Cornwall Partnership NHS Foundation Trust

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

At our last inspection we rated this key question requires improvement. At this inspection the rating has remained requires improvement. We identified 2 breaches of the regulations in relation to timely access to assessment and treatment, and timely access to psychological therapy. The score of 1 for the quality statement ‘Equity in access’ limits the key question rating to requires improvement.

Requires improvement: Some people experienced long waiting times to start care and treatment. However, staff provided person-centred care and gave people and carers information about care and treatment in a way that met their needs. Care was integrated to reduce the need for people to repeat their story to professionals. Staff supported people with activities outside the service, such as work, education and family relationships. The service identified inequalities and worked to overcome these to provide equitable experiences and outcomes for people. Staff helped people with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result. Staff helped people plan for their future.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with them, how to respond to any relevant changes in their needs.

Staff and managers across all teams in the adult community mental health service told us they were committed to working in a person-centred way. For example, some staff told us that some people who used services were paranoid about receiving telephone calls, so staff would send them text messages instead if they needed to contact them.

We spoke to 14 people who used services and 3 carers. Most people told us their care and treatment suited their needs and preferences. One person told us their crisis management plan was very specific to their needs, and staff had successfully implemented it when they experienced a mental health crisis.

Staff considered people’s previous history to help identify support they needed. For example, one person who used services presented as very unwell, with unusual behaviour. However, because staff were aware of their previous history of urinary tract infections, which can sometimes affect behaviour, they made sure to investigate whether there was a physical reason for the person’s change in behaviour rather than assuming it was only caused by their mental health.

Most staff and managers told us that people’s communication needs and any reasonable adjustments were identified and supported during their first assessment and considered throughout their time with the service.

Staff displayed consideration of people’s wellbeing when we were on inspection. For example, when we asked to observe care, staff considered individuals' needs and preferences as well as their risks, to ensure there was no detrimental impact on people.

When concerns were raised about people, staff considered the best approach to support their individual needs. For example, clinic staff raised concerns about someone during the daily huddle, so it was decided they would carry out a visit of the person before clinic started, to make sure they were alright.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff supported people who used services to access community activities and opportunities that they could continue to engage with after discharge. This ensured they had meaningful activities and support in place once their involvement with the adult community mental health service ended. Staff and managers told us about a range of community-based groups and activities they worked alongside or referred people to, for example community allotment groups or voluntary organisations.

Staff ensured people had access to education and work opportunities where appropriate. Some staff and managers told us they supported people to attend recovery college courses on a range of subjects. They also worked with local colleges and universities to support people’s wellbeing whilst they completed education. Some staff told us about employment specialists they referred to within teams, who supported people to find suitable paid employment.

Staff worked closely with partner agencies who provided housing and social support. We saw evidence of this in care records.

The trust’s clinical strategy described its approach to addressing health inequalities through partnership working and by developing services around localities and neighbourhoods. Staff demonstrated a good understanding of the diverse needs of people who used services and the challenges specific to their local communities, such as poor internet connectivity and limited public transport. Staff and managers consistently told us they considered these factors when planning and delivering care, adapting support to meet people’s individual circumstances and improve access to services.

The service provided appropriate, accurate and up-to-date information in formats tailored to individual needs.

The adult community mental health service complied with the Accessible Information Standard, which is a legal requirement for organisations providing NHS care. The standard ensures people with disabilities or sensory impairments receive information and communication support in formats they can access and understand.

When people were referred to the service, they received a phone call from an assessor. The assessor informed people about what to expect with their assessment, including how it would be conducted, and what the potential outcomes might be. An email was then sent which included a leaflet that repeated what to expect from an assessment and advising people of what to do if they experienced a mental health crisis. Staff and managers told us this helped to manage people’s expectations about the service and the support they may receive.

We saw evidence that people's communication needs were identified, recorded and responded to appropriately. For example, an autistic person had requested to receive appointment summaries by email after appointments, and records demonstrated this preference was routinely respected and followed.

The service could access interpreters and translation services if needed. Most staff told us they had never experienced any difficulty in getting any interpreters. We saw evidence in care records that people’s language preferences were recorded.

The service made sure everyone referred to them had information about what to do in a mental health crisis. Appointment letters included crisis telephone numbers. People also had crisis management plans that provided information on how to access help and support if their mental health declined.

People were told about how they could raise concerns or complaints. We saw posters in reception areas about how to make a complaint. Reception areas also contained information about local mental health services people could access.

At the time of our inspection, there was a quality improvement project across the trust which focused on identifying, recording, and responding to the communication needs of people who used services and carers. The aim was to better understand individual communication preferences and ensure that appropriate adjustments were made.

Most staff and managers told us about plans across the service to improve how carers were involved and supported. At the time of our inspection, the trust was in the process of updating its carers policy and had signed up to the Triangle of Care. The Triangle of Care is an improvement tool based on 6 principles to ensure providers include and support unpaid carers.

People could access information about medicines in a range of formats, including easy read. Posters and leaflets about medicines also provided website addresses for people to find out more information.

The service made it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. They involved them in decisions about changes to services.

The adult community mental health service sought feedback from people who used services and carers in a range of ways. Senior leaders told us feedback helped provide a comprehensive understanding of people’s experience of using the service, and they used this feedback to support continuous feedback. The service used the NHS’s friends and family test alongside an independent feedback forum. It also took part in the National Community Mental Health Survey.

The service had reviewed its 2025 National Community Mental Health Survey (published 31 March 2026). The trust was developing an action plan at the time of our inspection and had identified areas of focus including improving physical health support and routine feedback and co-production. The trust scored mostly above the national average in questions related to people’s experience of care.

The trust told us it also reviewed feedback it received through its experts by experience group, the carers partnership board hosted by Healthwatch, voluntary sector partners, Healthwatch Cornwall and any feedback given face to face.

The trust’s clinical strategy emphasised the importance of co-producing services with people who used them and carers. Some managers told us about a ‘scrum week’ in which people with lived experience of using services worked with staff to review and rewrite policies and processes, identify what was working well and identify where improvements could be made. This had led to a review of the entire patient journey from first contact letters to assessment processes and communication about treatment.

Some staff told us about co-production they had been involved in, such as the creation of information leaflets about psychosis in the early intervention team (EIT) East.

Across community mental health teams (CMHTs), most staff and managers told us about work that was underway to improve how carers were identified, supported and involved. We saw plans to review the offer for carers within EIT, which staff told us would then be replicated across the service.

In the 12 months prior to our inspection, the adult community mental health service received 92 complaints. Of those complaints, 17 were withdrawn, 10 were declined for various reasons and 4 achieved an early resolution. Of the remaining complaints made, 22 were not upheld, 19 were partially upheld and 9 were upheld, and 11 were recorded as ‘blank’. Complaints spanned a range of topics and there were no clear themes to complaints raised across the service or in individual teams. During that period, the trust was not made aware of any complaints referred to the Parliamentary and Health Service Ombudsman.

We spoke to 14 people who used services and 3 carers. All knew how to raise concerns, or where to find information about how to raise concerns if needed. Two people we spoke to told us they had raised concerns. One told us their issue was resolved quickly and the other told us they were not informed of the outcome after they raised concerns.

The service did not always ensure people could access care, support and treatment when they needed it. High demand and insufficient capacity resulted in long waits for assessment and treatment, particularly for psychological interventions, with some people waiting over five years to begin therapy.

In April 2026, the month before our inspection, the service carried out an ‘assessment week’ in which CMHT staff were asked to complete assessments to help clear the backlog of people awaiting assessment within the mental health access and brief treatment team (MHABTT). A MHABTT caseload review had identified 200 people were waiting for a routine assessment, which should have been carried out within 20 working days of being referred. Of the 200 people waiting for a routine assessment, 60 people had been waiting since the end of 2025, and of those, 25 people had not been offered an appointment. The service’s assessment week enabled the completion of 135 of the 200 assessments on the waiting list. The service carried out a ‘learning from experience’ review of the April 2026 assessment week and identified learning and recommendations to prevent similar situations in the future, as well as identifying how to improve the service’s response should a backlog in assessments occur again.

Data from 30 April 2026 showed there were 241 people on the waiting list for assessment with MHBATT. The service’s operating procedure stated the internal KPI to complete routine assessments within 20 working days (4 weeks). At the end of April 2026, of the 241 people awaiting assessment, 104 had been waiting for longer than 4 weeks, equivalent to 43% of those on the waiting list. Of those 104, 8 had been on the list between 18 and 52 weeks.

Waiting list data showed that at the end of April 2026, 301 people were on waiting lists for their first appointment with a CMHT. Of those 301 people, 241 had been on the list for under 18 weeks, equivalent to 80% of all people on the list. MHABTT provided brief treatment interventions, which meant most people waiting for their first appointment with a CMHT would already have received or started a treatment intervention.

Data from May 2026 showed that across CMHTs, 320 people were receiving psychology interventions, whilst a further 846 people were waiting to start psychology interventions, 201 of which were under the care of North Cornwall CMHT. In some CMHTs, people had particularly long waits to start psychology interventions. In North Cornwall CMHT, 96 people had been waiting to start psychology sessions having been added to the waiting list between September 2022 and December 2024. In Kerrier CMHT, 36 people had been waiting to start psychology sessions having been added to the waiting list between March 2021 and December 2024.

In the 12 months prior to our inspection, the service recorded 163 incidents of delayed access to care within the community mental health service. None of the 163 reported incidents resulted in severe harm or death. Of the 163 incidents, 60 resulted in no harm, 95 resulted in minor harm, 6 resulted in moderate harm, and 2 were near misses.

Most staff we spoke to told us their caseloads ‘now feel better’ and referred to having recently held high caseloads whilst teams experienced staffing vacancies and sickness. Some managers told us caseload data would not be a true reflection of everyone that each member of staff was responsible for, as reporting methods did not include people whose key worker was on long term sick leave.

Caseload data showed a high number of people on the ‘allocation’ caseload, which meant they had not been allocated a key worker. Across community mental health teams (CMHTs), in May 2026 there were 805 people on allocation caseloads. Although people received 3-weekly wellbeing calls whilst on the allocation caseload, being on the allocation caseload delayed people’s access to consistent support.

Some managers told us, and the trust confirmed, they were in the process of reviewing their processes for data collection and patient flow.

The trust had co-produced guiding principles to working with people with mental health problems and substance use, often known as dual diagnosis. The principles ensured substance use was not a barrier to people receiving care and treatment. Staff and managers understood the need to consider people’s need holistically, so that substance use was not an automatic disqualifier for receiving care and treatment. Some staff and managers told us the only time substance use would affect a person’s treatment would be if they were too intoxicated to be assessed at that time, in which case they would rearrange the appointment.

All teams we visited were based in buildings with accessible ground floors. They had accessible toilets available for staff and people who used services.

The service actively sought and listened to information about people who are most likely to experience inequality in experience or outcomes. They tailored care, support and treatment in response to this.

Staff were trained in equality, diversity and human rights. Across teams, compliance with equality, diversity and human rights training averaged 91% in May 2026.

Staff and managers across all teams in the adult community mental health service displayed a good understanding of the needs of their population. They told us about local issues that affected people’s mental health and wellbeing, such as geographical isolation and a largely seasonal employment market. Some staff told us they were looking at how to better support particularly isolated groups, such as those in rural farming communities.

The trust had completed its patient and carer race equality framework (PCREF) self-assessment. The self-assessment included actions, action owners and progress updates. The trust had started to engage with local groups that represented people from ethnic minority groups. The trust told us at the time of our inspection, it was developing a refreshed PCREF delivery plan to ensure implementation progressed in a structured and sustainable way.

The service monitored its use of Community Treatment Orders (CTOs). Data showed that the use of CTOs reflected the demographic profile of the trust’s population, with no evidence that any group was disproportionately or unfairly subject to a CTO.

All trust policies and procedures had equality impact assessments to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Some staff told us they had been trained to do assessments for neurodivergent people. This helped them to identify and provide any reasonable adjustments people may need.

Early intervention teams (EIT) worked with people for up to 3 years. For people who did not have a neurodivergent condition such as autism spectrum disorder, EIT staff started planning people’s discharge 6 months before the end of the 3 years. For neurodivergent people, EIT staff started planning their discharge 9 months before the end of the 3 years to support any neurodiverse needs that needed to be taken into consideration during the process.

The service supported people to plan for important life changes, so they had enough time to make informed decisions about their future.

Staff supported people to make decisions about their care and treatment and their future. They developed care plans to account for the person’s needs, wishes and feelings. We observed an initial assessment, in which staff discussed the person’s aims for the future.

We saw evidence in care plans of people’s individual goals, such as returning to employment or education, and reducing alcohol consumption.

Care plans included crisis management plans. These detailed the actions people should take in the event of a deterioration in their mental health, and included emergency contact numbers. One person who used services told us when their crisis plan was followed, it supported them to remain out of hospital. Unfortunately, they said that another team had not followed it and they required inpatient treatment.

Some staff and managers told us about professionals meetings. These enabled staff from a range of teams to work together to identify the best way to support people to move forward in their care and treatment.

We observed clinic care being delivered. Staff told people about what to expect in future appointments, including physical health checks, and a change of staff.