- 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 8 October 2025
Contents
Ratings - Community-based mental health services for adults of working age
Our view of the service
We carried out an inspection of the trust’s community mental health services for working age adults on 4, 5 and 6 March 2025. The community-based mental health services for adults of working age form part of the trust’s mental health services in the community. This inspection was completed as part of CQC's Adult Community Mental Health Programme. We also inspected crisis services and health-based places of safety as part of the programme. The programme of inspections contributes to CQC's commitment to inspect the standard of care in community mental health services across the country. We undertook a short notice announced, comprehensive inspection of this service, looking at all 5 key questions to assess if services are safe, effective, caring, responsive and well-led.
Kent and Medway NHS and Social Care Partnership Trust is part of the Kent and Medway integrated care system (ICS), providing care to a population of over 1.8 million people. Kent is the larger area of the ICS, with about 85% of the population based there, compared to Medway’s 15%. Both Kent and Medway are around national average for levels of deprivation, although Kent is less deprived than Medway. Life expectancy appears longer, and general health appears better, in Kent than Medway. Both Kent and Medway report higher rates of suicide and self-harm than nationally. Kent has a higher proportion of its population aged over 65 than England as a whole, while Medway’s is slightly lower. Both areas have younger populations (aged 0-17) at a higher proportion than England as a whole. Medway is more diverse than Kent, with higher proportions of Asian groups and Black groups, although both Kent and Medway have a higher proportion of white residents than nationally. According to the Census 2021 data, the areas with the lowest levels of white population were Dartford and Gravesham, which are both towards the west of the county.
Since January 2024, the trust had rolled out the new NHS Community Mental Health Framework for Adults and Older Adults for Kent and Medway. As part of their transformation, the trust introduced two new mental health services for adults; Mental Health Together (MHT) and Mental Health Together Plus (MHT+). The trust previously had community mental health services for younger adults aged 18-65 and community mental health services for older adults aged 65+. Both MHT and MHT+ provide care and treatment to adults from 18 years of age upwards. For people accessing early intervention in psychosis (EIP) or at-risk mental state (ARMS) services, the service accepted people from age 14+.
For our inspection, we looked specifically at the services provided to adults from 18 to 65 years old, in line with how we register assessment service groups.
MHT is available to people with complicated and long-term mental health needs. For people who need more intensive care, MHT+ offers specialised support for those with more complex needs. MHT and MHT+ mainly receives referrals from GPs, but also from other parts of the mental health system, such as acute and crisis mental health services.
Staff provide people who use services with care co-ordination and recovery-focused interventions, including psychological therapies. Staff work with people at team bases, satellite services and people’s homes.
The trust’s community mental health services are spread across 3 directorates, West Kent, North Kent and East Kent.
There are 7 community service localities across Kent and Medway:
- West Kent:
- Maidstone
- South West Kent
- North Kent:
- Dartford, Gravesend and Swanley
- Medway and Swale
- East Kent:
- Thanet
- South Kent Coast
- Ashford and Canterbury
During the inspection, we visited 9 sites (Britton House, Albion Place, The Beacon, Laurel House, Eureka Place, Ash Eton, Heathside Centre, Coleman House and Highlands House). These sites included the following teams:
- Mental Health Together,
- Mental Health Together Plus,
- early intervention in psychosis,
- at risk mental state services,
- and various medicines clinics.
We spoke to 102 staff of various grades and roles and 4 staff employed by the adult community mental health service’s partnership organisations. We spoke to 22 people who used services and 7 carers. We reviewed 46 care records of people who used services and observed a range of meetings and appointments including care and treatment being provided. We reviewed a range of data including complaints, incidents and policies. We reviewed feedback data from Kent Healthwatch and Medway Healthwatch.
The team that inspected the community mental health services comprised 2 CQC inspectors, 1 CQC assessor, 1 CQC operations manager, 1 CQC senior specialist in mental health, 3 CQC pharmacist specialists (also referred to as medicines inspectors), 2 specialist advisors, and 2 Experts by Experience (people who have experience of using, or caring for someone who uses services).
We last inspected the service as part of a focused inspection in November 2020 when we rated safe, responsive and well-led as requires improvement. This led to the assessment service group being rated overall as requires improvement. We found breaches in regulation relating to risk assessments, crisis plans and waiting times for treatment. Prior to this, the service was inspected as part of a comprehensive inspection in 2018, when the adult community mental health service was given an overall rating of good.
At this inspection we rated the service as requires improvement. We found 4 breaches of regulation in relation to safe care and treatment, buildings and premises, governance, and staffing. The service still did not robustly assess and manage risk or create individualised crisis plans with people who used services. We found the trust’s governance processes still lacked assurance of timely action in relation to risks that were identified. In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded. We have asked the provider for an action plan in response to the concerns found at this assessment.
People's experience of this service
People who used services and their carers gave mixed feedback about their experience of the service.
We reviewed feedback given to Healthwatch Kent and Healthwatch Medway between 1 September 2024 and 28 February 2025, which was mainly negative. Of 214 pieces of feedback from people during that period, 191 were negative, 11 were positive and 12 were mixed about the adult community mental health service. People said that communication in adult community mental health services was poor, including turning up to appointments to find they had been cancelled, lack of information in appointment letters and people being informed they had been discharged from adult community mental health services without explanation. People gave feedback to Healthwatch and to our inspection team about long waiting times for assessment, treatment and medication reviews, which negatively affected their mental health. Of the 214 pieces of feedback about the service to Healthwatch, 66 negatively mentioned communication between staff and people who used services and 48 negatively mentioned long waiting times and waiting lists. Some people felt they were discharged from the service too early, without having received help. Many people referred to being “bounced” between different teams and services without a clear plan of who would be caring for them. Healthwatch received 61 pieces of feedback between 1 September 2024 and 28 February 2025 which were negative about care co-ordination and continuity. Some people gave negative feedback about the removal of care co-ordinators and key workers. People who used services were not always aware of their care plans. We spoke to 22 people who used services and 7 carers, of which 4 people did not know if they had a care plan and 3 people and 1 carer said they did not have a care plan.
Results of the Community Mental Health Survey 2023, which took place before the community mental health transformation, were mainly negative. People who used adult mental health services scored their overall experience of using NHS mental health services (in the last 12 months) as ‘worse than expected’ when compared to other trusts. The trust was the lowest scored when ranked nationally and showed there was an overall feeling of disappointment with the care people received. Examples included not having a care co-ordinator resulting in them feeling “left”, not having the option to have a specific intervention they would like and not having a plan in place once an intervention ended. The trust’s Community Mental Health Survey 2024 results had not been published at the time of the March 2025 inspection.
However, the EIP team were praised for ensuring people worked with the same staff, which allowed people to get to know staff and for staff to better understand each person’s presentation. Most people told us they found staff helpful and caring and that staff treated them with respect and supported their mental health. Carers of people under the care of the EIP service spoke positively about short waiting times and being involved in their loved one’s care.
People provided feedback to the adult community mental health service through the trust’s patient advice and liaison service (PALS) and complaints team. Complaints received across all community services between March 2024 and February 2025 totalled 295. Compliments received during the same period totalled 757.