The Elms

Date of assessment: 24 September to 23 December 2025. The site visits took place on 24 September and 25 November 2025. The Elms is a residential home for a maximum of 13 people. The home provides support to younger adults, people who may be living with dementia, people with mental health conditions, those who have substance misuse issues and those who may have a physical disability. There were 11 people living there at the start of our inspection. There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. There was also a deputy manager in post. The person who carried out this deputy manager role changed part way through the inspection. The provider had a restrictive condition on its registration about not supporting people whose primary need was due to a person’s learning disability or autism. However, the provider was supporting a person with these primary needs. We considered Right Support, Right Care and Right Culture during the inspection, which is the guidance which underpins our regulation of services who support people with a learning disability and autistic people. The service was not fully meeting this guidance due to the size of the service. The provider worked to plan and mitigate risks to people, however care plans showed some risks were not always effectively planned for which could leave people at risk. The provider learned from accidents and incidents to reduce the ongoing risk to people. Staff in the home collaborated with other health professionals to help people remain well and staff shared information between themselves, so they were aware of people’s changing needs. Professionals were complimentary of the home. People were protected from abuse by staff who understood their safeguarding responsibilities and concerns were reported. People were protected through the application of the Deprivation of Liberty Safeguards (DoLS). There enough trained and safely recruited staff to support people to help keep them safe. The home was clean and tidy; people were protected from the risk of cross infection. People were generally supported safely with their medicines. People had their needs assessed and plans put in place to support them with their health needs. Monitoring tools were in place to ensure people remained healthy. People had enough to eat and drink according to their needs and preferences. The provider complied with the Mental Capacity Act 2005. People were treated with kindness, dignity and respect. People had positive relationships with staff, were supported as individuals, and offered choices to promote independence. Activities were available for those who wished to take part. Staff were supported in their roles. People’s care plans were person-centred and staff knew people well. There was a stable staff team so people had consistency, and staff could get to know people. People were supported to access health professionals and relatives were kept updated about people’s care and support. People were supported to plan for the future, including their end of life care, if they wished to discuss this. The provider and registered manager had developed a positive person-centred culture. The registered manager was approachable, and staff felt supported and able to raise concerns. The provider’s governance systems to ensure the effective oversight of the safety and quality of care were not always effective so risks to people and omissions were not always identified. The provider had failed to check or recognise some environmental risks in the home which had put people at significant risk of harm. People had been at risk of harm from hot water and exposed hot pipes in the service. Following our feedback concerns were addressed. Staff told us they felt able to raise concerns, but the whistleblowing guidance did not include details of external organisations for situations where staff might feel unable to raise concerns internally. However, no concerns were raised with us during the inspection. The provider was in breach of a regulation in relation to the governance of the service. We have asked the provider for an action plan in response to the concerns found at this assessment.