What Makes a Children's Home Trauma-Informed? | #TRIBE Talk - Ep. 34

In this episode of TRIBE Talk, we explore what it really means for a children's home to be trauma-informed. While many services describe themselves as trauma-informed, the reality is that trauma-informed care is much more than training, policies, or good intentions. It requires a whole-system approach that shapes how staff understand behaviour, build relationships, respond to crises, and support young people every day.

Drawing on real-world experience from residential care settings, we discuss the key ingredients of effective trauma-informed residential care and how they create environments where children can feel safe, develop trusting relationships, and begin to heal from past adversity.

Episode Highlights:

• What trauma-informed residential care actually means
• Why training alone is not enough to create trauma-informed practice
• Understanding behaviour through a trauma and attachment lens
• The role of relationships in supporting healing and recovery
• Creating safety, predictability, and consistency within the home
• Supporting staff to deliver trauma-informed care effectively
• How assessment, formulation, and intervention work together
• What good trauma-informed residential care looks like in everyday practice

Transcript

SPEAKER_00 0:00

Welcome to Tribe Talk Everybody. You're here with Laura Neal. I'm Rachel Evans. And today we're talking about trauma-informed residential care.

SPEAKER_01 0:15

So I think when people hear the word residential care, they often think of something that's quite institutional, something that's less personal, less relational, maybe less therapeutic. But in reality, when it's done really well, um it can look very different.

SPEAKER_00 0:30

Yeah.

SPEAKER_01 0:31

So let's start the podcast with um talking about what is residential care. So, Laura, what is residential care? How would you define and describe residential care?

SPEAKER_00 0:40

Yeah, so residential care, I mean, sometimes it's referred to, not so much in this country, but a group home. So it would be a home that has more than one child placed there from different families. Sometimes it can be from the same family, but you essentially have a staff team that are looking after multiple children in their care within one home environment. Um, now in the UK, that's usually between one and four young people. Sometimes it uh goes up as far as six. But I think you you mentioned that people can think of residential care as institutionalized, and um you think of lots of people being within that environment. But actually, residential care is more of a home environment where you might have uh one, two, three, four children, sometimes five or six, but uh more often than not, um, not that many. Uh and they're all living together, they're supported by staff members, and it's very much a home environment.

SPEAKER_01 1:40

Yes, definitely. And as you were talking then, I was thinking there are different types of residential care or residential homes, isn't it? They're that serve different purposes for children to meet their needs. So you might have homes that are purely for assessment or on an emergency basis where children go for a short space of time, you then have residential homes that provide more longer-term care um for children, and then looking at residential care for um adolescents and then moving into adulthood. So there's there's lots of different visions, yeah. I suppose.

SPEAKER_00 2:15

Yeah. Rach, how are residential care homes different from foster care homes? How do they look different?

SPEAKER_01 2:22

Yeah, I think from our experience of working with care experienced children, um, children with significant trauma histories that haven't been able to maintain foster care placements are usually placed in in residential care where they need a little bit more support. Um, but the difference is with foster care, children are placed with a family. Um they um have maybe one or two primary caregivers that are um supporting them that they're living with, um, and they might be living with their sibling or um other children in the home, whether they're their care experience or whether they're foster um the foster family's children as well. But in residential care, um the child will be living with, like you said, up to four four um additional children that are all care experienced, have all individual needs. But the big difference is you have residential staff that are on shift. And I we're gonna we're gonna get into this a little bit more how it presents a barrier, but how we can overcome that as a barrier when we're providing um trauma-informed care in a residential setting. But I think that is one of the one of the big differences, isn't it? Where there's multiple people that are back and forth the home when they're on shift.

SPEAKER_00 3:38

Yeah, so you have a staff team who are on a shift rather than a family who are caring for a young person. And uh, one of the things you mentioned was that uh young people who have um complex needs often uh need residential care, and that's a lot to do with there being a staff team there. So there's a staff team there that are equipped uh to meet their needs, they're still trying to create a family environment for that young person, um, but because there's a staff team and it's not just reliant on one or two primary carers, they are able to manage more complex needs.

SPEAKER_01 4:12

Yes, yeah, definitely, and because there are more people that are there to be able to help and manage and support that that young person.

SPEAKER_00 4:21

Um so what a residential home might look like, um many residential homes these days they are actual family homes. So they're uh four or five bedroom houses that have been converted into a residential home for children. And then you might have um four children, each of whom has a bedroom each in their own space, and a staff bedroom, usually for staff who stay overnight within that residential home. Um, and you'd still have your normal um kitchen, your family room, your living room, um where you go to watch TV, where you spend time together, where you eat meals together. Um, so it looks very much um like a family setup, but the big difference is that the children that are there are usually not related, they're there because they have more complex needs, and then you have a staff team that comes in and they um change over on shift. So you might have a day shift and then an evening shift and a night shift, and um those people who are caring for uh the young person are changing uh throughout the day.

SPEAKER_01 5:22

Yeah, it's all about providing that family kind of home overbeat. Like I've been to some homes, they have games rooms, they have gyms, yeah. Some are state of the art, yeah. Trying to provide a lot of um different, like variety of different activities for for children.

SPEAKER_00 5:42

Which are really important. One of the things we know is that if we can keep children occupied, give them things to help them learn and develop, um, then that can help them settle with environments within environments. So um some homes do have a lot more facilities than a family home would.

SPEAKER_01 5:57

So there are some barriers, I suppose, that residential homes and staff are kind of faced with. Um, you know, we just described the difference between foster care and and residential care, and there is a big difference, and there's barriers that we have to overcome to make sure that we are mimicking that that family type of environment and and that home. So one of the one of those things is staffing, isn't it? Um homes are quite heavily staffed to support shift work. So what that means then is that um, like you said, Laura, staff have got a day shift, evening, so and then sometimes there's sleep-ins, um, and it's staffing that. So what that means is there's a there's a high turnover of of staff that are that are on shift, um, and that that presents a barrier because that there's new faces um that um come into into the home at different times, so children uh might be a little bit unsure who's on shift at that point, but it presents more of a barrier for relationship building, doesn't it? Um when staff members are not on shift that frequently, they might do a four-on, four-off type of shift pattern, um, but it's not as if you're with that child every every day to build that relationship with them, so it's something that we really have to think about when providing trauma informed care.

SPEAKER_00 7:20

Yeah, it's very different from that primary carer uh child relationship because you have multiple primary carers who can change quite frequently within residential care and it it does then create that barrier.

SPEAKER_01 7:32

Yeah, well, residential homes I think are really good at doing, and what we advocate for as well is having keyworkers.

SPEAKER_00 7:39

Yeah.

SPEAKER_01 7:40

So you that child is assigned a key worker where they would they would complete some work with them on a regular basis, um, which supports some of that relationship building as well, but um residential staff have to make even more of an effort to plan in how to um how to build a relationship with with a child getting to know their interest, what they like, um, have they got any anything in common, you know, to to have conversations around, but it's something that um you know residential workers have to be really mindful of when um when working with young people in residential care.

SPEAKER_00 8:17

Yeah. Um but you can create trauma-informed residential environments, and that's something that we do through our um tribe residential program, is support residential homes to create trauma-informed environments for their young people. Um, but there's some fundamentals that you'd put into a trauma-informed environment within residential care. And what about other barriers you've encountered?

SPEAKER_01 8:40

Yeah, I think when you're trying to create this kind of family home, but you have a staff, um a staff team, there's usually an office, and the placement of that office is is really important because you wouldn't typically have a staff office in your home.

SPEAKER_00 8:55

No.

SPEAKER_01 8:55

Um, so trying to um manage that, or sometimes we have to work with what we work with, you know. Um, but when new homes are opening, we're always having conversations around like where's your staff office gonna be, like, where's the best placement of that? Because that can present as a barrier where it kind of creates this us this is them type of situation. Um, but yeah, that is another barrier I I think in in residential care when you've got a staff office.

SPEAKER_00 9:23

Yeah, that's in the middle of the home environment, yeah. So residential care can look really different from a home environment and what you'd um experience in foster care. Um, but you can create trauma-informed residential environments, and that's what we support uh residential homes to do through our tribe residential programme is to uh develop and implement trauma-informed environments for young people in their care. And there are some core components to doing that. Uh, so should we talk through those, Rachel?

SPEAKER_01 9:55

Yeah, definitely. I'll I'll start things off. Okay, go ahead. Um, because I think the first thing that we do whenever working with a new home or with a new young person is making sure that there's an assessment that takes place. So getting to know the child, and we've done some podcasts on this, I think, previously. The importance of providing trauma-informed care, one of those key things is your assessment. Um, so the the the child's trauma history, their their current presentation, what are their attachment needs, um, what what what more do I need to know about this child to be able to provide then re real trauma-informed care. So um that is a must whenever we're working with young people and and homes is really understanding um more about um about their trauma history, their behaviours to provide trauma-informed care.

SPEAKER_00 10:46

Yeah, I think that's so fundamental, particularly in residential care. Um, just uh thinking about what you just said, I looking at that trauma history and identifying triggers, you've got multiple staff members that are going to be coming in to support this child. They need to know what might trigger that child in terms of their past trauma. If they don't know, then how can they possibly provide trauma-informed care? Because they could be re-triggering past traumatic experiences just in the way that they're interacting. If we haven't done that background uh assessment and know about that trauma history, the other thing that comes up in residential care all of the time is the young person's attachment style. Um, and you can have multiple young people within one home, different attachment styles, they need different things, and they can come into conflict sometimes as well, where you've got one young person who needs a lot of interaction, another young person who on the surface presents as if they don't need as much interaction, um, but then they can go under the radar and not get what they need because uh one young person is so demanding of time and attention. So it's really important to identify things like that attachment style early on and then build that into your plans, uh, which is where your trauma-informed care comes in. That's what makes it trauma-informed.

SPEAKER_01 12:07

Yeah, and I think those assessments come in um, they're really informative, and with the homes that that we are supporting, it really helps make decisions on matching. You know, when you're talking about attachment styles, and you know, we're we're trying to house, say, four child children in a in a home, it's like you know, matching plays um a really important role that our children are gonna get on to a certain extent, or is it a complete wrong match where you know this is the you know this is not gonna work at all, and our assessments really help to to help you know make those those decisions around matching.

SPEAKER_00 12:46

Yeah, so every young person within residential care they should have an assessment before they come in, or when they um come into residential care, that should always be the first thought. How are we assessing this young person so we can make sure we're being trauma-informed and meeting their needs?

SPEAKER_01 13:01

Yeah. And another important thing that we that we consider when providing trauma-informed care to residential homes is how we create stability, and we do that in multiple ways, and we're um so one of those things is how we how are we um creating that structure, those the routines, the boundaries, how we set in those clear expectations, um, and we do that in a variety of of different ways. Um, but the but children need that consistency and that structure and the routine. They need to know what has happened or what what is to happen, um, what is next in my routine to help them prepare for their for their day and have that consistency that um this is my home, this is what we do, I know what to expect.

SPEAKER_00 13:48

And that consistency across young people who've come from different backgrounds, different environments uh is really important to make sure that everyone can get along and live together as well. Um, because if you have uh different rules for different young people, then that can create conflict amongst them as well. And that doesn't mean that you shouldn't adapt to the individual needs, but you almost need your two layers, you need your base layer of this is how we all live together, and then this is your additional needs layer that you're adding in for each individual young person as well.

SPEAKER_01 14:19

But having you know your home kind of values, your routines, that that structure that provides that foundation, doesn't it, to um to that that all that everyone should be really following in that form, which mimics residential care and the advice that we sorry mimics foster care that we and advice we would give to carers is having that that structure and routine so um and that's because it provides that that consistency for for children, um, and the same goes for residential care. That is a a master foundational strategy.

SPEAKER_00 14:54

I think it also goes beyond um for children within residential care as well, because it's consistency for staff. Um they all know they're all doing the same thing, they're all working in the same way. So if one staff member's on and the young person whose bedtime is eight o'clock says, Can I stay up till nine? Uh on a school day, it's well actually no your bedtime is eight o'clock, so let's start you with your bedtime routine, and you haven't got different staff members saying a different thing to that one child, which creates lots of confusion, it doesn't give consistency, it then doesn't build that stability, and uh it doesn't build trust with our young people either.

SPEAKER_01 15:31

Yeah, uh yeah, absolutely, and it's it's that consistency in responding, and like you said, in residential care, you you are kind of running like a bit of a tight ship where you know we we have to provide consistent responses, root root routines are set for for everyone, and that just helps like with the with the running of the home. Yeah so everyone is is doing the the same things.

SPEAKER_00 15:54

And if you think in terms of trauma, um something that that might seem minor, like the time of a meal time, can be huge when you're thinking about children who've been neglected, they haven't always consistently had food available, and then it when they come into residential care, if people are telling them different times for meals, that's gonna give them no faith that they're actually gonna get fed. So um it's thinking about those things when you're thinking about residential care, that could be a trigger for a huge meltdown because they're worried about am I gonna get fed today because people are changing their time. So there's consistency, predictability, reliability is absolutely fundamental in trauma-informed residential care. Absolutely. So, what about building relationships, Rachel? We know that um building relationships and maintaining relationships is absolutely uh fundamental in trauma-informed care for all of our young people. Um but how does this present in residential care?

SPEAKER_01 16:56

Yeah, so we've already talked about that, you know, there's um different staff that come on shift, so the opportunities that that residential staff um worker would have to build a relationship is a little bit more limited than if you were a foster carer. Um but there's lots of ways in which we we can build relationships with children. So we we've spoken about key worker sessions and how that can that that can support with um creating those opportunities to have a bit more positive interactions with with young people. Um but I think we do this really well uh within our residential service because we are constantly asking ourselves and our and our children that we're supporting what are their preferences, what are their likes, what are their dislikes? That is like one of the first questions that we ask in any piece of work that we do with children. But that's really important to understand um what are they into? You know, how am I gonna what common ground am I gonna find here with this young person um to build relationships? So it it might be that they enjoy um playing board games or they um they like um making things, you know, arts and crafts. And but what once we know that information we can make sure that it's part of their day um and how we're um using like those activities to help um build relationships with with children, finding that common ground and the common interests.

SPEAKER_00 18:26

Yeah, and those keyworkers can be those people who they know that they can always go to, and even if because there's multiple staff, they might not be able to remember every staff member's shift, but if they can remember their keyworkers shift and they might have a little timetable up which shows them their keyworkers shift, they always know that that person is going to be coming in at a specific time to be there for them, yeah, which is important.

SPEAKER_01 18:50

And I I think it's about knowing the the children in terms of their skill level, their developmental age, their chronological age, to know how you're kind of pitching information and pitching that interaction. So, for example, we're working with home at the moment and it just so happens that there's younger children there, so staff are having to um adapt their their types the the way that they engage children to make it more play-based because they're a lot younger. Whereas they've had um children that are approaching teenage years where it is more conversational based, so yes, it's about like not making things like too childish then, um and just pitching at that right level, um, so you can find some some interests that you have together and you can build on that then, and that's how you build a relationship.

SPEAKER_00 19:40

Yeah, and I think it within residential care as well, recognising that some staff will be better at that than others, so there'll be some who are very play-based and they um engage really well with the younger children, and then some who um are more adept at working with teenagers and play into people's strengths.

SPEAKER_01 19:58

Yeah, and knowing what your strengths are and where you're not really playing to your strengths, and being honest about that, isn't it? About and and that becomes particularly important when say a new child comes in or new young person and they're looking to assign a key worker that might not be playing to your strengths, and just having those conversations is important, so um, yeah, you're you're doing something that um you're gonna be really good at. Um but yeah, building relationships and how we do that is is really important um when we're trying to provide that family home home type um environment.

SPEAKER_00 20:37

Uh so another area that we're always thinking about is um we mentioned it at the very beginning, um, having enough activities for young people to do within residential care. Um, and this can be really important. Um, there is lots of changes of staff, the environment is usually new to them. Um, so having an activity schedule where they know what's going on throughout the day and throughout the week can be really important and important for their engagement, but we also like to use activities for learning as well. So we call it natural environment teaching, where you're teaching them different skills through day-to-day activities, and it might be a cooking activity, it might be a going to the shops activity, it might be a football game where you're doing a bit of maths when you're tallying the scores. It there's lots of opportunities there if you look at where they are to be able to build uh skill building into daily activities, and for our young people, that can be so critical because very often they've missed out on school, they've missed out on other learning opportunities, so we need to look at where we can build these in. So, activity schedules kind of serve two purposes they're keeping the young person busy, they're keeping them engaged, and they're an opportunity for them to develop and learn as well.

SPEAKER_01 21:53

Yeah, this has become particularly important for some of our homes where children are not accessing education. Education and then spending a lot of time in their bedrooms, their wake-up times become later and later because they've got nothing to to leave their bedroom for. Yeah. You know, which is a s you know a sad thought to have, isn't it? You know? Um but activity schedules is was one of our first recommendations to make sure that there are things that are planned throughout the day that's going to engage that young person. How we're building relationships, how are we creating that motivation, that intrinsic motivation for them to want to get out of bed in the mor in the morning and spend some time with it with the team and um do some activities throughout throughout the day. Um so that's become particularly important and um you know could can really now see the benefits of what that's doing for that young person.

SPEAKER_00 22:49

Yeah. Uh and then I think another area is planning direct work with young people. So from your initial assessment, you will have identified areas 100%, you'll have areas within residential care, they're there because um they have more complex needs than other young people. You'll identify areas that actually need some more specific work um uh done to support the young person, and that can be on things like emotions, it can be social skills, it can be things like hygiene. Uh, for our teenagers, it can be around puberty, um, and you're building in direct work sessions uh around those things that you know that they need to learn more about.

SPEAKER_01 23:28

Yeah, and they uh again another foundational type of approach where um those sessions are really important because that's where like the real skill building happens. Like you said, we we're working with children with complex needs, so we need to do something else. We need to teach them something, you know, to to um for them to grow, develop, um, to support them in their next phase of of life, yeah. Um, and and lots of that is is around teaching them emotions, teach teaching them different functional living skills, how to be in the community, how to prepare a meal? So um lots of things that come under that, but again, another fundamental.

SPEAKER_00 24:11

Yeah, and you do that always do that based on their trauma history. So, what is it that they've missed? What is it that they need to learn or develop? And um, the big question, what have they been taught in the past? Is there anything about this topic that is going to be re-triggering for them? Is there going to be anything that um we need to go over because of their experiences? So, with all residential care, it also isn't usually permanent. Um, very rarely is that the final option for a young person. Usually they go to residential care because they need additional support, but um, there's thought of okay, what comes after this? So, as part of a trauma-informed residential home, you always need to be thinking about what comes next. Um, and for our younger children, that might be uh returning to foster care or going back to family members. Uh, for our older young people, it might be moving on into independence. Yeah, um, so we're always thinking about that. Um, so how do you approach that, Rachel?

SPEAKER_01 25:13

Yeah, I think um again the assessments become particularly important because we identify in those skills that that that child might might be missing and what we need to develop. Um, but yeah, it all comes down to what what does that child need to move on to the next phase of of their life, whether they are returning to um going back to foster care, maybe, or going back to family, or we need to prepare them for um semi-independent living, you know, it it could be anything, but um lots of our functional living skills come under this category where we're helping them to um helping them to um develop more independent skills around um especially if they're moving on to more um like a like a um semi-independent home or something, how they're gonna prep prepare a meal, how they're gonna run a home, how are they gonna do their washing, um, money management. So we're always thinking about those skills that are right for their age and their stage, um, and then what what skills they they they they're needing to move on to the next phase of life. Um, but we we are continually, once you've done that assessment, we're continually completing reassessments to see you know how how a child is progressing and where we need to move next. That assessment definitely provides that roadmap for us.

SPEAKER_00 26:33

Yeah. I think there's so much that we could cover in what comes next for young people after residential care. Um, and it takes really careful planning, doesn't it? So whether they're returning back to family, foster care, uh that's going to need a really good transition plan in place. Yes. If they're moving on to independence, there's usually a big plan of things that they need to learn before they can move on to independence. And then the big question, how are they going to be supported when they are independent? One of the biggest worries many of our young people have that come through residential care is who's going to support me afterwards. So that needs really, really robust transition planning as well. Um, and I think this is why we do so much of this within our Tribe Trauma-informed care service for residential homes, um, where we're not just looking at the assessment, how are we implementing trauma-informed care, but it's how are we supporting young people to transition out of residential care as well in a very trauma-informed way. Um, it's actually one of the areas that I really love and value about um supporting residential homes is when you get a child to a place where you know they can transition on to the next stage.

SPEAKER_01 27:49

Yeah, and you know, the goal is the same, you know, for children learning foster care as well. We want them to be able to progress and reach their comp like their full potential that they can go on to go to university or college and and get that job that they wanted, you know. We really want to support those kind of dreams for them, and yeah, the goal is exactly the same. Yeah. Progress in all these areas.

SPEAKER_00 28:17

And I think it's what makes a trauma-informed home different, is you're always thinking about how are we being trauma-informed, how are we providing that reparative care to allow that child to move on to the next level of their you know development or growth or their life wherever it is that they're going next? Um, and so that's all fundamental to our tribe uh uh tribe trauma-informed residential care service, um, and I'll put a bit about that in the description if anybody is interested in finding out more about that.

SPEAKER_01 28:49

Yeah, great. So we always end on a question. So this has come from a residential support worker. Um, so how is it as a residential support worker you know that your home is providing trauma-informed care?

SPEAKER_00 29:01

Oh, that's a nice question. Um, so I I think fundamentally, for a home to be saying that they're trauma-informed, you have to be doing that trauma-informed bit. So, where's your not just where's your assessment, but where's your assessment? What have you learnt about that individual young person's trauma from that assessment? And then how are you integrating that into the care and intervention that's being provided? So if you're a residential support worker and you're thinking, well, actually, I don't know very much about this young person's trauma history, then you're not in a trauma-informed home or environment, is what I would say. Um, homes that are trauma-informed, they have to understand that trauma history and then be supporting their workers to integrate that into care and intervention. So, whether that's helping uh residential support workers to understand what that young person's triggers might be, um, why certain events or times of the year might have an adverse impact on young people because of their history, why certain people might have an adverse impact. Um, but then also thinking about healing, how do we provide that reparative care? What has this young person missed out on? Have they missed out on emotional development, social development? How are we integrating that into our support plans, into our direct work plans, into the day-to-day care that we're providing?

SPEAKER_01 30:27

Yeah. That's what I was going to mention. Like, are you providing reparative care? That is so important. How are you helping that child and young person to come on and progress? Like, what are we doing to teach skills and um to fill in those learning gaps that they've missed? Because that is so important, because there's lots of there's usually lots of things that we need to work on with with children and young people. So that's the end of our podcast on trauma-informed care in residential settings. Um, key takeaways then for for today is you know, asking yourselves as a home, as a residential support worker, am I providing trauma-informed care? So those fundamental um things that should be happening in a trauma-informed care home is you know, having that assessment. Are you understanding the child's trauma history and their current presenting needs? And how are you um implementing those strategies to support? Also, how are you creating stability, the the routines, the the structure, is that all in place? And how are you building relationships with children and young people as well? They are um key things that there should be going on in homes to you know being able to provide trauma-informed care.

SPEAKER_00 31:38

Yeah, thank you, Rachel. Thank you for listening. If you've enjoyed today's podcast, then subscribe to Tribe for more trauma-informed care in practice.