Patients 'detained beyond time permitted by law'

Assessment centres in Maidstone, Canterbury and Dartford were assessed

An NHS mental health service is not always detaining patients in line with legal requirements, a regulator has found.

The Care Quality Commission (CQC) reviewed 15 records at assessment centres in Kent and found nine of the patients "had been detained beyond the time permitted by law".

Inspectors said they issued a warning notice to Kent and Medway NHS and Social Care Partnership Trust, which runs the centres in Maidstone, Canterbury and Dartford.

Trust chief executive Sheila Stenson accepted the report made for "difficult reading" but said staff had a "detailed plan in place" to address the issues.

The CQC downgraded the rating for the mental health crisis services from "good" to "requires improvement" after the March inspection.

According to its report, trust staff "did not always demonstrate the duty of candour and apologise" when patients were detained longer than legally permitted.

Managers claimed "a lack of availability of inpatient beds and wider system pressures" caused delays, inspectors wrote, but "did not have a reporting mechanism for this".

People can be detained in a place of safety for up to 24 hours pending an assessment if they appear to have a mental disorder and authorities believe it's necessary on safety grounds, according to the NHS.

The CQC found centres at St Martin's Hospital in Canterbury and Littlebrook Hospital in Dartford did not give users "direct access to outside space and fresh air".

Staff at assessment centres were "unaware" of translator services and used Google translate instead, inspectors said.

'Increased risk'

Inspectors examining the trust's community service found high demand and insufficient staffing capacity.

The trust "removed processes to proactively monitor risk to people who were waiting for assessments", the CQC said, which "increased risk of people's mental health deteriorating without the service's knowledge".

One person "had still not started their initial intervention and had to wait six months for a medication review" despite numerous hospitalisations, according to the report.

Trust staff had to contend with unreliable internet but "shared a compassionate approach to supporting people in their care to have an improved quality of life", inspectors wrote.

Community services were rated "requires improvement" and for the "safe" category, rated "inadequate".

The trust's chief executive Ms Stenson accepted the findings and said the trust was "committed to delivering significant service improvements".

She said: "We shared our plan to respond to the warning notice within weeks and urgent changes were made immediately."

Serena Coleman, CQC deputy director of operations in Kent, said the trust's community care "declined significantly" since its previous inspection in 2020.

She said it had "told the trust exactly where improvements are urgently needed" and would "continue to monitor services closely".