Anna Freud Centre

On this page

• 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

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment of this service, we rated this key question as Good.
This is the first rating of the service at this current location.

At this assessment, the rating has remained Good.
This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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

We found the service demonstrated clinically led shared direction, underpinned by a positive and inclusive culture. The senior leadership team had effectively communicated the provider’s vision and values to frontline staff, which promoted a clear sense of shared purpose across the service. Staff told us they had meaningful opportunities to contribute to discussions about the service’s strategic direction through meetings, consultation processes and project work, supporting engagement, ownership and collaboration.
Leadership undertook two away days with the clinical leadership group as part of the 2024 review of the Clinical Division. These sessions included informal consultation with staff to understand how the division was functioning and its remit, fostering openness and trust. Senior leaders told us that learning from this process directly informed the development of a new single multidisciplinary team (MDT) structure, reinforcing a shared direction and strengthening team cohesion across the service.
The service demonstrated an open, transparent and inclusive culture in which patients, families and staff felt confident to raise concerns without fear of detriment. Staff described a wide range of well-established and accessible routes for raising concerns, including senior leaders, HR, the Equality, Diversity and Inclusion (EDI) Lead acting as an employee advocate, anonymous feedback mechanisms and the annual staff survey.
These arrangements strengthened staff voice and accountability, and supported a culture of learning, openness and continuous improvement. Staff were proud of the organisation as a place to work and spoke highly of the culture.

The provider 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.

Staff told us that the senior leadership team had achieved an effective and supportive balance in the way they worked together and were readily available when needed. They described a healthy and positive working environment and gave consistently positive feedback about the senior leadership team. HR leadership used triangulation of data such as supervision records, sickness absence, exit interviews, and staff survey findings to identify patterns that could impact staff wellbeing and to ensure compliance with regulatory standards.
Current sickness absence levels remained below national benchmarks, demonstrating the effectiveness of wellbeing interventions delivered by leaders. Leaders had also strengthened staff support during periods of organisational restructuring, including carrying out equality impact assessments to identify and mitigate potential risks.
The service continued to develop and enhance its leadership structures to ensure a safe, supportive and equitable working environment for all staff.

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

Staff told us they felt psychologically safe and were confident they could raise concerns without fear of retaliation. They said the organisation promoted openness, transparency and mutual respect, and described positive working relationships with senior leaders, including the Chief Executive Officer. Staff reported having access to several formal mechanisms for raising concerns, including the Chief People Officer, HR Business Partners, the Equality, Diversity and Inclusion (EDI) Lead, the senior leadership team, anonymous feedback routes and the annual staff survey. These arrangements supported a strong culture of accountability and ensured staff voice was prioritised and protected. This meant issues could be identified and addressed early, strengthening accountability, improving staff wellbeing and contributing to safer, higher-quality care for children and young people.

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

The provider demonstrated a strong commitment to equality, diversity and inclusion (EDI) and to developing an inclusive and fair workplace culture. The service operated an established EDI Committee with senior leadership oversight and delivered a management development programme focused on inclusive leadership. Recruitment practices aimed to attract diverse and inclusive managers that better reflected local population demographics.

An annual EDI metrics report evidenced positive trends, including 25% workforce representation from ethnic minority backgrounds. Workforce data showed that 75% of staff were White females, and the service had set a clear ambition to achieve a more balanced and diverse workforce, targeting a 75% mixed workforce through structured recruitment and retention strategies, including partnerships with academic institutions.

To promote belonging and inclusion, new staff received a structured four-week lunch allowance to encourage team integration and participation in EDI activities. Managers met all new starters in person on their first day, and staff received a comprehensive induction pack containing key policies and organisational information, supporting them to feel welcomed, included and well prepared from the outset.

The service had also implemented mentoring programmes, including reverse mentoring, enabling senior leaders to gain insight from the lived experiences of staff from minority backgrounds. Comprehensive mental health and well-being plans were delivered in partnership with Occupational Health. Staff told us the Human Resources leadership triangulated data from multiple sources to identify trends affecting staff wellbeing and ensure regulatory compliance. Sickness absence levels remained below national benchmarks, demonstrating the effectiveness of these wellbeing initiatives.

Governance and performance monitoring arrangements in place supported the quality and
safety of service provision and identified risks. The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.
The robust governance framework ensured oversight, transparent decision-making and sustained improvements in safety, quality and overall service delivery, resulting in positive outcomes and experiences for children, young people and their families.
Senior leaders maintained formal oversight of the organisation’s risk register and risk level, including the complaints log, ensuring that all incidents and complaints were recorded, monitored and reviewed in line with governance standards and statutory requirements. For example, we found evidence of several areas of good practice, including staff undertaking regular clinical audits and assurance checks that were effective in identifying shortfalls and informing improvements.
The service uses the audit system, Routine Outcome Monitoring (ROM) to assess the completeness and compliance of clinical documentation across all active cases. The portal enabled managers to view when care plans and risk assessments were last updated, track all family contacts, and monitor the completion of data. In addition, the audit demonstrated consistently robust documentation of risks and risk levels. It also confirmed a sustained increase in the use of the new patient outcome database (POD), with over 50% of recorded outcomes now captured within the system, supporting improved monitoring and service development.
The Clinical Governance Leadership Board (CGLB) monthly meetings provided effective oversight of safe, effective and person-centred care for children and young people and their families, while ensuring performance data and related metrics were formally documented in governance minutes and service activities were routinely reviewed, audited and informed by shared learning. This oversight spanned all domains of clinical activity, including therapeutic interventions, assessments, research, participatory initiatives, and compliance and regulatory activities.

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

The organisation operated in line with good practice guidelines for multi-agency and interdisciplinary cooperation. Formal mechanisms for stakeholder engagement and partnership working were embedded within governance structures to optimise outcomes for children, young people and families. We saw evidence of extensive Quality Improvement (QI) activity and ongoing projects delivered in collaboration with external partners, including statutory services, schools, local authorities and voluntary sector organisations. These partnerships were supported through formal frameworks that enabled shared learning, joint problem-solving and consistent system-wide approaches to care. The service had a clear vision for what it wanted to achieve and a partnership strategy to turn this into action, developed collaboratively with all relevant stakeholders.

This strong, integrated approach promoted coordinated support, improved continuity of care and strengthened the overall effectiveness of the local health and care system.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.
The service approach ensured that the voices of children, young people, parents and carers influenced ongoing service development, research participation and strategic decision-making.
The service actively contributed to creating safer, more effective practice and ongoing research, ensuring that children, young people, and their families were meaningfully involved in developing and evaluating improvement and innovation initiatives. Children and young people ambassadors formed part of the engagement framework, operating within the Lundy Model of Participation, which is structured around four interdependent domains. For example, space was provided through safe, inclusive and accessible opportunities for young people to express their views; Children and young people’s voice was enabled through appropriate facilitation so they could share their views freely without fear of reprisal; Audience ensured that their views were actively listened to and recorded; and Influence meant their views were given due weight in decision-making in line with their age and maturity.
Young ambassadors were actively involved in external research activities, including the DNA Children and Young People's Health Resource (D-CYPHR) project, in which participants aged 0–15 and their parents or guardians completed questionnaires and provided bodily samples to support national research on children and young people’s health. Ambassadors met monthly online to discuss progress, share ideas for increasing participation, and stay connected. Meetings were supported by leaders and staff, including a parent, a carer (parent participation assistant) and individuals with lived experience, who took notes and ensured that feedback was captured and acted upon.