Medway Community Healthcare C.I.C

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Are community urgent treatment centres well-led? This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained unchanged. We rated well led as requires improvement because managers and leaders did not ensure that the service consistently delivered a high quality and safe service.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a clear vision and strategy. Part of the organisation’s strategy included encouraging staff to become shareholders in the company and to voice their opinions on the decisions that face the business.

The organisation's values included partnership working with staff and people using their services while delivering high quality and compassionate care. Staff and leaders told us they demonstrated these values in their day-to-day work.

While staff felt they are mostly kept informed of the changes in organisation, they felt communication could be better to ensure that they are involved in decisions that could impact their roles.

Staff could explain how they were working to deliver care within the budgets available.

Leaders had the skills, knowledge and experience to perform their roles. Leaders had a good understanding of the services they managed. They could explain clearly how the teams were working to provide good quality urgent treatment to people in the Medway and Swale area.

Staff felt the service leaders were kind and compassionate. They felt their leaders were supportive and inclusive and we observed a good working relationship of mutual trust and respect among the team. Staff told us that their leaders were approachable and always available to provide both professional and emotional support to them.

Staff spoke very highly of their leaders, particularly of the head of service and medical director for their leadership and support. Staff told us they felt their leaders genuinely cared about their wellbeing.

Leaders ensured that development opportunities were available for all staff.

Staff told us they were able to safely raise concerns without fear of retribution. Staff knew about the provider’s Freedom to Speak up process. Freedom to Speak up (FTSU) is a framework across the UK healthcare sector that empowers workers to raise concerns safely, confidentially, and without fear of retaliation. It ensures patient safety, addresses workplace bullying, and drives continuous improvement.

Leaders told us they promoted openness and transparency and encouraged feedback to improve care, treatment and support.

The provider had an up-to-date freedom to speak up policy which outlined how concerns raised by staff will be resolved. Staff could also contact the managing director or human resources director directly if they felt their concerns had not been resolved satisfactorily.

The provider did not report any whistleblowing or freedom to speak up concerns in the last 12 months prior to this assessment.

The service valued diversity within its workforce and worked towards creating an inclusive and fair culture. Leaders recognised the importance of equality and equity and took steps to support a working environment where staff felt respected, valued and treated fairly.

There were arrangements in place to promote equality, diversity and inclusion, including access to flexible working opportunities to support staff with different personal circumstances, such as caring responsibilities or health needs. Managers understood the importance of flexibility and applied these arrangements appropriately to help staff remain engaged and productive.

Managers were responsive to staff needs and put reasonable adjustments in place where required, supporting staff to carry out their roles safely and effectively. This helped reduce potential barriers for disabled staff and others who required additional support, contributing to a more inclusive working environment.

The provider undertook equality monitoring of the workforce and used this information to understand representation and identify areas for improvement. The provider had recently introduced equality and diversity steering groups, and the role of inclusion ambassadors who were working with human resources to develop equality objectives to reflect protected characteristics. This was an action in response to the workforce race equality standards (WRES) review.

Staff described a culture in which diversity was respected and inclusion promoted, and where concerns related to equality or discrimination could be raised and addressed appropriately. This supported positive staff morale and helped create a fair and inclusive workplace culture.

On the last CQC inspection in 2022, we told the provider it must ensure that all aspects of its governance processes were robust and effective. Leaders must ensure that all service level risks were managed well and responded to in a timely way which included ensuring that the environment was cleaned to a high standard. We also told the provider it must ensure that the security measures were robust to ensure the safety of people in the department by preventing the unit being used as a thoroughfare. The issues raised in our 2022 inspection remained an issue during our 2025 inspection. We are therefore unassured that governance systems are overseen in an effective way to keep people safe and free of risk of avoidable harm.

On this inspection we saw that poor cleanliness and management of infection control continued to pose a risk to people using the service. The environment including the toilets were visibly dirty. Staff told us Medway Foundation Trust was responsible for providing the cleaning. While the provider carried out infection prevention and control audits, the service continually failed its cleaning audits month on month. This had been escalated to the CIC but there was no evidence of action taken to drive improvement as cleanliness remained a significant concern. At the time of the assessment, the provider could not provide up to date cleaning records. There was no indication of when an environment had been cleaned. The service operated 24 hours a day 7 days a week, however staff informed us that the cleaners attended once a day for cleaning.

The service repeatedly failed its cleaning audits and while some actions including getting staff to clean the unit was taken, this was not sustained and therefore poor cleanliness of the environment and potential risk of infection to people visiting the service.

The provider reported inadequate cleaning provision and infection control risks on its risk register. The action as of September 2025 was to instruct an independent cleaning provider to carry out the cleaning. As of October 2025, when we carried out our assessment of the service, we saw that this had not been done. The provider had not taken urgent and immediate action to remove the risk. The environment was poorly maintained. There were broken chairs in the reception area which should have been removed and repaired or replaced. There were signs telling people not to sit on them; however, patients and carers still sat on these chairs. Managers had not taken proactive measures such as removing the damaged chairs that could cause harm.

At the time of this assessment, the service was still being used as a thoroughfare by people to access other parts of the hospital. Staff told us that they were not allowed to shut the doors, even though this presented a security risk. This was on the providers risk register, but effective and sustained action had not been taken. This was a concern from the last inspection, and we required the provider to take action.

The service worked with other services to deliver care and treatment for people. The service worked in collaboration with a range of external partners and community stakeholders, including commissioners and other relevant organisations including GPs, local acute trust and ambulance services. Leaders engaged appropriately with these partners to support service delivery, planning and improvement, and to ensure care was aligned with local needs and priorities.

There were arrangements in place to share information and learning with partners when appropriate. This supported coordinated care, reduced duplication and enabled services to respond more effectively to people’s needs.

People using the service and staff had opportunities to engage with senior leaders and external partners, including commissioners, to share feedback and views via the friends and family tests and staff surveys. This helped ensure that perspectives from people and frontline staff informed partnership discussions and service development.

Staff understood the roles and responsibilities of partner organisations and how to work with them to support people effectively. This helped ensure timely referrals, appropriate information sharing and coordinated responses, particularly for people with complex needs.

Staff made notifications to external bodies as needed including the CQC and local authority safeguarding teams.

Leaders told us they were committed to continuous learning and improvement across the organisation and the local system. Leaders and staff recognised the importance of learning from experience and used this to support improvements in the quality and safety of care. For example, the provider had updated its business continuity plans with mitigations in place following a recent cyber-attack.

Managers and staff said they were encouraged and supported to identify opportunities for improvement. Leaders promoted reflection and learning from incidents and feedback, helping staff to understand what worked well and where improvements were needed.

Staff and managers told us that the service supported innovation in practice and that there were several innovative programmes across the service, such as reducing unplanned admissions to the acute hospital.

The service was actively involved in research programmes to improve the service delivery and outcomes for people. For example, the provider was working in partnership with the University of West London and Geller Institute of Ageing and Memory to understand and support the needs of African and African-Caribbean people living with dementia, their care partners and families and the impacts of delayed support. The programme was aimed at identifying inclusive strategies to facilitate timely and culturally appropriate social care support.

The providers research department had developed a basic awareness training which is delivered to staff on a monthly basis through the New Starters Clinical Induction Program and Elected Members Forum Coffee Afternoon.