Skip to main content
Due to maintenance, some parts of the ACEVO website won’t be available on Wednesday 27 March, from 7–9am.
For urgent requests please email

Growing pains: sharing experiences of organisational growth

By Katie Antill, CEO, Alzheimer’s & Dementia Support Services.

When I saw the ACEVO growing pains event, I booked straight away. Until that moment, I hadn’t realised that it wasn’t just something I wanted to do. I also needed to. To connect with other CEOs who have grown their charity. Perhaps they, too, felt the burn we are feeling following our rapid and enormous growth.

I will start from the beginning. Alzheimer’s & Dementia Support Services (ADSS) is a service charity providing support and care for those affected by dementia and has been going for over 30 years. When I joined in 2018 as a senior manager, we were little known, operating in a small part of Kent, serving around 800 people a year, with about 50 staff and 20 volunteers. I knew we could and should be doing more. What we were offering was special but not enough people who needed us were getting us. Fast forward five years and with a promotion to CEO, the phrase that comes to mind is “be careful what you wish for.”

Yep, you’ve guessed. We have grown. In that time our team has doubled, volunteers quadrupled, we are now serving over 4,500 people a year, and most importantly, we are doing it well. We know that more people’s lives (often in the hardest of circumstances) are better because of what we do best every single day.

A big part of our growth has happened in the last 18 months after being awarded three big contracts from the NHS and local authority. This has involved us scaling up, developing a new service and working methodologies, recruiting and inducting 40 new team members, sub-contracting, measuring KPIs and a whole lot more in between. I would be lying if I said it has all been plain sailing, but I am still smiling and feeling incredibly proud of what we have become and the difference we are making in the lives of people with dementia.

Before the ACEVO growing pains session, I had a few unanswered questions and even more nagging doubts. I knew that the mobilisation of our new contracts would be hard work, we had expected and prepared for that, but 18 months down the line, a few things caught me off guard and left me thinking ‘should I have seen them coming?’, ‘would a more experienced CEO have planned and mitigated for them?’, ‘am I driving myself and my team too hard?’ etc etc…. Which probably all boiled down to the big question, or self-doubt you could call it: am I enough?

The things I was kicking myself about were related to a period of overwhelm in the team driven by high demand for our service and the desire to constantly do more for the people we serve; compounded by a higher-than-expected turnover rate in our team and a few rumbles of discontent; not foreseeing the number of safeguarding concerns our team would uncover; and being unsure how to keep elevating mine and my management teams’ leadership skills.

The growing pains session did not disappoint. It was reassuring, cathartic even, to hear from other CEOs about their experience, and they were very generous in sharing their wisdom. I took away a few insights that have already helped me in my thinking, some confidence that where we were deliberate and intentional about things we were probably on the right lines and the reassurance that no one has a crystal ball to predict all eventualities.

The themes which resonated most with our preparations and helped me to realise we actually did pretty good, were:


Get this right as soon as you can. Safe growth can only happen by having the systems and processes in place and the people who will help you on your journey. With the help of a Pilotlight project and a few ACEVO webinars from Joy Allen, I worked with our board to ensure we had the right people, and the right number of them, around the table. It was all about collaboration and mutual trust, and I knew that the number of sleepless nights I would have would be drastically reduced if I could share my wins, hopes, fears and disappointments with my chair and board. I now have a chair who could not be more generous with his time, especially when it comes to listening to me moan, calming me and showing he cares.


Growth needs to be strategic and conscious. It probably won’t work if it’s a happy accident. If you haven’t got a strategy that clearly demonstrates how you will achieve your vision and why you need to grow to do that, then you will fall over. We worked hard on defining our vision, mission and purpose, clearing the decks of things that we were doing that weren’t moving us in that direction, looking hard at what other charities could be doing and most importantly, listening to the people we support about what was working for them and what we could do better.

Letting go

For the leadership and governance structure to work, you have to be less involved in the detail. Trusting those whose job it is to know what they are doing. At ADSS, we did some targeted work looking at our skills across the whole organisation. This started with a skills audit of the board but we also looked at the capability of our team. We became pretty deliberate in finding people who could get stuff done, use their initiative but understand the vision. We recruited some specific role descriptions for our board. We are on a journey of using data, feedback, evidence, and insight to make our decisions rather than just observation and anecdotes. 

Feeling slightly buoyed up, we moved into the breakout rooms, and I really enjoyed being asked by one of the delegates ‘Katie, what’s enabled you and the organisation to get through?’. This gave me the chance to wax lyrical on a subject, that I could probably talk endlessly about, which I think is the key to our success and is enabling us to improve the lives of people affected by dementia. Our values.

So, after a little whoop of delight, I set about talking about our values. This for me is what has kept us going when times have been tough, guided us when everything felt new and different and kept us together when we could have divided. I induct every new team member on our values and what they mean for the way we behave. For me, values are our ‘how’ and if we had only been guided by our ‘what’ and ‘where’, we would be a very different charity today.

We have been on a bit of a values journey but the deliberate and intentional things we did to help us prepare were;

  • We had a board away day with the fabulous Jackie Le Fevre. This not only gave the board and senior leadership team a common understanding and language but also started a greater sense of collaboration. It also helped us all as individuals understand where our personal values were aligned with those of ADSS and where they were complimentary (it helped one board member realise he wasn’t a fit, and he said goodbye).
  • We recruited using our values. With the high number of new people needed we had to take some who had no previous experience in dementia care. We very deliberately set about finding the people who shared our values. We knew we could teach them most of the job but if they didn’t get how we wanted to make the people we support feel, then they just wouldn’t get ADSS. Trustees, finance managers, frontline workers, and volunteers, they are all required to demonstrate they share the things that matter and the things that get the heart pumping faster.
  • We have since kept the conversation about values alive. We all challenge ourselves to walk the walk and we try to be open when people are not quite getting it right, and my goodness, we celebrate it when we are.

So, what has this all meant for me as a CEO? I have told those nagging doubts to ‘do one’ and I am feeling more comfortable with the fact that there will always be those unforeseen circumstances and unintended consequences. But keeping the organisation agile, well governed, collaborative, with our values as our beating heart, will help us deal with them. I have given us all, especially myself, a good pat on the back. We deserve it!

It was a jolly good hour and a half. Growth will always lead to some growing pains, but your preparation, governance and culture will help the pain to feel more like a little graze than a big open wound!

Share this

Not an ACEVO member?

If you have any queries please email
or call 020 7014 4600.

This website uses cookies to improve your experience. Privacy & cookie policy

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.