Anna Freud Centre

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment of this service, we rated this key question as Good. This is the first assessment of the service at this current location.
The overall rating for caring at this location remains Good.
This meant people were protected by a strong and distinctive approach to safeguarding, including positive risk-taking to maximise their control over their lives. People were fully involved, and the provider was open and transparent when things went wrong.

We have not awarded this service a score for Safe.

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

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

There was a strong learning culture within the service
Staff knew how to recognise, respond to and report incidents, and they followed the provider’s procedures to ensure that learning was shared, and actions were taken to prevent recurrence.
There had been no serious incidents in the 12 months before the inspection. The provider had a clear policy outlining what constituted a serious incident and the process staff should follow to report one, including reporting to the Care Quality Commission. Any serious incidents would be escalated to senior management and discussed at governance meetings.

Staff told us there was a culture of openness, transparency and learning within the service. They described how children, young people and families were provided with full and honest explanations when things went wrong, in line with the organisation’s duty of candour policy.
Staff also told us the team learned from incidents and near misses to support continuous improvement. These were discussed in team meetings. For example, a near miss involving a delay in reporting a safeguarding alert was reviewed, and parents were informed promptly about the potential delay.
Staff understood the importance of learning from incidents and maintaining trust through clear and compassionate communication. Regular team meetings and supervision sessions provided opportunities to discuss lessons learned and identify areas for improvement. The minutes of multidisciplinary and team meetings reflected that learning was shared during these meetings.

Staff were encouraged to reflect on their practice and share learning from incidents, complaints, and feedback. Managers promoted openness and accountability, ensuring that learning was cascaded effectively across the team. Staff told us they felt supported to raise concerns and confident that their views would be listened to and acted upon. The service used tools such as the Routine Outcome Measure (ROM) to track progress during audits and outcome reviews to identify trends and implement changes aimed at improving the quality and safety of care.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service did not have a waiting list. Referrals were appropriately screened and triaged to the relevant team to ensure timely access to care for children and young people. There was a robust care pathway supported by effective multidisciplinary working, including clear processes for referral, assessment, and discharge. The service ensured that all essential information was obtained to determine whether patients’ needs could be appropriately met. Staff worked in partnership with statutory and community services to promote continuity of safe care, both within the service and following discharge.
Services were tailored to meet the individual needs of young people and delivered in a way that promoted flexibility, choice, and continuity of care. The involvement of schools, Local Authority and NHS partners and the local community was integral to how services were planned and developed, ensuring that care was responsive and aligned with young people’s needs. There were innovative approaches to providing integrated, person-centred pathways of care that involved close collaboration with other service providers, particularly for young people with multiple and complex needs. These pathways also included early intervention initiatives for children who did not meet the criteria for the Child and Adolescent Mental Health Service (CAMHS) but required support to prevent the escalation of mental health difficulties, including support for emotional, behavioural or developmental needs.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.
Mandatory training compliance was regularly monitored to ensure all staff maintained up-to-date knowledge. All staff were required to complete safeguarding training at levels 2 and 3 before having any contact with patients. This ensured they upheld best practice standards and approached all interactions with a clear understanding of safeguarding principles by following appropriate safeguarding principles Staff we spoke with demonstrated a strong awareness of their responsibilities in recognising and responding to concerns, and they knew how to make safeguarding alerts and did so appropriately when required. This included staff working in partnership with other agencies. Staff who worked in outreach services, including the school services, also demonstrated a clear understanding of safeguarding procedures. They were confident in identifying and escalating concerns, both within their own team and through appropriate channels within schools. This collaborative approach helped to ensure that safeguarding issues were addressed promptly and that children and young people received coordinated and safe support.
Staff told us that the senior staff member on duty was the first point of call in safeguarding issues, and the internal processes were followed, including referrals. The safeguarding issues raised are kept with the young person’s record, with plans of action, keeping the young person informed. A daily rota was in place for the clinical team to manage safeguarding queries, ensuring that advice and oversight were consistently available.
The service carried out annual safeguarding audits to identify learning themes and trends, which informed staff development and continuous improvement. Managers reviewed safeguarding incidents to confirm that appropriate actions were taken, and learning was shared across the team.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

We reviewed 5 care records in detail during this assessment. All patients had an up-to-date risk assessment in place.

Staff completed and regularly reviewed risk assessments for each child and young person, ensuring that risks were clearly identified and managed. They acted promptly when a young person’s mental health needs changed or deteriorated, escalating concerns and arranging timely transitions to services that could provide the appropriate level of support.
Risk management plans were detailed, person-centred and developed in collaboration with young people and their families. This showed improvement since the last inspection.
Staff communicated with and involved children and young people effectively to ensure they understood their care and treatment. They employed creative and age-appropriate approaches, including communication through play and drawing. This was particularly effective for those with communication difficulties, helping young people to express their views and take an active role in their care
Staff ensured that children and young people had access to advocacy services. Advocacy and support information leaflets were provided to families, listing a range of organisations that offer advocacy, advice, and guidance. The multidisciplinary team (MDT) risk management took place twice a month, and risks were also reviewed in weekly supervision. For cases involving multiple organisations, staff used shared formulation approaches to ensure families received the most coordinated and effective support.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The setting was accessible and welcoming, with input from young people to improve the waiting area environment. Parents told us they liked the team’s location and felt the premises were well-maintained with good accessibility. They described the environment as very nice, child-friendly and a very good setting for children. Families said they felt comfortable and safe when attending appointments, and they felt the environment was supportive for positive engagement and a reassuring experience for children and young people.
Staff regularly assessed the environment for risks, and access to entrances and exits was secure and well-maintained. The service operated from a six-floor, multi-use building with a main reception area on the ground floor. The premises were accessible to wheelchair users, and visitors were advised to inform the service in advance if accessibility support was required. Clinicians collected families from the ground floor waiting area and accompanied them to clinical rooms via stairs or lift.

A lone working policy is in place, supported by individual personal safety alarms and consultation rooms equipped with integrated alarm systems. The environment was clean, well-furnished, and well-maintained. Cleaning was completed by an external company, with staff maintaining sign-off sheets and completing regular cleaning audits. Records confirmed that toys and therapy spaces were cleaned in line with the provider’s infection prevention and control policy.

Staff were trained in fire safety, and fire extinguishers were appropriately placed throughout the premises. A fully stocked first aid kit was available on the ground floor, and all items were within date. Staff carried personal alarms into therapy rooms, which sounded at the floor’s reception area to ensure a quick response in the event of an emergency. Young people from the participation group had recently helped select new age-appropriate toys for the waiting area, and décor and furnishings were kept in good condition.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Staff told us they had manageable caseloads and did not have to work additional hours to complete tasks.

In the last 12-month reporting period, workforce capacity consistently met operational and clinical service requirements in line with established staffing standards. The service was fully staffed, with no active vacancies, and all posts were substantively filled.

All staff completed a comprehensive induction programme, which included the completion of mandatory and role-specific training modules prior to engaging in any clinical duties.
Staff told us that they had access to monthly clinical supervision and management supervision. We saw records that showed all staff had 100% attendance for supervision in the last 12 months.
Staff had completed all required mandatory training, including health and safety, fire safety, infection control, and safeguarding, in line with the Children Act. Training compliance was 100% across all divisions. Staff training, supervision, and reflective practice sessions included discussions on evidence-based practice and skills development. Staff discussed specialist training needs with their line manager and were able to access this. For example, staff attended specialist training such as suicide awareness, autism and ADHD with the Samaritans, the UK Trauma Council and the Anna Freud Centre, with ongoing monthly training and webinars.

The provider assessed and managed the risk of infection effectively

Infection prevention measures were effective, and staff were trained and confident in managing risks. Staff followed infection control principles; we found that equipment and toys were cleaned after patient contact, and equipment was labelled to show when it was last cleaned.
Staff received training in infection prevention and control. For example, they completed infection prevention and control risk assessments and followed clear procedures for hand hygiene, including the routine use of hand gel, cleaning schedules, and the appropriate use of personal protective equipment.

The service did not prescribe or administer medicines as part of treatment. There were no medicines stored on site.