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Posted on 14 Jan 2026

Today, the CQC has published its report following the Well-led inspection of our Trust carried out in September 2025. The Trust rating remains as Requires Improvement. 

The Well-led review followed a programme of 39 assessments of frontline services between May 2024 and August 2025 - part of the CQC's commitment to carry out the recommendations of the Section 48 review.

We are committed to providing high quality, effective and safe care to those people who need it most. External inspections are an important way of helping us learn and to make the improvements that are needed and we are thankful to all colleagues, partners and service users who engaged in the process.

We accept the CQC's findings and recognise where improvement is needed. We have already made significant improvements since the CQC's last inspection but fully appreciate there is still more to do. We will be addressing all areas identified in the report.

It is important to recognise the context in which the Trust has been working in since its previous inspections in 2022.   There has been unprecedented scrutiny and pressure following the tragic events in Nottingham in June 2023 and the Section 48 review, which required leaders to focus heavily on stabilisation, safety and governance, in addition to workforce shortages and financial constraints. These factors affected morale, consistency of leadership and some operational performance.

Despite these challenges, we have still achieved measurable improvements.  

The CQC report recognises many positive developments; the systems, investments and leadership activity we already have in place, that give us a strong platform to accelerate improvement.  

• We have no services rated inadequate (overall)
• Of the CQC's 39 assessments across 18 service groups, they identified multiple areas of strengthened practice, cultural improvement and service level leadership.   
• 10 services were rated as Good and 1 service rated Outstanding.  We have 4 services with improved overall ratings and outstanding quality statements were achieved in perinatal and children's community health services.
• There is strong and improving frontline care quality. Across many services, people consistently reported feeling listened to, involved in their care and supported by compassionate staff.  
• Positive feedback on interactions with colleagues were noted, people highlighted being listened to and involved in care decisions as key factors. Service users repeatedly described staff as supportive, helpful and knowledgeable.
• Freedom to Speak Up - colleagues felt more able over the last 12 months to raise concerns, report incidents and suggest improvements. Investment in this is a clear foundation for cultural change and has improved staff confidence to raise concerns in many services.
• We have made significant steps to strengthen governance and accountability. Since inspection, a standalone Mental Health Act Committee of the Board has been established, accountability routes from ward to Board clarified, and the Legislation Operational Group strengthened, with improved assurance reporting, learning from invalid detentions and restrictive-practice oversight.
• The CQC recognised strong and effective oversight of safety and quality with safety improvements across 83% of service groups. The implementation of PSIRF, SafeNow dashboards, robust patient safety systems, an expanded patient safety team, strengthened family liaison and strong leadership in safety governance.
• The emergence of stronger, clearer accountability structures. The CQC recognised major progress in restructuring care groups, clarifying escalation routes and improving senior leadership visibility.

Although we have made a significant amount of improvements, there is still more to do.   

There were a number of areas where the CQC found cause for concern.  They are important to recognise, along with how we are responding to them:

• The CQC found the Board did not consistently demonstrate a shared strategic vision or cohesive way of working. A Board development programme has been implemented, a clearer accountability framework approved and executive portfolios strengthened
• The CQC identified deterioration in our staff survey results and concerns about morale, psychological safety and experiences of racism or blame. We are working to address this through our Big Conversations, strengthened leadership visibility, enhanced Freedom to Speak Up activity, increased recognition and wellbeing support, and targeted interventions where survey results are weakest.
• The CQC found that medical leaders were not always fully embedded as equal partners within triumvirate leadership models. We are responding to this with our Valuing Medical Leadership programme, protected leadership time, medically-led quality improvement projects, job-planning and rota reviews, and increased involvement of medical leaders in care-group and strategic decision-making.  
• The CQC highlighted concerns about people's experience of crisis care. Improvement work was already underway in this area and has been strengthened through enhanced senior leadership, a monthly Rapid Improvement, weekly operational delivery oversight, daily breach reviews, consultant-led admissions, expanded out-of-hours support, and improving staffing and risk-assessment compliance.  
• Progress with EDI was not consistently embedded and leadership needed strengthening. We have responded by embedding measurable EDI objectives in executive appraisals, strengthening Board oversight through the People & Culture Committee, rolling out race equality and active bystander training, and accelerating PCREF delivery. This work is increasingly informing service redesign and clinical practice.
• Dormitory accommodation remains at one location (Cherry Ward) and some long-term segregation environments do not consistently meet Code of Practice standards. A lead director is in post to lead capital delivery, funding remains ring-fenced, and a full planning submission for dormitory eradication is scheduled for March 2026 with completion targeted for March 2027, subject to national capital approval. Governance, advocacy and multidisciplinary oversight of long-term segregation have been strengthened, with formal design and capital planning underway to improve environments.
• The CQC identified concerns about data reliability.  We have strengthened data governance through the appointment of a Director of Corporate Governance, a data-quality framework, enhanced validation and triangulation processes, and maintained real-time risk oversight through weekly executive reviews, monthly committees and daily SafeNow processes.

More detail can be found in the full report on the CQC website.  

I am positive that the foundations for sustainable improvement are in place and by continuing to work with the CQC and our partners, we can build on the work which was already underway at the time of inspection. 

I would like to recognise the hard work of all colleagues who are dedicated to making these improvements and delivering quality, compassionate care to tens of thousands of people, every day.  

Once again I want to reaffirm our commitment to improvement and providing high quality services to all those we care for.

Ifti