Across all South Wales Children’s Services, the Keys Group clinical team provides dedicated support to enhance children’s emotional, social, and developmental outcomes. Our South Wales Clinical Team comprises a Forensic Psychologist, an Assistant Psychologist, and a therapist, and they work alongside the Operations Team (Regional Manager and Peripatetic Manager) to support Residential Managers in ensuring that every child receives consistent, informed, and reflective care.
Before a young person is admitted to a service, a pre-planning multi-disciplinary team meeting takes place to coordinate the proposed care package and share an analysis of need with Operations, Clinical, and the Specialist Advisor Teams, with a follow-up meeting arranged within 7 days of admission.
A cornerstone of ongoing support through each placement is the daily handover system. At the end of each day, team members within each home formulate an overview of each young person’s day. This includes daily activities, routines, emotional responses, and presentation, and also signposts any additional recorded incidents. This overview is emailed to both the Operations Team and Clinical Team and is often used as the basis for preparing the weekly handovers for Social Workers.
This enables Clinicians to notice emerging patterns, understand each child in depth, and help guide reflective practice within the homes. The handovers include how the child is feeling, what has gone well for the child and any struggles. It is useful to see how the team have tackled any challenges and what has worked well. This helps the clinical team build a good understanding of the child’s needs and how we can best utilise the residential team's skills to aid the child’s progress. It also helps the clinical team to notice patterns or escalations in the child’s behaviour. These patterns are seen as opportunities for growth and development. Feedback to the handovers strengthens relationships between carers and clinicians, encouraging curiosity and improving observational skills, helping staff respond thoughtfully to children’s individual needs. Feedback will usually be given directly via email, but may also be provided at a later stage during consultations. This is also an easy way for the clinical team to praise the residential teams for the support they are giving the children, and for the excellent ways they have approached and worked through difficulties. At times when children are struggling, and the teams are worrying that they should be doing more, the information that has been conveyed in daily handovers can help the clinical team to reflect back on concrete examples of the progress that is being made.
Clinical and Operations meet weekly to discuss the regional support required, identify patterns or trends, and highlight examples of good practice or areas where additional support may be needed.
The Clinical Team attend monthly consultations with the services in person. We also have a connect assessment meeting after the child has been with us for three months, to which the manager, staff team, and social worker are invited. This is then reviewed every three months, and after a year, may be extended to every six months if the child is settled and doing well. This ensures clinical insights are consistently integrated into each child’s care plan, providing continuity and clarity for both staff and children. The daily handovers feed into monthly consultations and the quarterly reviews by helping us to see how the teams are working towards the child’s trauma recovery progress and working towards the goals/outcomes we have chosen for the children as a multi-disciplinary team.
Baruc House provides a clear example of this collaborative approach in action. Two members of the Keys Group clinical team, Sheena Wallace, Therapist, and Rachel Marcarian, Senior Psychologist, have worked closely alongside the team at Baruc House, embedding reflective practice and supporting tailored interventions for the children living there.
A 14-year-old boy, known as X, came to Baruc House from a previous placement under a Special Guardianship Order. The Pre-Placement meeting enabled us to identify needs and prepare the initial care package; the follow-up meeting then enabled us to add detail to the bespoke plan. X was nonverbal and found it difficult to communicate his needs and emotions.
The daily handovers enabled the supporting network to oversee daily interactions and presentations, thereby forming a clearer understanding of X. This provided sufficient detail to enable a consistent and informed approach from the Clinical Team, and the ongoing use of targeted reflective practice encouraged staff to tailor strategies to meet X’s individual needs. They noticed small attempts at communication, responded consistently with reassurance, and celebrated each step toward self-expression. They also noticed and reflected on how X was developing his understanding of the world around him through play and sensory exploration. Over time, X began using words alongside his gestures, gradually building confidence to express himself verbally. The structured guidance from the clinical team, combined with the nurturing, consistent support of the staff, helped X find his voice and feel understood.
Today, X is communicating verbally within the home environment, using words to express his needs, preferences, and feelings with staff he trusts. While he is still building confidence to use his voice more widely, the progress he has made is significant. Some of his very first words were playful and a little cheeky, a moment that brought huge smiles to the team who had supported him so patiently.
One example of this was when he was able to express to the team caring for him that he did not want to go to school, and was facing some fear and anxiety around this. With support and understanding of his needs, the residential team were able to take small steps to get X back to school, gradually building up from brief visits to a return to full-time attendance. This was made easier by the progress X had made in his communication, and by how well the team were able to understand his needs and advocate for him with his school.
This story illustrates how the systems in place across South Wales enable children to thrive, staff to grow professionally, and care to be responsive and consistent. By working together in this structured, reflective way, South Wales Children’s Services and the Keys Group clinical team create environments where children are deeply understood, staff feel supported, and meaningful outcomes are achieved.
