- 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 August 2026
Contents
Ratings - Wards for people with learning disabilities or autism
Our view of the service
We carried out an unannounced comprehensive assessment of the Brookfield Centre on 11 and 12 February 2026. The Brookfield Centre is a 13-bedded locked forensic rehabilitation and recovery inpatient service for adults detained under the Mental Health Act, including patients with learning disabilities and autistic patients. The service supports patients to step down from Tarentfort Centre, which is a specialist low secure unit. At the time of the assessment, 11 patients were receiving care.
At the previous inspection, carried out through an unannounced comprehensive inspection at Brookfield Centre on 28 March 2023 and announced activity at Brookfield Centre and Tarentfort Centre on 4, 5 and 6 April 2023, the service was rated requires improvement overall. Breaches were identified relating to safe care and treatment and staffing.
At this assessment, we rated the service as requires improvement. Governance systems and oversight processes were not always effective in identifying, escalating and resolving concerns promptly. During the assessment, we identified environmental concerns including damaged fencing, debris within the second garden area and kitchen hygiene concerns. We also identified concerns relating to medicines storage. This meant governance and oversight systems had not always identified and addressed risks within the service.
Outcome monitoring systems were not sufficiently robust to demonstrate that patients were receiving positive and sustained rehabilitation outcomes. Although staff supported patients to work towards greater independence and community living, leaders could not consistently demonstrate how rehabilitation interventions were evaluated, how patient progress towards rehabilitation goals were being measured or how the effectiveness of care and treatment was assessed. This meant leaders could not be assured that patients were consistently achieving positive outcomes or progressing towards greater independence and discharge.
The person-Led Care Planning Model and rehabilitation model were not consistently understood or embedded across the service. Local leaders were not consistently able to explain how rehabilitation outcomes were evaluated of how patients progress was measured. This created inconsistency in understanding and delivery across the staff team and reduced assurance that care and treatment was consistently focused on supporting patients to achieve their individual rehabilitation goals and aspirations.
Length of stay information and patient records showed some patients had experienced significantly prolonged admissions. However, leaders could not consistently demonstrate how rehabilitation interventions were supporting progression, reducing the risks associated with long-term admission or achieving meaningful rehabilitation outcomes. This meant there was limited assurance that care and treatment was consistently supporting recovery, independence and community reintegration.
Some staff reported inconsistent senior leadership visibility and said they felt disconnected from wider organisational priorities. This meant leadership and strategic direction were not always clearly embedded across the service.
However, patients consistently described staff as kind, supportive and reassuring. Patients were supported to develop independence, access meaningful activities and participate in decisions about their care and future goals. Restrictive practice remained low and staff promoted positive risk-taking, choice and autonomy. Multidisciplinary working was generally positive, physical healthcare oversight was robust and improvements had been made in relation to staffing oversight and mandatory training compliance since the previous inspection.
We used the principles of Right Support, Right Care, Right Culture to inform our assessment of the service. Patients received person-centred care from staff who understood their individual communication, emotional and support needs well. Staff used adapted and accessible communication approaches to support patients with learning disabilities and autistic patients to participate in decisions about their care and treatment. However, governance and oversight systems were not always effective in identifying and addressing concerns promptly, including environmental concerns identified during the assessment.
At this assessment, we identified 2 breaches of regulation relating to person-centred care (Regulation 9) and good governance (Regulation 17). We have asked the provider for an action plan in response to the concerns found during the assessment.
People's experience of this service
Patients spoke positively about the support provided at Brookfield Centre. We spoke with 7 patients and 5 family members or carers during the assessment. Patients consistently described staff as kind, supportive and reassuring. One patient told us staff “go above and beyond”. Patients told us they felt safe on the ward and staff were approachable and available when they needed support.
Patients told us staff listened to them, helped them understand their care and involved them in decisions about leave, activities and daily routines. Patients generally understood their rehabilitation goals and felt involved in planning for greater independence and future discharge.
Patients described enjoying a range of activities including fishing, badminton, music, board games, shopping trips and attending college. Two patients attended college and 1 patient volunteered in the on-site canteen, which supported independence, confidence and community engagement. Patients told us staff encouraged them to try new things and supported them to develop independence, including cooking, planning their week and managing money. During the assessment, we observed warm, respectful and compassionate interactions between staff and patients.
Patients valued having fob access to their bedrooms and access to the co-designed garden area during the day, which promoted autonomy and dignity. Staff used accessible communication approaches tailored to patients’ individual needs. Psychology staff adapted communication and outcome tools, including personalised visual emotion scales, to support patients with learning disabilities and autistic patients to express their emotions, preferences and goals. Accessible support plans using symbols, photographs and plain language were used where appropriate to support patients’ understanding and involvement in decisions about their care.
Community meetings took place weekly, and patients told us they had influenced changes within the service, including simplifying ward information boards and increasing opportunities for cooking and healthy eating activities. Friends and Family Test feedback from January 2026 was largely positive. The main theme identified for improvement related to food choices, and the service had introduced catering reviews and patient-led food initiatives in response.
Family members and carers generally described staff as caring and committed and told us they felt their relatives were well supported. However, some relatives said communication from the service was not always consistent due to the Family Engagement Lead role being vacant, which meant there was no dedicated point of contact for families.
Patients and carers generally described the ward environment as calm and welcoming. However, during the assessment we identified environmental concerns including damaged fencing, debris and kitchen hygiene concerns. While patients generally spoke positively about their care and treatment, some aspects of governance and environmental oversight did not always meet expected standards.
Overall, patients described positive relationships with staff and felt supported to build independence, make choices and participate in meaningful activities.