Mental health Trust must "significantly improve".

An NHS trust providing adult mental health services must "significantly improve", inspectors have again warned.The Care Quality Commission (CQC) said Avon and Wiltshire Mental Health Partnership Trust was not "always safe, effective, responsive or well led". Inspectors reported a lack of qualified nurses to manage complex cases.

CQC inspectors visited crisis, assessment and recovery services run by Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) in December after receiving information about “a number of serious incidents". Concerns were raised by a whistleblower, staff and the clinical commissioning group.

The trust was issued with a warning notice after the December inspection which was followed up on February 17.

The CQC said it was "satisfied" AWP had improved its management of referrals and waiting lists, but it still needed to ensure care was provided in a timely way and was safe.

The CQC’s Dr Paul Lelliott said: "At the time of our first inspection there were more than 500 patients waiting for assessment, some for several months. Also, staff did not follow up patients who missed initial appointments or did not respond to telephone calls. They were sometimes lost in the system.

"The trust has made some immediate changes to address the waiting lists and manage the service better. We still require it to look deeper across the service before we return to undertake a comprehensive inspection which will look into the whole trust."   

AWP's acting chief executive, Dr Hayley Richards, said: "Services should always learn from challenges so they can inform improvements and we are in constant dialogue with our commissioners to make sure we are all providing the best care."

In September 2014, AWP received four warning notices requiring it to take "urgent action" to improve services.

The trust received a formal warning in 2013 about staffing levels at a unit at Blackberry Hill Hospital, Bristol.

A year before, the CQC expressed concerns about staffing levels after a report into two patients who committed killings in 2007 described the trust’s culture as "centralist, top down and target driven, bureaucratic and controlling".

The trust was also criticised in the 2011 NHS staff survey where concerns were raised about staff morale.

Following the latest report, the CQC said inspectors would return in May to "undertake a comprehensive inspection which will look into the whole trust.”