Royal Cornwall Hospitals trust was one of four trusts to score weak on both quality of services and use of resources for the second year running.
In its own assessment of progress the trust board told the Healthcare Commission that it would not meet 31 out of 44 of its targets.
Chief executive John Watkinson, who joined the trust in January, said one of his priorities had been to build a stronger management team.
'We are an organisation in change and we have to focus on building competency and capacity,' he said.
'Another priority has been making sure we are absolutely honest and robust about where we are.'
He said the trust was making progress and had already achieved 21 of the standards. He was confident the trust would be 'fully compliant' by spring 2008.
For more HSJ coverage of the health check, click here