Ciconia Recovery London (Harley Street)

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that the service provided was well-led.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

The service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. The leadership team was proactive and committed to delivering high quality care for patients.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff knew and understood the service’s vision and values and how they were applied in the work of their team. Staff could explain to us how they were working together to ensure patients who needed treatment could access it effectively.

Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing. For example, contributing to the service’s website and its content.

Staff could explain how they were working to deliver high quality care within the budgets available. The manager ensured all patients could access their prescriptions.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. The registered manager had worked in the care sector for several years before joining the service and had been in post since the service registered with the CQC. The medical director had extensive experience working in mental health and addictions. They could explain clearly how the teams were working to provide high quality care.

The service manager and the medical director were visible in the service and approachable for patients and staff. The medical director worked closely with the staff team and listened to their views when discussing patients.

Staff were very positive when speaking about the service manager and the medical director. They said that it was easy to raise concerns with them, and this created effective team working.

Development opportunities were available. The service manager supported staff onto bespoke courses to train them into leadership roles.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff reported low levels of stress and felt positive about the work they did. Staff described the leadership team as having a focus on staff well-being and ensured a culture promoting good practice, good quality, and safe care and treatment. The service had a whistle blowing policy in place.

Patients and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. Patients and carers could give feedback on their care through annual satisfaction surveys. Staff sent out questionnaires to 110 patients. For the period 2024/2025, 22% of patients responded.

Staff had access to the feedback from patients, carers and staff and used it to make improvements. From the recent patient survey staff had identified several areas that needed improving. This included better support post-diagnosis, clearer communication about medicines and making prices more visible. The service manager had an action plan to address this.

Patients and carers were involved in decision-making about changes to the service.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff reported that the provider promoted equality and diversity in its day-to-day work.

Staff could apply to work flexibly. For example, flexible working agreements to account for personal circumstances such as caring responsibilities and health issues. Staff could work in the provider’s other office if they needed to.

The service manager put reasonable adjustments in place for staff members to help them carry out their role.

The service undertakes equality monitoring of staff within the service to ensure it is diverse in its make-up and representative of the patient group. Members of the team spoke various languages and were able to use this for the benefit of the patients.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

There was a clear framework of what must be discussed at a service level in team meetings to ensure that essential information, such as learning from incidents and complaints, was shared and discussed. The service held monthly team meetings to ensure essential information was shared amongst the staff. Staff discussed pertinent information such as patient assessments and emerging risks.

Staff had implemented recommendations from reviews of deaths, incidents, complaints and safeguarding alerts at the service level.

Staff completed audits to provide assurance on the performance of the service. Staff acted on the results. The service manager completed a monthly internal inspection. This looked at health and safety, record keeping and governance.

Management of risk, issues and performance. Staff maintained and had access to the risk register at ward or directorate level. Staff at ward level could escalate concerns when required.

Staff liaised with the local authority and the police if a patient or their family needed safeguarding.

Staff concerns matched those on the risk register. The service maintained a risk register. This included staffing, IT failures and fire and health and safety. The service also had plans for emergencies.

Where cost improvements were taking place, they did not compromise patient care. Staff went over and above to provide care and treatment to patients.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure, including the telephone system, worked well and helped to improve the quality of care.

Information governance systems included confidentiality of patient records. The service manager set up an NHS email to provide a more secure portal. Information was kept electronically and in one format. This avoided duplication.

The manager had access to information to support them with their management role. This included information on the performance of the service, staffing and patient care. For example, HR records, supervision records, staff training data and audits.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They share information and learning with partners and collaborate for improvement.

The service manager and medical director engaged with external stakeholders such as commissioners.

Patients and staff could meet with members of the provider’s senior leadership team and commissioners to give feedback.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

Staff were given the time and support opportunities for improvements and innovation and this led to changes. The service manager had developed the attention deficit hyperactivity disorder (ADHD) Alliance to support frontline workers with their ADHD care and treatment and treat them swiftly. This was developed in collaboration with public employers.

The service achieved NHS recognition after the manager applied for the National Framework Agreement for the provision of Mental Health and Wellbeing Services. This was a scheme through a local NHS trust that meant the provider was a service supporting NHS provision. This ensured that patients could access the care they needed when demand for mental health services had grown. This confirmed the GP shared care agreement and allowed patients to access NHS funding.

The service provided placements for psychology students which helped support the development of allied health professionals.

Staff offered adjusted fees for patients who needed it. This ensured all patients could access care and treatment.

The medical director collaborated with international services to create an addiction service abroad.

Staff had opportunities to participate in research. The staff team went to Saudi Arabia to attend an addiction rehabilitation conference where they received an award for their contribution.