In a Child of our Time blog last year, a team of researchers from University College and Kings College London said it was time for ALL policy to consider the needs of care leavers. The call was based on research findings that have now fed into the just-published Independent Review of Children’s Social Care. The findings from the Nuffield Foundation funded Looked After Children Grown Up project have played a key part in providing evidence to the review – and have been reflected in its report and the Government’s response. Professor Amanda Sacker, who led the project, reflects on the research, the report and the Government’s response and the implications for those who have spent, are spending and will spend time as a child in care.
The government’s 2019 Manifesto included a commitment to a review of the care system, and in March 2021 the independent review of children’s social care, led by Josh MacAlister, was given a year to produce a report.
The Looked After Children Grown Up project had already begun in February 2018 and was able to provide important evidence to the review.
The adverse consequences of being looked after as a child were already well recognised, but our research project was set up to address a lack of evidence on what happened to looked-after children later in life. Studies tended to follow them into early adulthood and no further, but using census data from the ONS Longitudinal Study we were able to explore outcomes for those who experienced care from the 1970s onwards, up to the age of 50.
We were able to track those who were children at the time of each census, and to identify whether they were living in residential care, as an unrelated member of an individual household, as a biological or adopted child in a parental household or as a child in a relative’s household.
By tracking care-experienced children into mid-life, the project we could look at their later outcomes from a variety of different angles including their likelihood of long-term illness, their employment, their education, their housing tenure, the type of family relationships they had and even whether they were at greater risk of dying early.
A fuller picture
The research, which we shared with Josh MacAlister at an event last July, was also able to drill deeper into the later experiences of children who experienced different types of care: it compared the outcomes of those who experienced residential and foster care with those who remained living with relatives, both parental and other.
The findings were welcomed by Josh MacAlister and many others seeking to improve not just the experiences of children in care, but their later life outcomes. In his report, Josh MacAlister focused on many aspects of the research, citing it explicitly and reflecting its findings in his narrative.
In particular, he focused on a 2021 report from the study which showed lower rates of long term illness and higher rates of employment for adults with a history of kinship care compared to those that grew up in foster or residential care.
He also highlighted a second report from the team which showed that care leavers who were in residential care had the highest prevalence of limiting long term illnesses (around 32 per cent on average), followed by adults who lived in foster care (around 16 per cent on average) and adults who lived in kinship care (12 per cent on average). This was significantly higher than the average prevalence of limiting long term illnesses amongst individuals who had not been in care (7 per cent), he said.
In addition, the report drew attention to mortality rates among care leavers from different types of care, and cited a 2020 report which used the ONS Longitudinal Study to link childhood out-of-home care status with all-cause mortality up to 42-years later.
It highlighted findings which showed adults who spent time in care between 1971-2001 were 70 per cent more likely to die prematurely than those who did not, and were also more likely to experience an unnatural death through self-harm, accident, mental health or behavioural causes.
The review report made a number of recommendations which chimed with the research findings, including:
- Support for families to cut down referrals and help to keep children in their family homes or with relatives – £2 billion over five years.
- Unlocking wider family support networks including payments for relatives to act as foster carers.
- Support for a ‘new deal’ with foster carers to help larger numbers of children to be cared for in families rather than in residential care – 9000 new carers over three years.
In his response for the Government, the Education Secretary Nadim Zahawi promised more support for family hubs which offer early help and intervention. This would add seven new areas to an existing network of centres in 75 areas that receive a £302 million pot of funding for family hubs. A further 5 areas would receive part of a £12 million investment to deliver on a manifesto commitment to a network of family hubs around the country, he said.
Addressing concerns about the educational outcomes of children who had been in care – the research found those in parental care had a 28 per cent chance of achieving an NVQ level 3 qualification compared with just 11 per cent for those in residential care – Mr Zahawi promised funding for local authorities to help them keep vulnerable children in education.
Funding would be provided to local authorities for continued delivery of the Social Workers in Schools and designated safeguarding lead supervision programmes, which launched in September 2020, he added.
An evidence-based approach
In both the review report and in the Government’s response, there was a strong focus on the need for reforms to be underpinned by evidence.
The review suggested the Office for National Statistics should collect and report data on the mortality rate of care leavers and care leaver health outcomes, and that the Government should also launch a new cohort study which tracks the health outcomes of care experienced people and helps to gather other missing data on housing, education and employment outcomes.
In his response, Mr Zahawi promised support to help the most at-risk families to stay safely together, and a focus on early help, preventing them from reaching crisis point.
As part of this, he said, the government would set up a new National Implementation Board of sector experts and people with experience of leading transformational change and the care system. This would boost efforts to recruit more foster carers, increase support for social workers including on leadership, recruitment and retention, improve data sharing, and implement a new evidence-based framework for all the professionals working in children’s social care.
“Everything we do to raise the outcomes for children and families must be backed by evidence,” he said. “This report will be central in taking forward our ambition to ensure every child has a loving and stable home and we will continue working with experts and people who have experienced care to deliver change on the ground.”
Of course, I was delighted to see that the recommendations from our project – to consider family care first and to provide financial and practical support to kinship carers – received such prominence in the Independent Review of Children’s Social Care. I truly hope that the government will act on this. But I remain concerned that with the emphasis on improving the care experience, the needs of adult care leavers will continue to be ignored, lacking the network of health, social, work and educational supports some need for a good life.