The Care Quality Commission
  • Mental Health
  • Independent mental health service

The Limes

Overall: Good read more about inspection ratings

Main Street, Langwith, Mansfield, Nottinghamshire, NG20 9HD (01623) 746002

Provided and run by:
Elysium Healthcare (Acorn Care) Limited

Important: The provider of this service changed. See old profile

All Inspections

During an assessment of Long stay or rehabilitation mental health wards for working age adults

Date of assessment: 24 and 25 March 2026

The Limes hospital provide long stay/rehabilitation inpatient mental health wards for working age adults.

The Limes is an 18-Bedded Level 2 mental health inpatient rehabilitation service that provides care and treatment for men who have an identified mental health rehabilitation need.

Level 2 rehabilitation provides specialised services focused on restoring function and independence for patients with moderate to complex needs, preparing them for a return to the community. This includes people who may also have a learning disability, and who may have a diagnosis of autism or Personality Disorder (PD).

The Limes is in the village of Langwith, Nottinghamshire, and situated just a short walk from local amenities. With public transportation readily available, patients built confidence in using the local bus and train networks.

Each patient had a private en-suite bedroom, and access to a shared bathroom with a bathtub. There is a therapy kitchen which has been designed like a home kitchen, enabling people to prepare meals for themselves and others. Furthermore, there is a multi-purpose room that houses computers, employment workshops, group therapy and leisure activities. The service has a spacious garden, a zen sensory garden and an allotment area, where patients can grow their own produce.

We assessed all 33 quality statements across the five key questions: safe, effective, caring, responsive, and well-led. The service was last inspected in May 2022 and was rated Good. Following this assessment, the rating has remained Good.

The Limes provided a safe, therapeutic, and personalised environment focused on rehabilitation and community reintegration. The environment was clean, well-maintained, and appropriate for the care and support it provided.

Care and treatment were delivered to a high standard. Staff demonstrated skill and innovation, delivering a wide range of interventions, including psychological therapies, vocational and educational support, and structured activity programmes. Patients made consistent progress towards independence and personal goals, with proactive risk assessments and an effective management structure in place.

Patients told us they had felt empowered, fully involved in decision-making, and supported to develop independence and control around their care. Were appropriate families were involved, and staff supported patients to maintain meaningful community connections and networks.

Leaders were visible, and focused on innovation, continuous improvement, and staff wellbeing. Staff felt empowered, valued, and supported to deliver high quality care.

Mental Health Act & Mental Capacity Act Compliance Summary

During our assessment, we evaluated the service’s compliance with both the Mental Health Act (MHA) and the Mental Capacity Act (MCA). Staff demonstrated a strong understanding of the MHA and its Code of Practice, applying it confidently when admitting and managing detained patients to ensure care remained lawful and patients’ rights were respected. Governance and oversight of the MHA and its use were robust, with clear escalation pathways, regular reviews, and effective monitoring arrangements. Patients detained under the MHA were supported to engage in decisions about their treatment, with access to independent advocacy and second opinion appointed doctors where required, providing safeguards for those who lacked capacity or were subject to treatment under legal frameworks. There was no evidence of systemic overuse or misuse of restrictive powers or practices, and leaders emphasised patient-centred decision-making when restrictions were necessary.

Staff consistently assessed patients’ capacity under the MCA to make specific decisions using the two-stage test and documented the assessments thoroughly. When patients lacked capacity, staff made decisions in their best interests after consulting the multidisciplinary team, families, and advocates. Staff clearly recorded the rationale, who was consulted, and what options had been considered. Reasonable adjustments were made to support patients in understanding and involvement in decision-making, including easy-read materials, interpreters, and adapted communication methods. Governance of MCA practices were effective, with regular audits of capacity assessments and best-interest decisions. Staff received ongoing training in the MCA, human rights, and equality to ensure decisions upheld patients’ rights and dignity.

During an assessment of the hospital overall

The Limes hospital provide long stay/rehabilitation inpatient mental health wards for working age adults.

The Limes is an 18-bedded Level 2 mental health inpatient rehabilitation service that provides care and treatment for men who have an identified mental health rehabilitation need.

Level 2 rehabilitation provides specialised services focused on restoring function and independence for patients with moderate to complex needs, preparing them for a return to the community. This includes people who may also have a learning disability, and who may have a diagnosis of autism or personality disorder (PD).

The Limes is in the village of Langwith, Nottinghamshire, and situated just a short walk from local amenities. With public transportation readily available, patients built confidence in using the local bus and train networks.

The service registered with the CQC in January 2010 and provides the following regulated activities:

Assessment or medical treatment for persons detained under the Mental Health Act 1983

Treatment of disease, disorder or injury

The service had a Registered Manager.

We visited the following service as part of the assessment:

The Limes – long stay/rehabilitation inpatient mental health wards for working age adults – 18 beds.

At this assessment we assessed 1 assessment service group: long stay or rehabilitation mental health wards for working age adults.

We visited The Limes on 24 and 25 March 2026.

At the time of our assessment, the service was supporting 16 patients’.

We assessed all 33 quality statements across the five key questions: safe, effective, caring, responsive, and well-led. The service was last inspected in May 2022 and was rated Good. Following this assessment, the rating has remained Good.

Staff provided care and treatment that was safe. The environment was clean, well-maintained, and fit for purpose. Environmental risks, including ligature points, were effectively identified, assessed, and mitigations were in place. Staff completed comprehensive risk assessments for patients and reviewed them regularly.

Care and treatments were consistently delivered in line with national guidance and best practice, to ensure the service achieved consistent outcomes for patients. Patient’s had access to a wide range of specialist support tailored to their individual needs. Staff were well trained and supported through supervision and appraisals, which enabled them to deliver high-quality, innovative care. The multidisciplinary team worked effectively together and maintained strong, proactive partnerships with external professionals to ensure continuity of care and the best possible outcomes.

Patients using the service were treated with kindness, compassion, and respect. Staff actively promoted dignity, independence, and personal choice, ensuring they remained central to, and involved in all decisions about their care. Patients told us they always felt supported to understand their rights and stay in control of their wellbeing.

There was effective leadership in place. Leaders were visible, supportive, and promoted a positive culture of learning, collaboration, and continuous improvement across the service.

04 May 2022

During a routine inspection

The Limes is a specialist rehabilitation service for men with a mental illness and/or personality disorder. The hospital is in Langwith Nottinghamshire. The hospital is run by the independent provider Elysium Healthcare Limited and provides care for up to 18 male patients aged 18 years and over. We carried out this inspection to follow up the breaches from the previous inspection.

Our rating of this location improved. We rated it as good because:

  • The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well.
  • Staff minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding. Staff engaged in clinical audit to evaluate the quality of care they provided.
  • The psychology team provided patients a range of therapeutic groups for example Mindfulness, hearing voices group, mutual help meetings and one to one work with patients. In addition, they supported staff with support groups and one to one support.
  • We saw comprehensive patients care plans that included an extensive patient history, were holistic and person-centred. We also saw positive behaviour support plans. We saw evidence of good physical health care, with physical health leads in place.
  • We observed many positive caring interactions throughout the inspection. They actively involved patients and families and carers in care decisions. Patients were involved in a January 2022 recruitment day speaking to interviewees about the service.
  • Four patients were interviewed and overall provided very positive feedback. They told us some patients are paid to undertake household chores and gave many positive compliments about the registered manager and the service doctor.
  • Staff felt valued and empowered. Some staff told us they felt happy to come to work. Staff morale was good and had improved over time. Staff and patients told us there was strong leadership. Two student nurses complimented the support from the lead nurse.
  • The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
  • Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
  • Staff supported patients with protected characteristics and made sure they received the right care.
  • Staff planned and managed discharge well and liaised well with services that would provide aftercare. As a result, patients discharge were not delayed.
  • The service worked to a recognised model of mental health rehabilitation. The model combined positive behavioural support with compassion focussed therapy, alongside Safewards. It was well led, and the governance processes ensured that ward procedures ran smoothly.

However:

  • We found gaps in the ligature audit. Ligature points identified had not been included on the audit. For example, hinges on bedroom doors, shower doors. In addition, follow up action were not included. Following the inspection, the manager reviewed ligature audit with improvements.

12-13 September 2018

During a routine inspection

We rated The Limes as REQUIRES IMPROVEMENT because:

  • Staff were not up to date with mandatory training and managers did not have clear oversight of this.
  • We found several omissions in the cleaning and temperature of the clinic room and equipment and staff did not accurately adhere to national guidance for medicines management.
  • Patient care and treatment files were disorganised and contained several assessments and care plans that were out of date. Care plans and mental capacity assessments varied in quality and detail.
  • The hospital did not provide clinical and managerial supervision to staff as often as outlined in the provider’s supervision policy and this impacted on the hospital’s recording and auditing of supervision.
  • Staff did not complete patient observations in line with the provider’s policy guidance.
  • The hospital did not effectively use nationally recognised tools to monitor patients’ physical wellbeing.
  • The hospital did not consistently use audits effectively to identify and learn from mistakes and make changes to processes.
  • Some patients and their relatives/carers told us staff did not always engage with patients when completing their observations.
  • There was no designated space for patients to meet with visitors.
  • Staff were not aware of the provider’s vision and values.
  • Staff did not consistently review and record emergency equipment, in line with their policy.
  • Staff did not consistently record they had reviewed patient’s daily risk assessments, as outlined in their local procedures.

However:

  • The hospital was well staffed and rarely used agency staff to cover short falls.
  • We observed positive and friendly interactions between staff and patients.
  • Staff provided a comprehensive programme of individual therapeutic activities to help patients achieve their recovery goals.
  • The multidisciplinary team completed a robust assessment and regular review of risk for each patient and developed individualised plans to manage these.
  • Staff worked hard to reduce restrictive practices wherever possible to support patients’ rehabilitation.
  • The hospital welcomed patients of different cultures, languages, religions, sexualities and staff had embedded equality and diversity into the everyday running of the hospital.
  • Staff were well supported by the hospital manager and staff told us they had been supported by the provider during the transfer process.