Langdale Heights

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

Well-led – 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 good. At this assessment the rating has changed to outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 93 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

Leaders at Langdale Heights had developed a set of ‘Core values.’ Core values are guiding principles that shape the culture and behaviour of the organisation. These had been thoroughly embedded and had been successful in creating a home where people felt they belonged, where staff responded quickly to provide excellent, compassionate care that had been developed in partnership with families and promoted people’s independence. A further ‘core value’ of ‘Integrity in every action,’ had been successfully embedded into the management and governance practices of the leadership and staff team. In particular, the consistency of leaders and staff to do everything they did well, had helped to build a service that reliably provided people with consistent levels of high-quality care.

Leaders supported staff to fulfil their responsibilities to the best of their ability and to meet the clear standards that had been set. For example, supervisions focused on getting things right. Topics covered included, how to complete medicines audits, how to complete accident and incident report forms and how to complete wound care plans. These shared expectations, supported by clear supervision and policies, enabled staff to achieve high standards in all aspects of their work.

The leadership team continually explored how they could make things better for people. They regularly built reflection into meetings and audits to explore how they could, ‘move from good to excellent.’ They consistently identified learning points and framed these as positives rather than failures. This ensured there was a positive culture where leaders did not look to blame, rather they constantly looked how to improve.

Leaders invested in their own, and staff’s learning and development. Leaders were well qualified in a range of health and social care disciplines and actively used their experiences to develop others. For example, through the use of reflective and relevant clinical supervisions. This helped to reinforce good practice standards.

Staff we spoke with had a passion for care and wanted to do their best. Clinical staff we spoke with told us, “We strive to provide high clinical standards. I feel very well supported here. There is great team work here.” Another staff member told us, “I believe care is having passion for care, I like being here, I cared for my [family member] and I know what it feels like. I love what I do.” Another staff member told us, “It’s a nice place, I am happy to work here, we are making a difference in people’s lives, we make them smile, they make us smile.” Staff were motivated to do their best for people.

Staff development was recognised and valued. For example, staff had recently developed and contributed to a new referral protocol. Leaders had clear expectations of staff and supported them with clear guidance and protocols. These protocols made it very clear for staff when they should make a referral to other professionals, for instance when to refer to the speech and language team. This led to a shared understanding and knowledge of what care people needed and when.

The provider had exceptionally 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 always did so with integrity, openness and honesty.

Throughout our inspection, leaders in the provider group demonstrated their commitment to ensuring people living at Langdale Heights had high quality, safe care. One leader told us, “We have high standards, we are very hands on, we care very much; staff can reach out whenever they need it.”

The leadership group had a wide range of relevant skills, experience and competencies in health and social care with each Director taking an active and defined role in the service. For example, in the areas of workplace safety and employee development, clinical governance and quality assurance, pharmaceutical compliance and clinical risk management, compliance and operations and commissioning and strategic development. Leaders maintained their skills and qualifications to ensure they understood the context for health and social care provision and used skills and competencies from previous relevant work experience. Leaders were able to train staff under the ‘Train the Trainer’ qualification route for moving and handling and manual handling skills. They worked effectively as a leadership team to share their skills and embed their knowledge into the systems used at Langdale Heights. They were capable leaders who lead the team with confidence as they had the skills, competence and knowledge to do so.

Staff told us they appreciated the supportive leadership team. One member of staff told us, “The leadership team are so supportive and kind. They regularly visit and are always available on the telephone if needed.” Another staff member described leaders as, “Supportive, friendly, appreciative, helpful. They are good at teamwork, if you need help, the manager will help.” Recent incident records showed the home manager had attended the home in the early hours to help provide management oversight and help with de-escalation strategies. Leaders in the service were hand-on and supportive.

Staff received ongoing support and training and were supported and encouraged to develop. One staff member told us, “We are given opportunities to progress.” Staff completed training in a wide variety of areas relevant to their job role and received support to ensure they reached the expected levels of competence. In addition, all staff had regular supervision and appraisals. Supervision provides staff members with the opportunity to reflect and learn from their practice, receive personal support and professional development. There was an on-going programme of clinical supervision that ensured nursing staff were equipped to maintain their skills and competences.

Relatives knew the leaders in the service and told us they were approachable and available. One relative said, “The manager is always around, and the deputy; one or the other are always there.” Leaders in the service were capable, compassionate and inclusive.

Leaders and staff were clear and transparent on their roles. An organisational chart, along with an information board with all staff and their different roles was displayed in the reception area. Further details were provided when staff had additional roles, such as being ‘Champions’ for specific areas of care, for example, for nutrition and dignity. This helped ensure roles were clearly defined and understood.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us they felt encouraged to be open and transparent and had no concerns with speaking up. They fully understood the provider’s policy on whistleblowing. Whistleblowing is a law that protects staff from being treated unfairly by their employer if they have raised genuine concerns about a person’s care. One staff member told us, “We operate a very open culture.” Leaders had displayed the whistleblowing policy in the main reception, so it was easy for staff and visitors to reference.

Leaders had created a culture where staff were encouraged to speak up and their experiences listened to. For example, leaders from across the provider group visited the home and completed audits. They consistently spoke with staff members at these visits about how they could escalate any concerns. In addition, they provided staff with supervision meetings where they could reflect and learn from their practice, receive personal support and professional development and leaders spoke with staff about their well-being and stress levels. This helped to create a culture where staff were encouraged to speak up about anything that was not right and any matters that were worrying them. Leaders demonstrated they were willing to listen and try and work with staff to provide solutions to the issues they raised.

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them.

Leaders valued their staff team and worked hard to create an inclusive and positive culture. Staff valued this. One staff member told us, “We've been doing well, we all agree on one thing, if you have supportive people, the shift goes well, we have good teamwork here. We have a diverse workforce and we all get on. We all feel treated fairly.” Another staff member told us, “I feel listened to by my managers. We have a nurses’ meeting every 2 months and a daily flash meeting with all staff. We work really hard to ensure that we communicate with one another.” They added, “We are very fairly treated.”

Leaders had received recognition for the work they had done to create an inclusive and fair culture. Both registered managers at Langdale Heights had been recognised by NHS England’s 2023 Midlands Inclusivity and Diversity Award Scheme (MIDAS). One registered manager was a finalist for ‘Inclusive recruitment and talent management, while the other registered manager was awarded ‘Changemaker of the Year.’ This helped to demonstrate that leaders were passionate and committed to promoting workforce equality, diversity and equality.

Leaders had a wide range of support available to staff to help them feel included and valued. There was a flexible working policy displayed in reception for all staff to reference. Alongside this, leaders supported staff wellbeing by offering access to services that helped to support and protect their rights. This included access to mediation, financial services and education and development.

Leaders created an inclusive culture where all staff proactively contributed to the development of the service. Staff were regularly asked for their views in supervisions and meetings. A staff member had recently developed and written a protocol to help ensure referrals were made consistently. This showed staff were supported to develop and were confident to step into development opportunities.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

There was an established and embedded rolling programme of audits that had been successful in driving improvements for people. They were effective at identifying improvements and developed action plans to identify what actions were required, who was responsible, the timescale involved and whether the action was completed or still in progress. For example, they had driven improvements in people’s fluid intake. Audits and checks made by visiting Directors completing quality and compliance checks demonstrated a commitment to high standards and excellence. For example, one visit identified that, ‘care plans and risk assessments were found to be up to date and well completed however, a small number of grammatical and spelling inconsistencies were identified. Whilst these do not affect care delivery, addressing them will improve overall professionalism and clarity.’ This showed the commitment of leaders to strive for high standards in all areas of the service. Records we reviewed were consistently thorough, clear, robust and of a high standard.

Leaders from across the provider group met regularly to discuss audits, actions and any lessons learnt. Staff with roles in quality and compliance reviewed the documentation for when people moved to Langdale Heights to check it was all in place and completed to expected standards. They also completed audits and reviewed incidents to ensure all actions taken met with their expectations and standards. For example, any falls were robustly reviewed. One falls audit confirmed, ‘All required post-fall actions were completed within required timescales, demonstrating effective governance oversight and timely management response in line with CQC expectations under Safe and Well-led.’ This helped to confirm people were receiving safe care and any risks to their health were managed well. Audits, and the checks from other staff within the provider group with responsibilities for quality and compliance, added a robust level of external scrutiny to the governance work of leaders based at Langdale Heights.

The provider’s governance systems were based on clear roles and accountability and had been consistently completed. This helped to create a robust culture that was successful in delivering high quality care and treatment to people provided by a stable workforce. Leaders planned staffing in advance, and all staff had clear roles and responsibilities, with dedicated induction and supervision pathways for different roles. This helped staff have clear accountability and understand their role and how they contributed to the provider’s aims.

Regulatory responsibilities to notify for specific incidents and duties to report to other bodies, such as the Health and Safety Executive and the local authority were robustly checked to ensure all notifications and reports were submitted in line with legal responsibilities.

Robust policies were in place and embedded into the systems used to ensure protection of people’s private and confidential information. Business continuity plans were detailed and helped to ensure people continued to receive high quality and safe care in the event of a foreseeable emergency such as loss of internet connection and how the impact of on digitally held care systems this would be mitigated.

The provider was dedicated to meeting their corporate social responsibilities, giving back to communities and creating positive change. The provider had a global outreach programme where they worked in collaboration with a Nairobi-based community-based organisation to help provide health care and educational resources to young people. Additionally, the provider, as well as individual staff, held fund-raising events and donated to various local charities.

The provider was aware of their commitment to sustainability and the environment. A recycling checklist was in place to ensure waste was recycled and disposed of appropriately, with staff knowledge supported thorough specific training and supervision. This covered what could be recycled and what routes other waste should be disposed of.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Health and social care professionals who worked to provide services to people living at Langdale Heights provided positive comments on how well staff worked in partnership with them. One healthcare professional told us, “Safety of people is taken seriously. They look after and care for them well. Any queries or concerns are discussed on the ward round weekly.We help with any referrals that need to be made.”

Staff working at Langdale Heights understood how to work well with other services so that people received seamless care. For example, one staff member told us, “There is a GP ward round every Tuesday. If we have any concerns about any of our people, they can be seen by the GP as part of this round or sooner if needed. We have good relationships with the dementia rapid response team and the community team. We have regular visits with the health visitors and district nurses.”

Care plans showed people received quick and timely referrals to other healthcare services when needed. Any guidance given by visiting professionals was reflected in care plans, followed and reviewed with the external teams involved. This demonstrated people benefited from joined up care as staff worked effectively in partnership with others.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider had an established and embedded culture of learning. Systems were established to support sharing good practice and learning between the provider’s care homes. Respective leaders along with Directors with roles in compliance and quality attended regular information sharing meetings between the homes that looked at what was going well and what could improve. One leader told us, “We have open conversations to share good practice.”

Leaders were qualified in providing education and training and were ‘Train the Trainers’ for staff in areas relevant to their job roles. Staff told us, “We have lots of support for training and development.” Staff training covered a wide range of areas relevant to staff member’s job roles and the provider maintained an oversight to ensure this was completed. At the time of our inspection, staff had completed 100% of their training. This demonstrated there was a strong and consistent focus on continuous learning and development.

Further continuous learning was demonstrated by how any accidents and incidents were managed. These included thorough lessons learnt reviews that were completed and implemented through the use of effective action plans. Staff understood and supported the culture of continuous learning and development. One staff member told us, “We have incident forms if needed for reporting any incidents. We often do a lessons learnt meeting to debrief if needed. There are always lessons to be learnt.” This showed the culture of continuous learning was embedded and embraced by staff.

Innovations in health and social care was embraced by the provider. The nominated individual and some of the Directors were part of the team that had developed the digital system used to manage and record the administration of medicines at Langdale Heights. Further digital developments and innovations were planned. Leaders told us that as part of the development of the digital system, staff tested the system to help find any limitations that could then be overcome before it was rolled out.

Further innovative approaches to health and social care management were recognised in the Awards that leaders and staff had won or been recognised as a finalist for. For example, ‘Changemaker of the Year’ in 2023 from NHS England awarded to one of the registered managers at Langdale Heights. Leaders additionally supported research initiatives. For example, Langdale Heights were also a participant in a wider health and social care research study to help reduce infections. This demonstrated the provider focused on and actively contributed to continuous learning, innovation and improvement.