Cheshire and Wirral Partnership 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

Cheshire and Wirral Partnership NHS Foundation Trust (CWP) is a combined NHS provider of mental health services, learning disability services, community mental and physical health services and primary medical services. The trust has services across Wirral and Cheshire, as well as Trafford, Warrington, Bolton, Halton and Liverpool. It also commissions specialist eating disorder services for the North West. The trust was formed in 2002. In June 2007, the trust became the first mental health trust in the North of England to become a foundation trust. The trust has over 14,700 members and employs more than 4,500 staff across 73 sites, serving a population of over 1 million people and highly specialist services for 2 million. We undertook a trust-level assessment (well-led review) of the trust which included an on-site visit on 2-4 July 2024. We undertook further visits to observe the trust’s board and committee meetings on 31 July, 2 September, 11 September and 17 September 2024. We assessed all 8 of the quality statements in the well-led key question used when assessing an NHS trust in the Single Assessment Framework. We found areas for improvement within three of the eight quality statements and positive findings within five of the eight quality statements. We have asked the trust for an action plan in response to the concerns found at this assessment. The well-led review followed several assessments of the trust’s frontline services (assessment service groups). The initial assessment of the trust’s services was triggered following two serious incidents (inpatient deaths) in Bowmere Hospital. This resulted in an assessment of the trust’s acute mental health wards at Bowmere Hospital, and the psychiatric intensive care units at Bowmere Hospital and Springview Hospital. The assessment found significant concerns regarding the staffing levels across Bowmere Hospital and a letter of intent was served on the trust requiring them to take immediate action to ensure a reduction of the risk of harm to people who used services. The trust responded to the letter of intent and addressed our concerns through an action plan detailing how the issues would be resolved. Further assessments included wards for older people; community mental health services for working age adults; mental health crisis services and health-based places of safety; community end of life care and Willaston Surgery. We undertook these assessments to ensure we had a thorough understanding of the full range of services provided by the trust ahead of our well-led review. We assessed all 8 of the quality statements in the well-led key question used when assessing an NHS trust in the Single Assessment Framework. We found areas for improvement within three of the eight quality statements. The trust had a strategy however it was not supporting a shared direction within the trust. There was work in-progress to reframe and reset the trust’s strategy to focus on the highest priority objectives. Governance systems, particularly the systems in place to identify and manage risk, quality and performance, did not always operate effectively to sight leaders on all emerging risks within services. Information systems were in development which meant the board did not always have consistent systems in place to capture, analyse and present information. There was work in-progress to strengthen freedom to speak up processes. However, the trust had a clear statement of vision and values. These were well-embedded within the trust. Leaders consistently demonstrated their commitment to compassionate and inclusive leadership. Leaders were visible within the trust and there was strong evidence of the commitment of the board to the equality, diversity and inclusion agenda. The trust’s commitment to learning, innovation and research was clear, particularly the focus on patient outcomes. There was strong evidence of both the commitment and passion within the provider collaboratives led by the trust. There were examples of partnership working and innovation in relation to involving communities and co-production.

People's experience of this service

Survey results from people using the trust’s inpatient and community services showed mostly positive results in relation the trust’s culture. The trust’s inpatient survey showed people felt staff supported them and listened to them. In community services, the trust achieved the highest score out of all trusts nationally in: Overall experience, Mental health team, Involvement in care, and Respect, dignity and compassion. There was a range of experiences including positive and negative interactions with staff. In the trust’s primary medical services, people told us they felt the trust was receptive to feedback and actioned improvements where they were identified. In community end of life services, people told us they felt supported and listened to by staff. The trust’s governors were positive about the trust’s senior leaders and described their experience of working with the trust as open, honest and transparent.