This paper explores the development of practice in residential child care, initially within the context of generally negative perceptions of this and the wider care system. Discussion of therapeutic perspectives is set within the context of the development of Care Visions residential services and considers the significance of the Sanctuary Model of trauma informed care and social pedagogical principles. It is suggested that approaches primarily defined by procedures can stifle the intuition of professional carers to respond meaningfully to the needs of young people. Compassionate relationships accompanied by an ethical disposition offer an effective alternative. The article concludes with a discussion about what has been learned through supporting continued relationships between professionals and young people after they have moved on from care, and a commitment to applying this in residential child care settings. This promises to support an approach that foregrounds trusting reciprocal relationships as a medium for healing and growth that facilitates nuance and differentiation while ensuring safety.