. Ninety three percent felt that their work had a positive impact on the wider community.

Senior leaders visited the services regularly and staff described them as supportive, approachable, and responsive. A staff member described to us how a monthly meeting between nursing staff and senior leaders helped with discussing issues and finding solutions.

Staff told us they felt respected, supported and valued. The service promoted equality and diversity in daily work and provided opportunities for development and career progression. Staff could raise any concerns without fear and would have no hesitation to do so.

We scored the service as 3. The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. Ward managers were supported by a well-established senior leadership team and had a good understanding of the service they managed. They could explain how the team was working to provide quality care.

Leaders were visible in the service and approachable for patients and staff. The staff we spoke with told us that senior leaders were supportive.

Staff development was supported through access to further training and courses. Staff we spoke with reported that the provider offered opportunities for ongoing learning and professional development. The provider had introduced monthly continuous professional development sessions that were open for all staff to attend. The provider reported that attendance was good and continued to grow.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Patients and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. The service was conducting regular staff and patient surveys and corresponding action plans were in place. Managers and staff had access to feedback from patients, carers and staff and used it to make improvements.

The staff we spoke with told us that they felt able to speak up when they needed to. All the staff members who participated in the 2026 staff survey stated that they understood the provider’s whistleblowing policy.

Patients and staff could meet with members of the provider’s senior leadership team to give feedback. Patients had the opportunity to raise concerns, compliments and make suggestions for improving the service in community meetings. There was also a patient council. Patients provided feedback at the clinical governance meetings.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Leaders took action to review and improve the culture of the organisation in the context of equality, diversity and inclusion. All staff were completing diversity and inclusion training as part of their mandatory training programme.

Staff were able to apply to work flexibly to account for personal circumstances such as caring responsibilities and health issues. A staff members told us that over the past couple of years there have been significant improvements on how the provider was supporting staff with sickness, parental responsibilities and other family commitments.

The provider undertook equality monitoring of staff to ensure it is diverse in its make-up and representative of the patient group. The staff team at The Langford Centre were made up of people from diverse backgrounds. The provider actively recruited staff from overseas and the staff we spoke with told us that they were well supported to adjust to living and working in a new country.

We scored the service as 1. The evidence showed significant shortfalls. The service did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The service did not always have robust governance processes in place to ensure that issues were promptly identified and actioned. The checks and audits staff completed were not always sufficient to provide assurance. For example, daily environmental checks completed by staff did not identify changes to the environment that placed patients at risk of harm, such as repairs done on bedroom wardrobes which could be used as fixed anchor points for ligatures. The ligature risk assessments had not been updated to reflect these risks. We also found some issues with medicines governance and oversight. Audits from the pharmacy provider showed extensive interventions recorded including prescribing and administration errors, however the provider had only recorded one medicines incident in 2025. There was limited governance to ensure PRN protocols were reviewed after prescribing changes. While audits and pharmacy support were in place, these did not always identify or address risks, including gaps in documentation and out of stock medicines. Issues raised by patients in community meetings were not always followed up. For example, patients had repeatedly raised concerns about staff not always respecting patient’s privacy, such as knocking on doors before entering the patient’s bedrooms, but we found no evidence that these concerns had been recorded and actioned.

However, there was a clear framework of what staff must discuss at ward and hospital level to ensure that they shared and discussed essential information, such as learning from incidents and complaints. Managers ensured that the improvements and actions plans were in place and were regularly reviewed and updated.

Staff maintained and had access to the hospital level risk register. Staff could escalate concerns when needed. Staff reviewed the risk register during clinical governance meetings.

Staff understood the arrangements for working with other teams, both within the provider and external, to meet the needs of the patients.

Team managers had access to information to support them with their management role. This included information on the performance of the service, staffing and patient care.

Staff had access to the equipment and information technology needed to do their work.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Staff regularly engaged with external stakeholders, such as commissioners and community teams. For example, the service was liaising with commissioners for delayed discharges and community placements. The service participated in the NHS Culture of Care programme, a transformation initiative which aims to make mental health wards safer and more therapeutic. This involved staff attending sessions in various locations across the country, and collaborative working with NHS trusts and other providers.

Staff maintained community partnerships and worked with local organisations to support patient care. For example, the service worked with an external professional to promote physical exercise with patients with mobility issues.

Patients and staff could meet with members of the senior management team and commissioners to give feedback. Staff understood the arrangements for working with other teams, both within the provider and external, to meet the needs of the patients. The provider organised carer events throughout the year to help improve communication between the service, patients and their carers.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

Managers gave staff time and support to make improvements and this led to changes. For example, the service had introduced a dedicated security lead to oversee all security issues across the hospital, including delivery of security training, review of all security policies, and support staff with security incidents.

The service was member of networks relevant to the service and learned from them. For example, the service was a member of the Quality Network Forensic Mental Health Services. This is a quality improvement network for secure inpatient forensic mental health services in the UK which aims to facilitate quality improvement through a supportive network and peer-review process. Being a member of the network meant that the service received peer reviews alongside carrying out peer reviews for other services. Staff were also able to attend different forums and conferences organised by the Quality Network Forensic Mental Health Services.