Anna Freud Centre

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment of this service, we rated this key question as Outstanding. This is the first rating of the service at this current location.
At this assessment, the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them.

We reviewed 5 care records of children and young people.

The service provided an initial clinical contact through a screening process to triage and prioritise patients’ needs when they assessed the service. Staff then completed a comprehensive assessment of each patient’s mental health needs to determine the most appropriate treatment options.

We found evidence of comprehensive assessments of the patient’s needs. Staff worked collaboratively with the patients to develop individual care plans, which were reviewed and updated as required. Care plans reflected assessed needs and were personalised, holistic, and recovery oriented. They were age-appropriate and included pictures and simple, accessible text. Staff involved children and young people in the care-planning process through play and drawing activities appropriate to their age and developmental stage. Parents’ views and voices were also clearly documented. Care records contained all the relevant information clinicians needed to plan and deliver care, support, and interventions. They also included details necessary to inform decisions about whether patients required transfer to another team.
Staff delivered care in line with best practice and national guidance, including recommendations from the National Institute for Health and Care Excellence (NICE).
However, in all five care records we reviewed, there was no evidence that care plans had been shared with the children, young people, or their parents. In addition, four of the six parents we spoke with told us they had not received a copy of their child or young person’s care plan. This limited their ability to review and reflect on agreed goals and actions outside of sessions. This was not in line with NICE guidance, which recommends that children and young people should receive a copy of their care plan where they consent to it. For younger children, a copy should be provided to their parents or carers. Guidance states that care plans should be presented in an accessible format and updated as needed, with a new copy provided to the child, young person, and their parents or carers whenever changes are made.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

Care and treatment were delivered in line with national guidance and good practice. Staff used evidence-based approaches to support the emotional and mental health needs of children and young people, ensuring that interventions were tailored to individual circumstances.
The Clinical Services MDT delivers a comprehensive suite of assessments, therapeutic interventions, and support mechanisms for children, young people, and their families who have experienced significant relational trauma, particularly within caregiving contexts.
The team provides structured, multidisciplinary assessment and treatment packages tailored for parents, carers, and Special Guardians. These interventions are underpinned by a mentalization-based therapeutic framework (MBT-C), with a specific focus on attachment-related difficulties and trauma-informed care.
The current structure of the Clinical Division included several teams: Adaptive Mentalization-Based Integrative Treatment (AMBIT); Psychodynamic Psychotherapy and Mentalization-Based Treatment for Children and Young People (MBT-CYP); Family Trauma; Early Years; Evaluation & Implementation; and Central Support, alongside leadership. Much of the clinical delivery sits within the Family Trauma team, with limited clinical provision currently within the Early Years team. AMBIT predominantly delivers training, and this income offsets a significant proportion of the division’s current deficit.
The newly structured MDT operated a clearly defined clinical pathway, with referrals triaged and reviewed to determine need and priority, followed by MDT allocation for full assessment and care planning. Therapeutic interventions were delivered individually or with families in line with agreed care plans, with outcomes and feedback used to monitor progress, inform regular reviews and, where required, return cases to the MDT for further consideration.

The multidisciplinary team worked collaboratively to review care and monitor progress, ensuring that treatment remained effective and responsive to changing needs. The Child and Adolescent Psychotherapy Service deliver comprehensive psychological assessments and evidence-based therapeutic interventions for children and young people presenting with a range of emotional and psychological difficulties. The service offers both brief and long-term psychotherapeutic support, tailored to individual clinical needs and formulated in accordance with best practice guidelines. For example, the Clinical Services MDT delivers a comprehensive suite of assessments, therapeutic interventions, and support mechanisms for children, young people, and their families who have experienced significant relational trauma, particularly within caregiving contexts.
The team provides structured, multidisciplinary assessment and treatment packages tailored for parents, carers, and Special Guardians. These interventions are underpinned by a mentalization-based therapeutic framework (MBT-C), with a specific focus on attachment-related difficulties and trauma-informed care.
We saw evidence where parents’ contributions were clearly recorded, reflecting a strong commitment to partnership working and shared decision-making. Discharge planning and follow-up were completed in partnership with young people and their families, with post-discharge outcomes captured through the POD system to evaluate intervention effectiveness.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.
We reviewed the minutes of the service’s MDT meetings, which are held fortnightly. The purpose of these meetings was clearly defined and centred on fostering shared learning, effective multidisciplinary working and clinical safety. The agenda covered day-to-day operational tasks, case referrals and case tracking, and clinical case discussions. Meetings also included a review of routine outcome measures, safeguarding tracker updates, and space for staff to provide feedback and suggestions, demonstrating an open and collaborative approach to continuous improvement.
We found evidence of effective multidisciplinary and interagency working. Staff from different teams, including external services, were committed to working collaboratively to ensure the best care for the patients and supported each other to ensure there were no gaps in care. They had strong working relationships with other relevant teams within the organisation, such as the Schools & Colleges Early Support Services (SCESS), as well as with multi-agency collaborations and Statutory services (e.g., Social Care, CAMHS)
There was effective multidisciplinary collaboration, with professionals working closely together to deliver coordinated therapeutic care and support. Records showed good engagement with the school’s division and clinical team, social care, and voluntary sector partners, promoting early intervention and ensuring continuity of care. This collaborative approach meant children, young people, and their families received well-coordinated support that reduced delays and improved overall outcomes. For example, the provider used LAPTUS, an electronic patient record system, to record, review and share clinical information, which supported effective risk management and continuity of care for children and young people.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and, where possible, reduce their future needs for care and support.

Staff supported people to access information about healthy living, including leaflets and posters promoting a healthy diet. However, there was limited evidence of active interventions to support people to live healthier lives.
Additionally, we saw evidence of practical support and advice for people to make informed decisions about their care and treatment. They understood how to support patients who lacked the capacity to make their own decisions or were experiencing mental ill health. For example, the service offered structured therapeutic interventions following trauma. These included therapy packages for children and young people, as well as for parents, carers and whole family units. The interventions focused on recovery, emotional regulation, coping strategies and strengthening family relationships following experiences of trauma, including physical, emotional or sexual abuse.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Clinicians took responsibility for using outcome measures in their work and were supported by the People’s Outcome Data (POD) system, an online mental health outcomes and feedback tool introduced in January 2024 and due for upgrade in January 2026. The service used evidence-based approaches, sharing outcome information with new referrals to support understanding and engagement. Outcome data showed that 75% of cases demonstrated positive progress.
Staff used recognised rating scales to assess and record severity and outcomes, and they made effective use of technology to support children and young people. Staff also participated in clinical audits, benchmarking, and quality improvement initiatives. For example, the introduction of the Patient Outcome Data (POD) system, an online mental health outcomes and feedback system, over the past 12 months has strengthened the collection of outcome data. Managers used audit results to identify learning and implement improvements, enhancing the quality and effectiveness of care.
Managers and staff used the results to improve patients' outcomes. The MDT routinely reviewed and updated outcome measures, including monitoring outcomes with evidence recorded in meeting minutes. Learning was cascaded across the wider team, with supervisors ensuring outcome measures were consistently applied. This system-wide approach supported the use of individual outcome measures in a meaningful and relevant way and learning and expectations were shared across the service to promote consistent practice.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
We found evidence that staff obtained consent for care and treatment in line with relevant legislation and national guidance, and this was clearly recorded in patients’ records. Written consent was present in all five records we reviewed, and where parents or carers were involved, their consent was also obtained. Parents and young people had access to information about independent advocacy and support. This ensured that care decisions were made transparently and that young people were fully informed and involved in the process, with parents and carers included where appropriate.