A trust's urgent and emergency care services have bounced back from an 'Inadequate' rating to 'Good'.
The inspection by the Care Quality Commission (CQC) in February noted significant improvements since its previous visit to Medway Maritime Hospital.
In the report, inspectors commended staff for managing infection control risks, assessing risks to patients, and acting upon them.
They praised the way care was planned to meet the individual needs of people and said staff felt respected, valued, supported and were focused on patients' needs.
However, it said the service does not always have enough nursing staff on duty but added the trust took mitigating actions to address the shortfall.
Inspectors reported patients were queuing outside to be booked in during poor weather conditions, some had waited up to 40 minutes, and staff did not always go outside to assess the situation.
There also "continued to be poor flow of patients out of the department" and people were waiting for speciality reviews and medical beds, the report added.
The department in Windmill Road, Gillingham, was rated 'Good' overall but the services response was said to need improvement.
"We know there is still more that we can do to improve, and we remain committed to providing the outstanding service..."
The trust said it had made a number of changes following the CQC inspection of the Emergency Department in December 2020.
It said it had worked with health partners to managing demand, leading to a reduction in the number of patients waiting in ambulances for longer than 60 minutes, put processes in place to quickly identify those who are deteriorating in ambulances so they can be prioritised and increased the review of people waiting to be admitted.
It has also opened an additional 20 beds, investigated how it can decrease discharge time and introduced a programme to improve leadership.
Trust interim chief executive, Jayne Black, said: "I am delighted the CQC has recognised the significant improvements that have been made to the way emergency care is provided at the trust.
"I would like to thank colleagues for their hard work and commitment to delivering these improvements despite a very challenging backdrop of increased demand for services and the pandemic.
"Thanks to their efforts we are now providing more timely and consistent care for patients coming into the Emergency Department.
"We know there is still more that we can do to improve, and we remain committed to providing the outstanding service that the people of Medway and Swale expect and deserve."