- SERVICE PROVIDER
Kent and Medway Mental Health NHS Trust
This is an organisation that runs the health and social care services we inspect
Assessment report published 25 June 2026
Contents
Ratings - Acute wards for adults of working age and psychiatric intensive care units
Our view of the service
Assessment date: 16, 17 and 18 September 2025
We carried out an unannounced comprehensive assessment of the acute wards for adults of working age and the psychiatric intensive care unit (PICU) provided by Kent and Medway Mental Health NHS Trust (formerly known as Kent and Medway NHS and Social Care Partnership Trust (KMPT), because we were required to follow up on actions taken by the trust following CQC issuing a warning notice to them in 2023 due to significant risks identified relating to the management of high risk medicines. We had also received information that gave us concerns about the safety of patients at the service.
The trust provides assessment and treatment for adults of working age with mental health issues in 9 acute wards and 1 PICU, based in 3 hospital sites across the trust.
Littlebrook Hospital, based in Dartford, has 4 wards; Amberwood is a 17 bedded male-only acute ward, Pinewood is a 16 bedded female-only acute ward, Cherrywood is a 17 bedded female-only acute ward and Willow Suite is a 12 bedded male-only PICU.
Priority House, based in Maidstone, has 3 wards; Boughton is an 18 bedded male-only acute ward, Chartwell is an 18 bedded male-only acute ward and Upnor is an 18 bedded female-only acute ward.
St Martin’s Hospital, based in Canterbury, has 3 wards; Bluebell is an 18 bedded male-only acute ward, Fern is an 18 bedded female-only acute ward and Foxglove is a 16 bedded female-only acute ward.
We rated the service as requires improvement. The service had made some improvements since our last assessment. The service had improved its auditing of emergency response equipment and staff now ensured that each patient received a physical health assessment on admission. Enough nursing and support staff was deployed to the wards to keep patients safe and a new medicines record keeping system (EMPA) had been put in place across the trust.
We also saw that staff effectively responded to patient feedback and ensured patients felt they could speak up and feedback about their experience. This was reflected in trust data that showed a high number of feedback submissions. Patients had access to a physical health nurse and St Martin’s Hospital had access to registered general nurses who were specially trained in catheters and wound care. Staff could describe significant positive changes to the culture on Chartwell ward.
However, at this assessment we found 4 breaches of regulation. We identified breaches of Regulation 12 (safe care and treatment), Regulation 13 (safeguarding), Regulation 15 (premises and equipment) and Regulation 17 (good governance).
The service was not always reporting incidents and near misses in a timely way. These incidents did not always inform the way patient’s care was being delivered.
Staff were not always using the systems and processes in place to deliver a high quality person-centred service.
The service did always have robust governance processes in place that allowed for sustained improvement within the service. The trust did not have effective processes in place to ensure that staff were fully trained and understood the electronic systems being used. The monitoring and recording of blanket restrictions were inconsistent. This impacted on leaders being able to maintain oversight of the quality and safety of the service being delivered.
The service did not always ensure that medicines were used safely or in line with national guidance. Although staff followed systems and processes to prescribe and administer medicines using an electronic prescribing and medicines administration (EPMA) system, there were some concerns around documentation, monitoring, and oversight of high-risk medicines.
Documentation for 'when-required' (PRN) medicines were used for the management of anxiety or agitation was inconsistent. Patient records did not always explain the rationale for administration, what de-escalation techniques had been attempted, or whether the medicine had been effective. This was noted across multiple wards and could lead to inappropriate use or increased risk of side effects.
The service had significant estates and maintenance issues with no robust process in place to record and monitor when these occurred and had been completed. There were several maintenance issues that had been raised a long time before our assessment. One of which dated back to 2012 and was still on the ward risk register.
People's experience of this service
Patients felt involved in their medicine reviews. However, 2 patients on Fern ward and 1 patient on Willow suite told us that they do not like their medication and would like to discuss alternatives with the consultant psychiatrist.
Patients generally were positive about the food available. Most patients felt the food was of good quality. Food options were available that catered for all dietary needs. Most patients told us that they could make food or drink whenever they needed to. However, some patients and families and carers told us that fruit and drinks were not always readily available and mealtimes were not flexible. Patients, families and carers told us that there was not always drinks, food and clean mugs available for patients to use.
Across the acute and PICU wards, we received mixed feedback about staff. Most patients told us that staff were “nice”, “brilliant”, “polite” and “care for all”. One patient told us that staff are interested in them as “an individual”. Another patient told us that “staff do everything to make them feel safe and comfortable”. Families and carers felt staff were generally caring towards their loved ones, but some families had witnessed staff speaking rudely to patients. However, 1 patient told us that some staff have assaulted him and felt 1 staff member was bullying them. We raised this with the provider at the time of the assessment. Another patient told us that some staff make them feel like anything is too much trouble and felt ignored by some staff. Two patients told us that staff did not give them enough time because they were busy with more demanding patients. Patients on Fern ward did not feel that their voice was heard and felt staff deemed any concerns or opinion as part of their mental health issue.
Most patients told us that there was room for privacy and enough time for themselves. Most patients felt safe on the wards. However, 1 patient on Willow suite told us that there was not enough quiet time as the acuity on the ward was high.
Patients generally knew their treatment plan and objectives for discharge although 1 patient was unaware of what their discharge plan entailed. Families and carers told us that they were not always invited to ward rounds and meetings regarding their loved ones.
Patients actively participated in activities on offer. We observed patients participating in arts and crafts and karaoke. Patients on Upnor ward enjoyed occupational therapy interactions such as “Start of the Day” group to plan the day and said, “there were lots of helpful groups to attend”. However, 3 patients we spoke with felt there were not enough activities at the weekend.
Patients told us that the wards were clean and told us that the cleaners were fantastic. However, a patient told us that the showers on Cherrywood ward did not flow properly and 1 patient on Upnor ward told us that their shower floods regularly. A patient on Fern ward told us that the toilets were regularly blocked and that the environment could be cleaner, for example there were spiderwebs on the ceiling.
Patients felt safe on the wards. Staff were quick to respond to patient aggression. Patients told us they received a debrief after any incidents. However, some families felt the wards were unsafe due to incidents their loved ones were involved in.
Most patients knew how to access advocacy. However, 2 patients told us that they did not know how to access this or who their advocate was.
Patients were able to personalise their bedrooms.