The adult community learning disability team in Cornwall made a commitment to provide a better service for people with profound and multiple learning disabilities (PMLD). This resulted in audits against government papers and reports that encourage high-quality care for people with PMLD and a range of projects, including care pathway development and implementation, staff training and improving links with primary care. The care pathway aims to provide multidisciplinary assessment and intervention for people’s specialist health needs. Evidence shows that it has had a positive effect, but also identified areas for further work. Further recommendations have been proposed to improve care delivery for people with PMLD in the Cornwall adult learning disability service.