Pennine Care NHS Foundation Trust

Ratings - Well-led

• Well-led Our assessments of NHS trusts now focus on leadership. We no longer rate trusts overall for their safety, effectiveness and responsiveness or how caring they are. We do still publish those ratings for the services they provide.

  Good

Our view of the service

This assessment gave the trust an overall rating of good for its leadership, culture and governance. There were no breaches of regulation although there were a few areas where the trust should make some improvements. We assessed all 8 of the quality statements in the well-led key question used when assessing an NHS trust using our current framework.

Pennine Care NHS Foundation Trust provides mental health, learning disability, and autism services to people across Greater Manchester and the surrounding areas. They serve a population of 1.3 million and their vision is a happier and more hopeful life for everyone in their communities.

They employ approximately 4700 staff and deliver care from 88 different locations in six boroughs:

• Bury
• Glossop
• Oldham
• Rochdale
• Stockport

• Tameside

The trust has an annual budget of £350 million.

The trust provides 11 services within our assessment service groups (ASGs).

• Community based mental health services for adults of working age
• Mental health crisis services and health based places of safety
• Child and adolescent mental health wards
• Forensic inpatient and secure wards
• Acute wards for adults of working age and psychiatric intensive care units
• Wards for older people with mental health problems
• Long stay or rehabilitation wards for adults of working age
• Community based mental health services for older people
• Substance misuse services
• Community learning disability services
• Specialist community health services for children and young people

The well-led review followed assessments of the following frontline services. The initial assessment of the trust’s services was triggered by the age of the trust’s ratings. We assessed six front line services from November 2024 onwards.

The ASGs we assessed included:

• Community based mental health services for adults of working age
• Mental health crisis services and health based places of safety
• Wards for older people with mental health problems
• Child and adolescent mental health wards
• Acute wards for adults of working age and psychiatric intensive care units
• Forensic inpatient and secure wards

We undertook these assessments to ensure we had a thorough understanding of a range of services provided by the trust ahead of our well-led review. Across services, we found assessments identified committed and caring staff, generally positive team cultures and examples of effective Multi-Disciplinary Team (MDT) working, alongside clear opportunities to strengthen consistency in risk assessment, person‑centred care planning, governance arrangements and workforce capability.

• Acute and Psychiatric Intensive Care Units (PICU) services were rated Requires Improvement, with a Section 29A Warning Notice issued to drive rapid improvement in safety, medicines management and oversight.
• Older People’s wards were rated Requires Improvement and needed further development in personalised care and staffing stability.
• Adult community mental health services and crisis teams were rated Requires Improvement and demonstrated strong engagement but experienced capacity and access pressures.
• Forensic services were rated Good with targeted compliance and estate actions required.
• Inpatient Child and Adolescent Mental Health Services (CAMHS) were rated Good and showed notable improvement in leadership and therapeutic culture despite ongoing environmental, staffing and discharge challenges.

Since these assessments, the trust has responded with timely action plans to address the findings and support improvement.

During this assessment we undertook a visit to the trust’s headquarters from 24 February to 26 February 2026. We carried out interviews with more than 25 members of the trust’s leadership team, including the chief executive, trust chair, executive medical director, chief operating officer, executive director of nursing, quality and healthcare professions, and executive director of finance. We also held interviews with non-executive directors.

During the assessment we also:

• ran focus groups with; trade union leads, staff network leads, governors, and service user and carer groups
• spoke with trust leads for equality diversity and inclusion, use of force and reducing restrictive practice, patient safety and safeguarding
• observed a public and a private board meeting
• observed a range of trust meetings and committees which including performance and finance committee, quality committee, and the people and workforce committee
• observed a meeting of the trust Board of Governors
• wrote to stakeholders including local authorities, NHS England, the police and the Integrated Care Board (ICB) to seek feedback about the trust.

People's experience of this service

People using services and their families gave feedback in a variety of ways which was largely positive.

The trust gathered patient and carer feedback through a bimonthly programme of themed inpatient surveys, the NHS Friends and Family Test across inpatient and community services, targeted ad hoc questionnaires in response to emerging issues, volunteer‑led feedback calls, and the annual CQC Community Mental Health Survey.

In March 2026, 2652 people completed the Friends and Family Test. Most respondents reported a positive experience, with 88% rating their care as very good or good. A small number of respondents, 2%, rated their experience as poor or very poor, while 10%, felt their experience was neither good nor poor. Feedback consistently highlighted staff who were empathetic, patient and non-judgmental, and who listened carefully and treated people with dignity and respect. People described feeling supported, understood and reassured, with care that was personalised and responsive to individual needs. Comments reflected confidence in staff professionalism, reliability and communication, with many noting that staff were attentive, approachable and did what they said they would do, which helped people feel heard, valued and safe.

The most recent published CQC Community Mental Health Survey for the trust highlighted some areas of positive performance. CQC contacted 1,250 people and 223 responded, giving an 18% response rate. The trust scored within the highest‑scoring 20% for providing appropriate mental health support, giving clear information on stopping medication, the responsiveness of crisis teams, carer support during crises, staff checking additional needs, and offering advice on finances and cost‑of‑living issues. It also achieved the highest national score for crisis care overall. However, the survey also identified areas requiring improvement, with the trust scoring within the lowest‑scoring 20% for people needing to repeat their mental health history, not feeling in control of their care, receiving limited information on the purpose of medication, and privacy concerns during psychological therapies.

During our assessments of acute wards and PICU, inspectors spoke with 40 patients and 7 carers. Most described staff as respectful and caring. Patients noted differences between permanent and agency staff and reported inconsistent involvement in care planning. Carers highlighted mixed discharge support and gaps in physical healthcare.

On the older people’s mental health wards, feedback from 28 patients and 22 carers was largely positive, with staff described as caring and wards clean and well maintained. However, some patients experienced short staffing, unfamiliar night‑time staff, limited interaction, boredom, and inconsistent activity provision, and some lacked access to spiritual support.

For community mental health teams, inspectors spoke with 12 service users and 10 carers. People described staff as going “above and beyond”.

Feedback from forensic and secure wards included 9 patient and 3 carer interviews. All patients said they were treated well and supported with their physical health, though 2 found it difficult to see a doctor outside ward rounds and 3 criticised repetitive food. Patients valued culturally appropriate meals and positive cultural events. Carers described staff as kind, professional and communicative, and appreciated being included in meetings.

Across 14 Mental Health Act review visits in the previous year, patients consistently described permanent staff as approachable and supportive, and most felt safe despite some distress linked to disturbing individuals. Patients were generally aware of their section 132 rights, though documentation was inconsistent. Limited weekend activities and reduced outdoor access were common concerns. Carers praised communication and involvement and valued carer boards, events, chaplaincy support and flexible visiting.