An NHS mental health trust has been told its leadership must improve as patients were not always protected from the risks of poor care.
The Care Quality Commission (CQC) found Kent and Medway Mental Health NHS Trust was not “properly involving or supporting families and carers after serious incidents”.
It also said “local system pressures meant that the majority of people ready for discharge did not have appropriate accommodation to be discharged to”.
Trust chief executive, Sheila Stenson, said “a number” of concerns were already being addressed before the inspection but admitted there was “more to do”.
Kent and Medway provides mental health and learning disability services for almost two million people across the region, including inpatient and community facilities.
Following the inspection in March, the CQC’s deputy director of mental health in the south, Serena Coleman, said: “When we inspected… we found leaders and staff were committed to improving the care they provided, but we found significant concerns about the trust’s management arrangements which meant people weren’t always protected from the risk of poor care.”
Staff told the CQC they did not feel confident concerns they raised with managers would be acted upon, she added.
Some staff did not feel they could raise issues through their “normal management line” with a quarter of those who raised them anonymously doing so “because they feared reprisal”, Coleman said.
She continued: “We were particularly concerned to find that family and carers weren’t always involved in a meaningful way.”
The CQC said staff often treated communication as a box-ticking exercise rather than making sure families understood what had happened and received the support they needed.
There were also concerns staff from ethnic minority groups and those with disabilities were experiencing “disparities in recruitment, disciplinary processes and workplace discrimination, and white staff remained significantly overrepresented at board level compared with the wider workforce”.
Coleman added: “This matters because a trust’s leadership should reflect the diversity of the people it employs and serves.”
Inspectors did, however, say they witnessed examples of “compassionate, innovative care”, and that recent improvements had led to a significant reduction in the amount of time people were waiting for a dementia diagnosis.
The trust said it understood “the seriousness” of the issues, particularly with its governance, assurance and culture.
“We are sorry that there were areas where our performance, and the experience of some people using our services, were not where they should have been,” Stenson said.
“We have strengthened our leadership and governance arrangements and published a trust-wide ‘quality improvement plan’, bringing together the actions needed to deliver lasting improvements in the quality, safety and experience of care.”
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