Kent and Medway Mental Health NHS Trust

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs. At our last inspection we rated this key question as Good. At this assessment the rating has remained as Good.

Patients needs were met through good organisation and delivery. Staff managed beds well. The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service, such as work, education and family relationships. Staff helped patients with advocacy. The service acted on concerns and complaints, investigated them and learned lessons. The service made it easy for patients to share feedback and ideas, or raise complaints about their care, treatment and support. However, the service did not always work in partnership with patients and involve them in decisions about their care.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make sure people were at the centre of their care and treatment and ensured they were felt empowered to make their own decisions.

Staff did not always work with patients to ensure they felt involved in their care. Most of the care plans we reviewed were generic and not personalised. Staff did not always write care plans in the voice of the person and positive behavioural support plans had not been put in place for patients who had this as an identified need. Staff told us that there was a plan in place for occupational therapies staff to develop these plans, but this was not the case at the time of our assessment.

Overall patients felt involved in their medicine reviews. Two patients on Fern ward and 1 person on Willow suite told us that they did not like their medication and would like to discuss alternatives with the consultant psychiatrist.

Outdoor garden areas were available across all sites. During our visit, the gardens were being used by patients and the doors were unlocked. Staff confirmed that the gardens were accessible at all times. This meant patients had regular access to fresh air and outdoor space, which can help with relaxation and emotional wellbeing.

We scored the service as 2. The evidence showed some shortfalls. There were some shortfalls in how the service understood the faith needs of people using the service. However, staff ensured patients maintained contact with families and carers.

When appropriate, staff ensured that patients had access to education and work opportunities.

Staff supported patients to maintain contact with their families and carers. Wards had carers leads in place who helped facilitate communication with families and carers. Families and carers were routinely invited to ward rounds and discharge meetings. Families and carers were able to visit the wards.

Staff did not support patients to access their chosen place of worship within the community. We spoke with 2 patients who felt their religious needs were not being met.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed. Staff submitted notifications to the Care Quality Commission.

Information governance systems included confidentiality of patient records.

The wards had information boards which included information about therapies, safeguarding, the Mental Health Act, advocacy, complaints and quality improvement projects.

The information provided was in a format accessible to patients. Information was simple and easy to understand.

Relatives and carers had mixed feedback regarding the service sharing information with them about their loved one. Some families and carers told us that they were not always invited to ward rounds and were not always informed about treatment plans and when incidents had occurred. Other families and carers felt they were given information and there was effective communication, but this could be delayed.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Between August 2024 and August 2025, the wards received 106 complaints in total. These were made up of 42 from a relative or carer, 27 from the patient and 26 from CQC which were a combination of relative and patient contacts. The other 11 complaints were from MP’s and other external organisations. Of these, 7 were upheld, 33 were partially upheld and 52 were not upheld. There were also 4 complaints where consent was unable to be obtained but the trust provided a full response where they were able. The remainder were awaiting a response at the time of our assessment.

The trust identified 3 main themes from these complaints. Staff attitude (of nurses) was the main reported theme; many of which related to allegations that staff lacked compassion/empathy and their behaviour. Another theme related to patients not receiving a specific treatment or therapy and therefore did not meet expectations, and the third theme related to the lack of communication with a carer or next of kin. This was the most reported theme. The trust had identified communication with carers as a key area for improvement and had implemented several focussed projects and forums across the trust.

Patients knew how to complain or raise concerns. When patients complained or raised concerns, they received feedback.

Staff knew how to handle complaints appropriately. Staff protected patients who raised concerns or complaints from discrimination and harassment. Staff received feedback on the outcome of investigation of complaints and acted on the findings. Staff could provide examples of where practice had changed as a result of feedback. For example, care programme approach (CPA) meetings were now diarised so that all staff knew when these were taking place.

Between August 2024 and August 2025, 126 compliments were reported recognising the positive impact that staff had on patient and carer experience and expressing gratitude for ‘staff who are caring and supportive, compassionate, empathetic and kind’.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The Trust monitored their occupancy levels for each ward and across the service. Between September 2024 and August 2025, the wards were running at 95.6% occupancy. The average length of stay for the same reporting period, for the acute mental health wards for working age adults was 38.1 days and for the psychiatric intensive care unit it was 71.5 days.

Staff planned for patient’s discharge, including good liaison with care managers/co-ordinators. There had been 1398 discharges across the acute mental health wards for working age adults and the psychiatric intensive care unit between September 2024 and August 2025. The average readmission (within 30 days) was 12.6%, with Upnor ward and Cherrywood ward having the highest percentage of readmissions at 17.8% and 17.9% respectively.

In the last 12 months, there was an average of 19.5% occupied bed days for patients that were clinically ready for discharge from the inpatient wards. Most delayed discharges were due to no identified ongoing social care placements. All wards held a 'Red to Green’ meeting, which were effective for determining barriers to discharge and onward placements. Patients’’ records were coded as either ‘Red’ or ‘Green’ which helped the multi-disciplinary staff teams know if patients were ready for discharge or if there were barriers preventing timely discharge. Patients’ discharges were raised in handover meetings and relevant staff were assigned actions as required to address these barriers. There were also bed management meetings which proactively worked on removing barriers in a patient's pathway, preventing them moving on from the service when clinically ready.

Staff ensured patients had access to post-discharge care – for example, S117 aftercare, community mental health services and crisis services.

Staff ensured the needs of patients with mobility issues were met. All wards had accessible rooms for patients with identified mobility issues. Staff made reasonable adjustments for patients. We observed patients using walking aids and sensory aids to support them in the ward environment.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about patients who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff provided a variety of opportunities for patients to give feedback about the service, including patient forums, community meetings and surveys. Families and carers gave mixed feedback regarding whether they had been informed about how to feedback about the service.

The provider had undertaken equality impact assessments of some of their policies and procedures to ensure they did not place vulnerable patients or patients with protected characteristics at a disadvantage.

Staff were trained in equality, diversity, inclusion and human rights, with 96% of staff having completed the training.

We scored the service as 2. The evidence showed some shortfalls. Patients were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Care plans were generic with few elements of personalisation. Some care plans included contradictory statements regarding patients’ insight into their mental health. Although most patients told us that they understood their treatment plan and objectives for discharge, some patients were not aware of their care plans and had not been given a copy. Following our inspection, the trust told us that the acute and PICU services were transitioning to a new care planning model and this may have impacted on the quality and consistency of care plans we observed during the inspection.

Whilst staff ensured that relevant healthcare professionals were involved in the discharge planning process, some families and carers told us that they did not get invited to discharge meetings and did not feel included in decisions about their loved one’s future care. The medical team and staff told us that there were processes in place to ensure all individuals involved in the patients care had access to discharge information and a detailed plan was developed with the patient and partners.