The Cross-Regional Project also known as the Thames Valley Contract is a partnership between 6 Local Authorities and the Keys Group to provide therapeutic residential care and education for young people with complex emotional and behavioural needs. The participating Local Authorities are Buckinghamshire, Oxfordshire, Hertfordshire, Bracknell Forest, Reading and Milton Keynes.
The project provides 20 residential placements in small children’s homes within the Thames Valley region. The homes are all located within an hour’s drive of the project’s school – Unity College in High Wycombe.
Unity College is an independent special school which provides full-time education for up to 24 boys and girls in key stage 3 and 4 (secondary age children) catering for those with emotional behavioural and social difficulties (BESD). Many of the students have Statements of Special Educational Needs/EHC Plans. All the students have experienced difficulties and disruption to their education which has had a negative impact on their personal development and academic achievement. The school opened in January 2011 and was inspected by Ofsted in October 2011 and again in February 2015 and was found on both occasions to be a “good” school. The school can provide education for all of the residential places if needed plus up to 4 education day placements.
The homes are all registered with Ofsted for between 2 and 4 places. The project provides care for both boys and girls aged 12 – 18 years. One of the main aims of the project is to facilitate
young people who might ordinarily be placed in high cost/high intensity placements a long way from home, living in homes that are close to their home address.
The CRP vision and goals for the project , which are shared by both Keys Group and the participating authorities are:
To provide an established, well respected, high quality service for children and young people within their local area, offering integrated therapeutic, care and education. Homes which are nurturing and resilient, a school which is an exciting and inspiring learning environment and therapy which facilitates a healing environment. A therapeutic service which is creative, tenacious, and clinically well supported.
1. all homes to be rated good or outstanding
2. school to maintain its good rating and become outstanding
3. To provide placement stability and a happy home for children where outcomes are consistently good
4. for the Project to be led by a strong and cohesive team who are committed to the development of a community
5. for adults and children to feel safe and be safe
6. all staff to be qualified, trained and well informed
7. staff in all settings to be confident in the therapeutic approach
8. To be seen as a national centre of excellence in terms of service delivery and commissioning
The homes and school share a common ethos and operate using the Secure Base model as the specific therapeutic approach. The Secure Base Model is an approach which is deep rooted in and underpinned by attachment theory, child development theories and integrated within a psychodynamic approach. All staff are trained in the Secure Base Model using a 12 module training programme. Staff are supported to use attachment theory to see the significance of early life experiences and how the impact of these events and relationships are likely to have on future functioning, and to develop ways of working that hold in mind the earliest experiences of the child.
Central to the approach is the fundamental belief that all children need a secure base- a parent or caregiver who is reliable and provides comfort, lessens anxiety and enables the child to explore, learn and enjoy. A Secure Base is inextricably linked to secure attachment and the model aims to develop staff so that they are able to offer a secure base, to become carers that are attuned to the needs of themselves and the child. The model develops resilience in the adults and the children and focuses on developing the qualities that are more helpful in relationships and that are important in helping to heal others, such as
• Holding the child in mind
The Cross Regional Project has 2 Therapists who support the homes and the school. Both Therapists are appropriately qualified and experienced and are either members of, or accredited with BACP. Both Therapists are externally clinically supervised monthly as well as meeting regularly with the Project Director to ensure they are well supported from a management perspective.
Therapeutic support is provided to all the homes on a 4 week rolling planner which includes 4 weekly consultation to the staff team and an additional drop in session for support. There is
also therapeutic support provided to Unity College with a Therapist spending 1 full day in school every week. There are opportunities for individual sessions with any of the young people where this is deemed to be appropriate. Not all young people will be assessed as needing individual therapy sessions and some young people will already be seen by other professional including CAMHS.
The Cross Regional Project Therapists will support all of the teams to work directly with the young people and they will maintain an overview of all young people. The Therapist coordinates an initial assessment of each young person and this provides the basis for a PiCi (Psychologically informed Care planning and intervention) which is then reviewed quarterly. The aim of the assessment is to develop an individually psychologically informed and therapeutically minded approach to the care of each young person.
The Therapist also uses the BERRI checklist and the Boxall Profile to inform the assessment process. The completed document (PICI plan) is then used to inform the Placement plan, IEP and IBP. The BERRI checklist shows a young person’s areas and extent of need in numerical and graphical form, and monitors their progress across the five domains over time. This methodical assessment process leads to a therapeutic care plan (PICI plan) and allows evidence-based decisions about who needs therapy, of what type and who will provide this. For every young person, target concerns are identified for intervention through key- working and strategies are identified that staff can use with the young people, and these target issues are monitored on a daily basis. The data from the BERRi can be inputted to a secure online monitoring system and this allows target issues to be tracked and presented as graphs to illustrate progress, identify patterns and to inform future care.
Staff team consultations provided by the therapists are a fundamental part of the therapeutic support to the houses in the Cross Regional Project.
A therapeutic consultancy is protected time for the adults to talk with a therapist about the work that they are doing. The time allows for the opportunity to share feelings, ideas, thoughts, worries and concerns about the children. The time can be used to talk about the child’s behaviours, language, thoughts and actions and together the staff and therapists can think of strategies and ideas for coping with the behaviours and supporting the young people more effectively. Teams also have the opportunity to reflect upon recent incidents and to talk about the impact of how the work can make them feel as individuals or as a group. Consultancy does not replace the need for ongoing and regular individual supervision. Managers meet 4 weekly with one of the therapists for C.A.R.E meetings. This meeting is an arena for addressing any themes that emerge related to developing the knowledge and skills across the project. it is protected time for the residential and education management team and the purpose of the group is to support the Project to develop a therapeutic management team.
In addition to the support provided by the Therapists, the project has a Consultant Psychiatrist and a Consultant Clinical Psychologist.
The Consultant Child and Adolescent Psychiatrist brings a much valued and needed psychiatric overview to the Cross Regional Project and he visits the project on a bi monthly basis to meet with staff teams, the Project’s Therapists and the management team. The aim of this input is to improve the mental health of the young people by empowering and supporting staff to further develop their skills, knowledge and expertise in understanding both the presenting behaviour and the emotional well being and mental health of the young people. The Psychiatrist would not normally provide ongoing treatment for children or carry out psychiatric assessments of young people but will liaise with other relevant CAMHS professionals where appropriate and he will offer direct advice and guidance to staff about all matters relating to a young person’s mental health. Any request for a specific assessment of a young person will be reviewed in the context of the child’s current situation and will take a full account of the roles of other professionals.
Dr Miriam Silver BSc, MSc, ClinPsyD, C.Psychol. AFBPsS. is the Clinical Director at Keys and she is a highly regarded and experienced Consultant Clinical Psychologist. Her and her team offer a minimum of 1 day per month consultation to the Cross Regional Project . Dr Silver is on the HCPC register of Practitioner Psychologists. She is an Associate Fellow of the British Psychological Society, Chartered, in the BPS Directory of Expert Witnesses and an active member of the Division of Clinical Psychology and on the committee of the Child Faculty of the BPS, having spent four years as Chair of the National Network of Clinical Psychologists working with Looked After and Adopted Children. Dr Silver was employed as Consultant Clinical Psychologist in the NHS until August 2011, leading the team providing services for Looked After and Adopted Children within Northamptonshire Child and Adolescent Mental Health Services. Dr Silver specialises in attachment issues and the impact of early trauma. She is responsible for devising the BERRi: A checklist to explore Behaviour, Emotional well-being, Relationships, Risk and indicators of psychological distress in children and young people, this is one of the tools used within the Cross Regional Project to measure outcomes and therapeutic progress. The psychological input to the Cross Regional Project includes staff training, psychological assessments of young people as well as psychological consultation and oversight of the assessments and the PiCi plans.
The project is a well resourced group of homes of and we are very proud of the outcomes achieved for the young people the project cares for.
|Fairlands (3 beds)||South of Aylesbury|
|Forest View (4 beds)||West of Tring|
|The Old Rectory (3 beds)||North of Aylesbury|
|Hythe House (2 beds)||Maidenhead|
|Bray House (4 beds)||Maidenhead|
|The Pines (4 beds)||St Albans|
The project supports young people (both boys and girls)aged 11 – 18 years to remain fairly close to their home address. Individual outcomes for each placement are agreed on admission and professionals are asked to complete score cards at each review or 6 monthly so progress can be assessed.
All staff are being trained to use a therapeutic secure base approach with support from a full-time therapist who is responsible for carrying out a therapeutic assessment on each young person within 6 weeks of admission. This informs the care plan and staff interactions with the young person.
The standards for Therapeutic Childcare produced by the Royal College of Psychiatry serve as a guide. Anyone considering making a referral is encouraged to speak to the Project Therapist, tel: 07425 621723.
The location of the school and the homes should make it easy for the young people to access additional clinical or educational resources from their home areas, where there is an assessed need for this.
Referral to the project is made via Keys’ general referral line, be sure to say you are interested in the Cross-Regional Project and ask for a project referral form.
Fuller information can be found in the following documents:- Ofsted reports
- The Statements of Purpose for each home
- The UnityCollege Prospectus
- Children’s Guides to the homes and school
- Reports from commissioners’ visits – full or executive summary
- The Therapeutic Secure Base Handbook
These are available via local authority commissioners, the commissioners’ Project Manager: 07584 581200 or Keys’ referral line: 07918 716310.
Project Referral form
Care or Pathway Plan
On Admission or Before:
Within 72 hrs of Admission:
PEP / SEN / IEP
Placement Info Record