• CQC issues warning notice to Kent and Medway
  • Regulator found appointments cancelled at short notice and poor communication with patients
  • It also raised concerns about patients being discharged with no clinical justification
  • Trust said it “fully accept the CQCs findings”

A mental health trust has been ordered to carry out an immediate review of community team caseloads after concerns about “ongoing risks” to patients.

Kent and Medway NHS and Social Care Partnership Trust has been issued with a warning notice by the Care Quality Commission. Inspectors told the trust to carry out the review after an unannounced inspection in January which was prompted by concerns over staffing levels being raised with the regulator.

The trust was told to put preliminary safety plans in place by the end of March, followed by a more comprehensive review with new assurance processes to be in place by mid-August.

The CQC report said adult patients’ risks were not always assessed appropriately; caseloads were not effectively managed and were very large for some staff; and staffing levels meant teams could not implement a new model of assessing new patients.

It also found appointments were often cancelled at short notice and staff felt overworked and patients’ care records were not always updated. Patients were also sometimes overlooked and were moved between caseloads without communication or were not followed up if they missed appointments.

The report said: ”Community mental health teams did not have systems in place to ensure that caseloads were effectively managed, staff did not have formal handovers, patients were not followed up if they did not attend and patients were not appropriately discharged from the service. This presented an ongoing risk to patients.”

The CQC inspected three of the trust’s teams for working age adults – two in East Kent and one in Medway – and found sickness rates of up to eight per cent, staff turnover up to 18 per cent and vacancy rates for qualified staff of more than 20 per cent in one case.

One team, operating in the Canterbury and Coastal area, had held a three day workshop and discharged 300 people who were unallocated or who had not been seen for six months. However, when inspectors reviewed 31 care records from this group they found little clinical justification for the discharges. Patients were not told they were discharged and care coordinators, who knew the patients, were not involved in the workshop.

The responsive inspection did not give services a rating but a CQC inspection in 2017 rated the trust as good overall – although community mental health services for adults of working age were rated as required improvement.

In a statement, the trust said: “In 2017, the CQC told us that we needed to improve the services provided by our community mental health teams. The CMHTs have carried out some really good work which was highlighted in the recent CQC inspection. However the progress has not been sufficient.

“We fully accept the CQCs findings. We were not where we should be at the time of the inspection, however the findings have helped us improve and work at pace and we have made excellent progress which we will continue in line with our comprehensive action plan.”