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People were left feeling 'uncertain and vulnerable' as mental health services at a Kent trust declined significantly, according to a damning new report. The Care Quality Commission (CQC) has told Kent and Medway NHS and Social Care Partnership Trust to make urgent improvements following an inspection of two of its services.
Inspectors found a decline in the quality of mental health care being provided by the trust when they visited the services in March. The CQC issued a warning notice due to the level of concerns during the inspections.
The trust was asked to show an action plan on how it will deliver wider improvements. Community-based mental health services for adults of working age have been re-rated as requires improvement overall, as have the ratings for effective, caring, responsive, and well-led.
Safe has been downgraded from requires improvement to inadequate. The rating for the mental health crisis services and health-based places of safety has been downgraded from good to requires improvement overall, as have the ratings for safe, effective, responsive, and well-led.
'Deeply concerned'
Caring has declined from outstanding to good. Serena Coleman, CQC deputy director of operations in Kent, said: "Following our inspection at KMPT, we were deeply concerned to find the trust didn't always provide care that was safe or personalised to people's needs, and its quality had declined significantly since our last inspection.
"In mental health crisis services and health-based places of safety, we found people were often detained beyond the legally permitted period and received treatment without the correct legal permissions. This meant people's rights under the Mental Health Act weren't always protected, and they were left feeling uncertain and vulnerable at a time of acute crisis when they most needed support and understanding."
Both Kent and Medway report higher rates of suicide and self-harm than nationally. For the inspection, the CQC looked specifically at the services provided to adults from 18 to 65 years old.
They visited nine sites, including Britton House, Albion Place, The Beacon, Laurel House, Eureka Place, Ash Eton, Heathside Centre, Coleman House and Highlands House. They spoke to 102 staff of various grades and roles and four staff employed by the adult community mental health service's partnership organisations.
They also spoke to 22 people who used services and seven carers. Inspectors reviewed 46 care records of people who used services and observed a range of meetings and appointments including care and treatment being provided.
'Improvements are urgently needed'
Ms Coleman added: "We also saw staff weren't aware of the tools available to support people with specific communication needs, making it harder for them to be heard and involved in decisions about their own care. This communication barrier prevents genuine person-centred care and can leave people feeling isolated when they most need understanding.
"In community-based mental health services for adults of working age, we found people didn't always have up-to-date risk assessments or person-centred crisis plans. Some records contained only generic plans, while others had none at all. This left people without clear support strategies, and some told us they weren't even aware they had a care plan.
"For people with complex or high-risk needs, this lack of personalised planning increased the risk of serious harm and left carers feeling abandoned and unsupported. These concerns around care plans were highlighted in our previous inspection, yet too many remained out of date or incomplete, meaning people's current needs and risks weren't always reflected in their care.
"We've told the trust exactly where improvements are urgently needed and have received the action along with along with assurances on where work has been undertaken. We'll continue to monitor services closely to ensure people receive care while these improvements are made."
Lack of training
In mental health crisis services and health-based places of safety, inspectors also found that the service failed to consistently ensure staff had sufficient training and awareness to fully support people with diverse communication needs.
The report shows staff failed to consistently personalise risk assessments and care plans or update them regularly, which left some people without clear support strategies. Leaders did not ensure some clinical environments were well maintained or suitable for people's care creating potential risks to people's safety and wellbeing.
It was also revealed that rapid response and home treatment teams failed to meet service standards for crisis care, as staff shortages and heavy reliance on bank and agency staff left people without timely support and at risk of serious mental health deterioration.
Trust accepts findings in full
The trust said it accepts the findings of the CQC's report in full. The CEO of the trust, Sheila Stenson, said it is committed to delivering significant service improvements.
She said: "The report makes for difficult reading, and while this is not the outcome we wanted, it reflects areas that we had already identified from our own independent review earlier this year and had begun to address as part of our continuous improvement plan. On receiving the report from the CQC on April 8, we acted quickly.
"We shared our plan to respond to the warning notice within weeks and urgent changes were made immediately. The inspection was undertaken at a moment in time for our Trust - during a period of significant change and transformation within our community mental health teams, and provides valuable feedback to help us improve further.
"Since March, we have already made improvements and have a detailed plan in place to address the remaining issues raised, and we are confident that the changes underway will lead to meaningful and sustainable improvements. We remain fully committed to delivering the highest standards of care and support, and with the continued dedication of our staff and the involvement of people who use our services, families and carers, we will move forward with determination and transparency.
"We thank the CQC for their feedback, and look forward to demonstrating the progress we are making in the months ahead."
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