- SERVICE PROVIDER
South London and Maudsley NHS Foundation Trust
This is an organisation that runs the health and social care services we inspect
Report from 5 February 2026 assessment
Contents
Ratings - Community-based mental health services for adults of working age
Our view of the service
We carried out an inspection of the trust’s community-based mental health services for adults of working age on 10 to 20 June 2025. This inspection was completed as part of the CQC's Adult Community Mental Health Programme. We also inspected mental health crisis services and health-based places of safety as part of the programme. The programme of inspections contributes to CQC's commitment to inspect the standard of care in community mental health services across the country. We undertook a short notice announced, comprehensive inspection of this service, looking at all 5 key questions to assess if services are safe, effective, caring, responsive and well-led.
South London and Maudsley NHS Foundation Trust is part of the South East London Integrated Care System (ICS). The population of the South East London ICS area is approximately 1.8 million. This includes six London Borough Councils, which are unitary authorities. While Bexley and Bromley have relatively low levels of deprivation, Greenwich, Lambeth, Lewisham and Southwark have higher levels of deprivation. All six areas are more ethnically diverse than the national average, with all having a lower percentage of white residents.
The trust’s community-based mental health services for adults of working age are spread across 4 directorates, Lambeth, Lewisham and Addictions, Southwark, and Croydon and Behavioural and Developmental Psychiatry.
- Lambeth directorate delivers care and treatment to working age adults through an alliance. The alliance is a collaboration between five organisations: Certitude and Thames Reach (voluntary sector); NHS SEL Clinical Commissioning Group (CCG), South London Maudsley NHS Foundation Trust, and Lambeth Council.
- Lewisham directorate provides core mental health services for adults of working age who live in Lewisham.
- Southwark directorate provides core mental health services for adults of working age who live in Southwark, alongside the trust’s specialist services.
- Croydon directorate provides core mental health services for adults ofworking age who live in the London borough of Croydon alongside national specialist services including forensic mental health services, prison health, and neurodevelopmental disorders including learning disabilities, autism spectrum disorder (ASD) and adult attention deficit hyperactivity disorder (ADHD), and specialist services for people with psychosis.
The way in which services were organised and delivered varied across the 4 directorates and across different teams. This included differences in governance systems.
The inspection team comprised 4 CQC inspectors, 1 CQC analyst, 1 CQC senior specialist in mental health, 1 CQC deputy director, 3 CQC pharmacist specialists (also referred to as medicines inspectors), 3 specialist advisors, and 1 Expert by Experience (people who have experience of using or caring for someone who uses services).
During the inspection we:
- visited the Lewisham Neighbourhood 1 team, the early intervention teams at Lewisham and Lambeth, the Southwark assertive outreach team, the Lambeth single point of access team, the Lambeth Living Well Centre north focused support team, the community mental health teams at Croydon central and north and the Croydon assessment team,
- the medicines team visited 5 sites, where community mental health services, early intervention in psychosis services and various medicines clinics were held,
- spoke with 122 staff of various grades and roles,
- spoke with 12 people who used services and 7 carers,
- reviewed 52 care records for people who used services, including medicines administration and associated care records.
We last inspected the service in August 2021 when we rated safe and responsive as requires improvement and effective, caring and well-led as good. This led to the assessment service group being rated overall as requires improvement. At our last inspection we found breaches in regulation relating to managing emergency equipment, medicines management and the management of controlled stationery, mandatory training compliance, delays to Mental Health Act assessments and not meeting the target for assessing non-urgent referrals within 28 days.
At this inspection we rated the service as requires improvement. We rated safe, effective, responsive and well-led as requires improvement and caring as good. We found 8 breaches of regulation relating to:
- assessing and responding to risks for people waiting for services
- risk management processes, including completion of risk assessments and risk management plans
- the suitability of care environments
- person-centred care
- compliance with reading people’s rights under section 132 of the Mental Health Act
- effective governance, including monitoring and improving outcomes for people and
- completion of care records.
- The service still had delays to carrying out assessments under the Mental Health Act 1983.
We have asked the provider for an action plan in response to the concerns found at this assessment.
However, the service had made some improvements and was no longer in breach of regulations relating to emergency equipment and management of controlled stationery.
People's experience of this service
Feedback obtained during the CQC 2024 Community Mental Health Survey showed that people who used services were not satisfied with their care and treatment. They described not always being treated with care, compassion or respect, and some felt that person-centred care was not present in both their care and other areas of life.
People told us about negative experiences related to longer waiting times for appointments and treatment, not receiving the personalised care they needed, and a lack of confidence in the system. People who used early intervention services described having little to no support during the waiting times, resulting in the deterioration of their conditions.
However, people who used services described staff interaction having a positive impact on their experience of mental health services, especially where having a good relationship with care co-ordinators led to feeling supported and understood.
Feedback gathered during our onsite inspection was more positive. We spoke with 12 people who used services. Feedback was mostly positive about staff attitudes and behaviours. Nine out of 12 people told us staff supported them to feel safe, and staff treated them well. One person told us “they have helped me be safe and cope better day to day”. However, 2 people commented they did not feel they got the help and support they needed from staff. One was not happy with their medicines and the other raised issues regarding communication from their care co-ordinator.
We spoke with 7 carers of people who used services. Feedback from carers was overwhelmingly positive about staff attitudes and behaviours. One person told us “they are polite, happy and they make me and my son feel like we are the only people they are dealing with”. People told us staff understood their relatives’ individual needs and they had been involved in meetings or reviews about their relatives’ care.Carers told us they had been offered support. For example, 2 carers talked about joining an online support forum for carers which they found very helpful. Carers told us about the positive impact staff and the service had for their loved one. One person said “Oh my God it’s been life changing for my [relative] and myself. Just amazing, really hard journey to get here but the change in my [relative] is massive”.
Feedback provided by Healthwatch in their report ‘Towards Inclusive Healthcare: Rethinking mental health services for Black African and Caribbean communities in Southwark’ published in February 2025 showed ‘significant barriers to accessing mental health support, including stigma, distrust of public services, and limited awareness of available resources, particularly for early intervention and preventive care. Many participants associated mental health services with negative experiences, including being medicated or detained, leading to fear and avoidance. These challenges disproportionately affect Black men’. Feedback obtained during outreach visits in the last year showed mixed feedback with some people who used services expressing satisfaction with services, activities offered and staff. Negative experiences were regarding delays for assessments and appointments and communication.