Pennine Care 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 good. At this inspection the rating has remained good.

Good: This meant people’s needs were met through good organisation and delivery. Staff delivered person-centred care. Teams and services were integrated to enable staff to provide continuity of care. People were given information about their care and treatment and involved people in service design. The service met the needs of everyone who used services, including those with a protected characteristic. Staff were knowledgeable about health inequalities and sought to address these. The service treated concerns and complaints seriously, investigated them and learned lessons from the findings. The service actively sought ways to encourage feedback from people who used services. Staff helped people plan their care to help achieve their future goals.

This service scored 75 (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 people, how to respond to any relevant changes in people's needs.

Staff across teams told us they focused on providing person-centred care and during our inspection we saw examples of how staff achieved this. For example, appointments were made in places and at times that suited people's preferences. Additionally, 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.

Staff had a good understanding of the needs and preferences of people they worked with. During meetings and conversations in offices, staff demonstrated empathy and persistence in maintaining contact with people who were harder to engage, which reduced people's isolation and risk of relapse.

Care was based around individual needs and preferences. Discussions with people who used services focused on what mattered to them. For example, we observed an appointment during which the person who used services jointly planned their care with their consultant psychiatrist. The consultant asked them how they felt about different aspects of their care and treatment and what they would like in the future. They explained why it was not the right time for certain treatments the person wanted, and how they could work together to get them ready for that treatment in the future.

Staff and managers told us they often identified people on their caseload who might have a learning disability or be neurodivergent, despite not having a diagnosis. However, they linked in with the relevant teams to ensure people were fully supported in a way that met their individual needs. When we visited one early intervention team (EIT), staff were scheduled to do a joint visit with learning disability staff later that day.

Most care plans we reviewed were person-centred, individualised, and reflected people's recovery goals. In all but two teams we inspected, Heywood and Middleton CMHT and Bury CMHT, care plans were consistently written with details that were clearly specific to the individual, such as hobbies that helped support their mental health and wellbeing.

The adult community mental health service provided a more assertive approach to supporting people in community mental health teams (CMHT) that did not have a local assertive outreach team. Staff and managers told us that they provided a more enhanced level of support to provide more frequent and assertive support for people who might be experiencing difficulties such as maintaining accommodation or relationships with peers and family.

Staff respected people's gender identities. We saw evidence in care records that staff used people's preferred pronouns.

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.

The trust had a well-established service user involvement group called PEER (patient experience and engagement). People who accessed the adult community mental health service could join PEER. We saw evidence of PEER involvement in a range of initiatives that supported the service, such as providing lived and living experience guidance for the trust’s sexual safety approach.

The community mental health service had a strong focus on co-production of services with people who used them and carers. For example, it co-produced a new community pathway standard operating procedure with input from over 140 stakeholders, including people with lived experience. We saw evidence that the Living Well neighbourhood mental health teams’ service model had been co-designed with people with lived experience and carers.

The adult community mental health service provided employment support for people through their individual placement and support service (IPS). IPS is a model of supported employment specifically tailored for people with serious mental illness that helps promote recovery through obtaining jobs that align with someone’s strengths and preferences.

Teams were designed to be responsive to people’s needs. For example, Community Treatment Orders (CTOs) could be overseen by the service’s non-medical responsible clinicians. This meant there were more staff available to respond when people under CTOs needed to be recalled to hospital if their health deteriorated.

Staff supported people to access groups and activities in their communities. For example, some staff told us they supported people to attend the local gym. This meant people who used services would have a familiar and established routine to support them after being discharged from services.

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

The service had access to translation and interpretation services. Staff across all teams told us examples of having people’s care plans, risk assessments and other information translated into their first language. They told us about the interpreter service they used to ensure people whose first language was not English could be fully involved in their appointments and decision making. However, some staff told us it was sometimes difficult to find interpreters for specific languages. They told us that if they had difficulty booking interpreters, they would record it as in incident, so the trust’s equality and diversity team was made aware of the issue. Some staff told us they had escalated interpreter availability issues to senior managers previously, which had resulted in interpreters being found and booked.

The adult community mental health service complied with the Accessible Information Standard. For example, we saw evidence in 2 care records that British Sign Language interpreters were used for appointments and visits with Deaf people. However, some staff told us British Sign Language interpreters were sometimes hard to find.

We spoke to 12 people who used services and 10 carers. They all told us they had enough information about the care and treatment being provided. Most people mentioned that staff explained things to them, including diagnosis and medicines information, so they could be fully involved in decisions about their care and treatment.

Staff ensured people were made aware of other sources of information and support. In waiting rooms, we observed posters and information leaflets on a range of local support groups people could access. Some of these were in different languages.

The adult community mental health service ensured carers were provided with sufficient information about people’s care and treatment and diagnoses. This supported their own wellbeing whilst enabling them to care for their loved one. The trust is a 1-star accredited member of the Triangle of Care, an initiative managed by the Carers Trust which supports care providers to become carer-friendly providers that understand, support and value the role carers have in being part of someone’s care team. The trust was working towards gaining 2-star accreditation in 2026. Within the service, carers had access to support and education programmes, carer groups and newsletters that kept them notified of important information about services and helped improve their understanding of their loved ones’ diagnosis and treatment.

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

People who used services and carers had opportunities to provide feedback on the adult community mental health service. The service encouraged people to respond to the Friends and Family Test by using postcard surveys, QR code flyers and posters, and an online survey on the trust’s website. The trust told us six volunteers supported the service with collecting telephone feedback and more volunteers had been recruited. Friends and Family Test feedback was reviewed to identify any gaps and was reported to the trust-wide Patient Carer Voice and Impact Group. This enabled ongoing oversight and supported continuous improvement in patient and carer experience.

Between October 2024 and September 2025, the adult community mental health service received 21 complaints. The data supplied by the trust stated the most common theme of those complaints was patient care and clinical treatment, followed by communications. Data shared with us showed that across the adult mental health service and mental health crisis and home treatment teams, the trust received 31 complaints between October 2024 and September 2025. Of those 31 complaints, 12 were not upheld, 4 were unsubstantiated and 15 were partially upheld or upheld. The data did not state the themes of complaints that were upheld, partially upheld, not upheld or unsubstantiated. The data did not state the number or themes of complaints specifically in relation to the adult community mental health service.

Between October 2024 and September 2025, the Parliamentary and Health Service Ombudsman (PHSO) informed the trust of 3 complaints it had received in relation to the adult community mental health service. Of those 3, the PHSO decided to take no further action in relation to 2 complaints and was considering whether to proceed with the third complaint at the time of our inspection. The trust confirmed the PHSO had not upheld any complaints referred to it in relation to the adult community mental health service in the 12 months prior to our inspection.

We spoke to 12 people who used services and 10 carers. All of them told us they either knew how to make a complaint or would feel able to find out how if needed. Of the 22 people we spoke to, only 1 said they had raised a concern and they told us the service resolved the matter quickly and they were happy with the outcome.

Managers had a good understanding of the complaints process and spoke positively about complaints as an opportunity to learn and improve. For example, actions had been put in place to improve communication after referral in one of the community mental health teams (CMHTs) following a complaint about lack of contact.

Some managers told us they met with local partners such as Healthwatch to gain feedback on services.

The trust committed to involving lived experience in all projects that led to changes or improvements in the organisation. The trust told us projects had to have engagement plans to show how they would engage people with lived or living experience of using services. ‘Being Shaped by Lived Experience’ and ‘Shaped by Lived Experience’ awards were achieved by projects that had successfully implemented their engagement plan and could evidence how they had listened to, and acted on, what people with lived experience had said as well as involving them in decisions about the project.

The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff, managers and senior leaders told us the adult community mental health service had increasingly high levels of demand. Despite this, people did not have to wait long to be seen once referred to the service. In September 2025, about 80% of people referred to one of the community mental health teams (CMHTs) had an appointment within 28 days of being referred. Data shared with us did not state individual waiting times people experienced.

The service’s early intervention service teams (EIT) had a target of 60% for people to have an appointment within 2 weeks of being referred. NHS England’s access and waiting time standard states 60% of people with a first episode of psychosis should start treatment within two weeks of referral. Across EIT, the 2-week target was consistently achieved at rates significantly higher than the 60%, though data shared with us did not state how long all people were waiting. Bury EIT, for example, regularly achieved 100% of referrals being seen within 2 weeks. This meant people were able to start accessing the care and treatment they needed without delay.

The trust had a target that 80% of people who were discharged from inpatient wards would have a follow up from a team in the adult community mental health service within 72 hours of discharge. From October 2024 to September 2025, the service exceeded the target in every month except November 2024, when 74.6% of people received a follow up within 72 hours, and July 2025 when it was 78.57% of people. Everyone received a follow up after being discharged.

We asked the trust for details on its current waiting lists. The trust provided data that showed overall compliance rates with national and trust targets and the numbers of people on specific waiting lists. The data did not give detail about any individual waiting times.

We spoke to 12 people who used services and 10 carers. All of them told us they had not had to be on a waiting list upon being referred to any of the teams in the adult community mental health service.

Some staff told us about specific work the service had undertaken to improve access and remove barriers to access for people who used services. For example, the trust worked with a local charity to address mental health inequalities faced by the South Asian community in Oldham. The project sought to address mental health inequality and inequity, by ensuring the South Asian population in Oldham were equipped with the knowledge, resources, and community support to address their mental health, and have equitable access to mental health services where needed.

We observed equality impact assessments for all trust policies. This helped ensure that reducing inequalities was considered in all aspects of service provision and ways to reduce inequalities, such as any barriers to access, were identified.

Staff and leaders tried to reduce health inequalities. They tailored people's care, support, and treatment in response to this.

In 2024 the trust established its Health Inequalities Oversight Group and one of its focuses was on implementing the Patient and Carer Race Equality Framework (PCREF). PCREF is a national framework which aims to reduce the racial inequalities often seen in mental health. The trust worked with a neighbouring trust on implementing PCREF across Greater Manchester and had participated in community engagement events as a Greater Manchester Reducing Racial Inequalities Provider. The trust had presented on their progress to date at the NHS England Advancing Mental Health Equalities Task Force Meeting in June 2025. We saw evidence the trust had received praise for the progress it was making, particularly in the development of a local dashboard to help monitor inequalities, from NHS England. The trust's PCREF self-assessment had identified areas of focus, such as on collecting demographic data. We saw evidence in care records and in Community Treatment Order (CTO) application data that demographic data was collected.

Health inequalities were included in the trust's strategy and annual plan. The trust told us their strategy adopted a 'prevention first' approach. Staff and senior leaders told us the community transformation aimed to reduce health inequalities by providing a greater level of preventative support.

Staff were trained in equality and diversity. All teams across the adult community mental health service had at least 88% compliance, with most teams at 100%.

All staff, managers and senior leaders were knowledgeable about the health inequalities often faced by people who used services. For example, some staff told us about how peopled diagnosed with serious mental illness often have worse physical health than the rest of the population. In response, the service had a significant focus on supporting people's physical health.

Staff made sure they reduced barriers to people being fully engaged and supported in their care and treatment. For example, some staff in Oldham EIT told us they had friends and family support group posters translated into other languages and booked interpreters for the groups. They also tried to meet individual requests and had booked a different language interpreter for a future group.

The adult community mental health service monitored its use of CTOs in relation to ethnicity and gender. Ethnicity data from financial year 2024/25 showed no evidence of any ethnicity being disproportionately subject to CTOs.

Senior leaders told us care hubs had been set objectives as part of their business plan to improve understanding about access and outcome inequalities locally.

Managers were proactive in increasing staff's understanding and awareness of inequalities. For example, in one team there were upcoming learning disability awareness activities scheduled in an effort to improve the identification of learning disabilities within electronic care records. The aim was that staff would then be able to identify and flag when someone had additional learning needs that meant staff could adapt their care to better suit their needs.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

We saw evidence that in some people’s care records, advanced decisions had been recorded. This enabled staff to know what someone’s treatment preferences were, or who they would like to make decisions on their behalf, should they lose capacity.

People who used services told us they were involved in making decisions about their discharge plans. Some people told us they had been previously discharged from the adult community mental health service and had been fully involved in planning. Others told us they were involved in planning their transfer to different teams.

In the Stockport assertive outreach team, some staff told us about the team’s ability to support people’s early discharge from hospital by providing proactive outreach support. They explained their team could provide the level of support needed in the community to prevent lengthy hospital admissions for some people.