Kent and Medway Mental Health NHS Trust

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

At our last assessment we rated this key question as requires improvement. At this assessment the rating has remained requires improvement. This meant the service management and leadership was inconsistent. Whilst we found some examples of where successful improvements had been made since our last inspection; the systems and processes were not yet fully embedded.

We found the service to be in breach of regulation 17 (good governance) because the trust did not yet have effective governance processes in place that enabled leaders to successfully monitor the quality and safety of their service and sustain improvements that were needed.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We scored the service as 1. The evidence showed significant shortfalls. The service did not yet have embedded governance processes in place to ensure the service was able to make sustained improvements. As a result of this, we identified inconsistent approaches to the care being delivered. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

At the time of our December inspection, we found that new governance processes had been introduced but were not yet effective in fully addressing the concerns we identified at our previous inspection. For example, the trust had introduced the new CRAM process for risk assessment and management, but its use was inconsistent as implementation was still ongoing. Staff did not consistently record risk events in the right place within the electronic record system, requiring staff to review extensive progress notes for specific information. We identified some patient records that did not contain up‑to‑date care plans and comprehensive risk assessments.

Although we identified areas for improvement during the inspection, senior managers were aware of the issues we identified and were working to make the required improvements. We identified that the physical health monitoring of patients had improved since our last inspection and the implementation of the RED (risk evaluation and decision) board process had been consolidated across all services. A consistent approach was now being used at all locations.

Team managers had access to information to support them with their management role.

The trust had introduced a new Business Intelligence (BI) dashboard which had been rolled out to give teams clearer oversight of waiting lists and high-risk patients. The trust had started to roll out the implementation of Dialog+ as the primary care planning tool - this began in December 2025 and was designed to improve care planning and outcome monitoring for patients. However, this was not fully implemented at the time of our inspection.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.