Kent and Medway Mental Health NHS Trust

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Staff assessed the physical and mental health of all people who used services on admission. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for people who used services based on national guidance and best practice. The team included or had access to the full range of specialists required to meet the needs of people who used services. Staff from different disciplines worked together as a team to benefit people who used services.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service always treated people with kindness, empathy and compassion and respected their privacy and dignity.

Across the crisis and home treatment teams staff treated people who used their services with compassion and kindness. They respected their privacy and dignity. They understood the individual needs of people who used their services and supported people to understand and manage their care, treatment or condition. We observed staff treat people with kindness, compassion and empathy.

We observed staff speaking with people over the telephone and when attending their homes for treatment. They were kind and respectful and explained the role of the team and the purpose of the appointments they were setting up. Staff gave people help, emotional support and advice when they needed it. People who used the rapid response and home treatment team service said staff treated them well and behaved kindly. We spoke to 6 people and they all said they felt involved in care planning, and staff were respectful and polite.

At the health based place of safety, staff gave patients help, emotional support and advice when they needed it. Staff told us they spent time talking with patients. They offered patients encouragement and reassurance. At the health based place of safety, staff referred patients to the crisis team or the community mental health team when they were not admitted to hospital.

The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics The service made adjustments for disabled patients. The crisis and home treatment teams and health-based places of safety (HBPoS) sites were all wheelchair accessible. Staff ensured that people who used their services and patients could obtain information on treatments, local services, patients’ rights, and how to complain. We spoke to 6 people and most told us they had received a welcome pack. However one person told us they had not received this and so did not know who to contact if they felt they were deteriorating. Staff received training on recognising and responding to people with learning disabilities and autism. The South East Kent and the Dartford rapid response and home treatment teams had 100% compliance rate with this training. The Medway and North East Kent rapid response and home treatment teams had 97% compliance, and the West Kent rapid response and home treatment team had 81% compliance rate with this training. All the managers of the crisis and rapid response teams told us that staff had requested further training and guidance in this area. They told us they were seeing a lot more referrals of people who met this criteria but may not have a formal diagnosis yet and staff wanted to be able to better support them.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. The home treatment and rapid response team promoted people’s independence, and ensured people had control over their own care, treatment and wellbeing. When a person was seen by the team for the first time, staff would use the first visit protocol. This included sharing with the person the range of interventions available, and people could highlight what they felt they required. All teams had occupational therapists and psychologists in the team, and people could be referred to them depending on their needs. There was joint work between nursing and medical staff to arrange additional appointments and appropriate medication, which could support the person staying in the community rather than having an inpatient admission. People who used these services were given information to make decisions about their medication. Consultants, pharmacists and non-medical prescribers spoke with people about medication choices, side effects, monitoring and benefits. This meant people were able to make informed decisions about their medications. We saw evidence in care records that people’s requests to have medication reviews led to medication review appointments.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimize any discomfort, concern or distress. The crisis and rapid response team staff were aware of and dealt with specific risk issues. There were weekly county wide monitoring reviews for people who used the service and patients awaiting beds in a mental health hospital. Risk assessments for people and patients were reviewed daily at the morning meetings. The crisis and rapid response teams listened to and understood people’s needs, views and wishes. The service had two types of feedback mechanisms which were the patient reported experience measures and the carer reported experience measures. Staff were encouraged to ensure this was completed. The outcomes from these feedback sources were discussed at trust wide patient experience group and trust wide carer experience bi-monthly forums. The feedback received from this was reviewed and used to improve the service. One example was the trust recognized they needed to obtain more diverse feedback from people, patients and carers. The trust was implementing a new engagement and involvement plan that was presented to the board in March 2025. At the health-based place of safety staff responded to changing risks to patients. Patients we spoke to told us staff had explained their section and next steps in their care and treatment. They told us they had been supported to make calls to inform their families and carers to inform them of their whereabouts and care and treatment.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. Staff we spoke to across the home treatment and rapid response service told us they enjoyed working in the service. They felt respected, valued, and were proud to work in the team. They told us management cared about their well-being and enabled them to deliver person centred care. Staff felt supported in their roles and were able to raise concerns with management. However, managers and staff at the Maidstone home treatment and rapid response team told us they had felt additional pressure due to the staff vacancies in the team. Staff had access to support for their own physical and emotional needs. The North East Kent home treatment and rapid response team service had created a new staff well-being space where staff could take time to decompress after appointments. Managers across all of the rapid response and home treatment teams ensured there was private space available in the office for difficult conversations and debriefs. The trust told us about an initiative senior leaders were introducing that was a digital staff room, where staff could ask questions about processes and strategy and the executive team would respond. The provider recognised staff success within the service. Staff felt their work was recognised and success rewarded within their own teams. The home treatment and rapid response teams had a rewards and recognition scheme. The trust spent the year prior to our inspection updating their values. The development of the new values had included both staff and patient involvement. These were in the process of being implemented when we inspected. Staff were not able to say when this would be completed. The trust had a values in practice award scheme which was most recently won by the North East Kent team. Managers supported staff to develop and gave them an annual appraisal of their work. The trust target for completion was 95% with most teams achieving this. Managers gave us examples of support workers who had been supported to develop into nursing through development pathways. For example, a nurse non-medical prescriber was a Band 6 nurse and completed the non-medical prescriber course while part of the team. Another example was a support worker that did phlebotomy training and was shadowing at community team clinic to develop their competencies. Leadership development opportunities were available, including opportunities for staff. Staff spoke positively about the range of development opportunities available and about how managers supported them to develop. We saw multiple examples of staff being supported to learn other roles, support other departments or have additional professional development. The home treatment and rapid response teams had annual appraisals. The North East Kent, Dartford, and West Kent rapid response and home treatment teams were at 100% compliance with this. The South East Kent team was at 94%, and the Medway team was at 90% compliance with this.