Greater Manchester Mental Health NHS Foundation Trust

Ratings - Specialist community mental health services for children and young people

• Overall

  Good

• Safe

  Good

• Effective

  Good

• Caring

  Good

• Responsive

  Requires improvement

• Well-led

  Good

Our view of the service

We assessed the specialist community mental health services for children and young people on 3 and 4 March 2026.

We assessed the service due to the length of time since the last inspection.

The location of Greater Manchester Mental Health NHS FT Trust Head Quarters where the teams are registered under, was registered with CQC on 1 April 2010 to deliver the regulated activities: Diagnostic and screening procedures and Treatment of disease, disorder or injury. The service had a controlled drugs accountable officer and a Nominated Individual.

The service has 10 teams:

• Day Service which operates 4 days per week, offering a variety of interventions on a 1:1 and group basis; including education to help young people identify appropriate coping strategies that might help build hope, resilience, and improve wellbeing.
• Bolton Children and Adolescent Mental Health Services (CAMHS) support young people who are struggling with emotional, behavioural or mental health difficulties which are affecting them in their school, family or social life. They also offer assessments for Autism and assessments and treatment for Attention Deficit Hyperactivity Disorder.
• Wigan CAMHS support young people who are struggling with emotional, behavioural or mental health difficulties which are affecting them in their school, family or social life.
• Wigan Mental Health Support Team (MHST), who deliver evidence-based interventions for mild-to-moderate mental health difficulties to young people in school and support the staff team to develop their approach to mental health needs in Wigan.
• Bolton Mental Health Support Team, who deliver evidence-based interventions for mild-to-moderate mental health difficulties to young people in school and support the staff team to develop their approach to mental health needs in Bolton.
• The Children and Young People’s Eating Disorder Service for Wigan and Bolton supports young people aged 8-18 who have an eating disorder.
• Building Attachment and Bonds service (BABS) in Wigan works alongside parents and direct carers from conception to the age of three years old. The service supports parents and infants/toddlers who are experiencing difficulties understanding their baby/toddler and who want to develop a greater understanding of and improve their relationship with their baby/toddler.
• The Children Young People (CYP) Crisis Service for Wigan and Bolton provides an assertive outreach model to support children and young people up to the age of 18 in crisis. The service incorporates the Crisis Care Pathway and the In-reach Pathway within both Royal Bolton Hospital and the Royal Albert Edward Infirmary. The primary aim to prevent further escalation and avoid Tier 4 admission and/or Accident Emergency (AE) Department admission. The Service provides intensive support for between 72 hours and up to six weeks which is dependent on individual need.
• Wigan Bolton Intensive Support Team work intensively with children and young people who have a diagnosed learning disability who are at risk of family/placement breakdown and/or a tier 4 admission to inpatient services.

• School link practitioners support school staff in Wigan to develop knowledge, skills and confidence in identifying and supporting mental health in schools. The service is an early intervention service providing routine advice and signposting or early assessment and early intervention to students presenting with an emerging mental health need.

We visited the day service, Bolton CAMHS, Wigan CAMHS and the Children and Young People’s Eating Disorder Service as part of this assessment.

The service was last inspected in October 2019. At that inspection there were 3 breaches of Regulation; Regulation 9 Person Centred Care, there was an ongoing breach for this, although improvements had been made. Regulation 15 Premises and Equipment, specifically the maintenance of emergency equipment, this was met at this assessment. Regulation 18 Staffing, in relation to staff receiving level 3 Safeguarding training, this was met at this assessment.

At this assessment we identified an ongoing breach of Regulation 9 Person Centred Care.

At this assessment we assessed the Specialist community mental health services for children and young people assessment service group where we assessed 33 quality statements.

We rated the service as Good. We found a breach of regulation in relation to individualised care plans and the waiting time to access Bolton and Wigan CAMHS services.

We have asked the provider for an action plan in response to the concerns found at this assessment.

Mental Health Act and Mental Capacity Act Compliance Summary

This service had limited involvement with the Mental Health Act. However, staff from the teams providing in reach support to the inpatient services may be involved in the care of children and young people who were detained under the Mental Health Act.

Staff had completed training in the Mental Health Act with 100% compliance in 6 teams. Teams with less than 75% compliance were Bolton CAMHS with 73%, Children and Young People’s Eating Disorder Service with 71% and Building Attachment and Bonds service with 67%.

The Mental Capacity Act only applies to young people over the age of 16. Staff knew where to get advice from regarding the Mental Capacity Act. Staff completed training in the Mental Capacity Act with 100% compliance in 7 teams. The other 3 teams had compliance of over 75%.

Staff took all practical steps to enable young people to make their own decisions. We saw accessible documentation in place for young people, especially with the use of images in the Children and Young People’s Eating Disorder Service.

We rated the service as good. The service had made improvements since the last inspection in 2019 and is no longer in breach of regulations 15 Premises and Equipment and 18 Staffing. However there continues to be a breach of Regulation 9.

We have asked the provider for an action plan in response to the concerns found at this assessment.

People's experience of this service

Feedback from young people gathered during the assessment was positive about the service. We spoke with 4 young people. They told us the staff were helping them to get better.

We spoke with 8 parents on site and 13 parents remotely after the on-site assessment. Parents told us the therapy provided by the service has helped their child.

Referrals to the Children and Young People’s Eating Disorder Service were responded to quickly.

Parents valued the consistency of workers when this happened, although parents told us that their children had several workers and this made it difficult for their child to progress One young person had had 5 different workers.

However, it took a long time to access the service in Bolton and due to illness, there had been changes in workers.

Families were not aware of any support available to them and would have welcomed this.

Stakeholders told us that there was positive partnership working in place. However, areas that stakeholders said the service could improve was the decision that children needed to be in a stable environment before being able to access therapy, which delayed access for children to receive the required interventions. We were told there could be delays or a lack of response to consultation requests and some children were discharged from the service quickly without clear communication. Stakeholders also identified issues in the following areas: communication from the service to external stakeholders, and willingness to meet to discuss service improvements and joint working; shared referral processes, transparency around risk and safeguarding concerns for people being referred improved communication and updates on actions that CAMHS services were leading on too; and clarity on the offer from CAMHS and waiting times for the services.