Does local authority care make a difference to the lives of vulnerable children? Longitudinal analyses of a retrospective electronic cohort

The proposed research aims to examine, over time, education and healthcare outcomes of children who are looked after (CLA) by the local authority (i.e. in care). Existing studies that use only one point in time have shown that CLA have poorer educational and health outcomes than the general population. Pre-care experiences, such as physical abuse, parental mental health illness and parental alcohol misuse, are common reasons for becoming looked after. These experiences also predict poorer health, education and social outcomes in young people who are not in care. For these reasons, it is difficult to understand whether poorer health and educational outcomes for CLA are because of differences in pre-care experiences, or of care itself. The proposed research will, for the first time link an existing Wales-wide dataset on education and health with routinely collected data on young people's support from social services.

The research has three objectives. First, it will address the lack of large-scale studies in the UK that statistically examine the role of CLA status in predicting educational outcomes and health care usage over time. Second, it will reduce uncertainty over the extent to which poor outcomes among CLA are because of pre-care experiences, or experiences of being in care. This will be achieved through comparison between CLA, and children who receive help from social services but are not CLA (Children In Need, but Not Looked After - NLA). There are likely to be differences between these two groups that predict why one group becomes CLA and the other does not, but NLA are likely to be more similar to CLA than the general child population. To take account of some further differences between groups, we will adjust for a number of common experiences linked to receiving help from social services in our analysis. These include physical abuse, parental mental health illness, parental alcohol misuse and domestic violence. Third, whilst CLA status is often based on the assumption that removing young people from adversity will move them toward better life trajectories, this study will be the first to examine over time the role of care in reducing the effects of pre-care experiences on education and health care outcomes.

The research will provide insights into critical issues for contemporary society, where social care budgets are under increasing financial pressure. It will estimate the impact of social services help for vulnerable young people in a way that has not been attempted before.

Our findings will be of benefit to a range of stakeholders including: policymakers with responsibilities in the areas of social care, public health and education; local authority social work practitioners and managers; child welfare charities and children in receipt of social services and in care. Upon commencement of the work, we will consult with Voices from Care (http://www.voicesfromcarecymru.org.uk/about-us), an advocacy organisation that brings children and young people together throughout Wales who are, or have been, looked after by local authorities. We will engage with carers throughout Wales through the PI's existing links with the Fostering Network. (https://www.thefosteringnetwork.org.uk/). Long is a member of the Fostering Network Foster Carer advisory group, held in Cardiff quarterly, and the Fostering Network have agreed to assist with dissemination of study results. We will continue to engage with Local Authority Social Care representatives, including social care practitioners and managers, through the ExChange Network at Cardiff University and via existing networks of the research team. Notably, 21 of the 22 local authorities recognise the significance of this project, consenting to allow data linkage. A consultant social worker and Head of Children's Services were consulted over the development of this proposal. A Government official with responsibility for family justice has been consulted and will serve on the Advisory Group (AG). Two leading social care academics have been recruited, namely Dr Dominic McSherry from Queens Belfast University and Dr Nikki Luke from Oxford University's Rees Centre. The role of these stakeholders, who are represented on our AG, is to advise the research team on refining the research questions, implications for policy and practice, translation of research findings, the dissemination strategy, and ensuring outputs are appropriate for the intended audiences.

In collaboration with key stakeholders described above and those recruited via ExChange events and our stakeholder workshops for health and education, we will develop a set of resources for key decision makers from public health, healthcare, social care and education. These will include 'policy briefings' (e.g. for local and Welsh Government). The stakeholder workshops and ExChange events throughout Jun/Jul 2019 and Mar/Apr 2020 will also serve as a platform to discuss research findings. In particular, participants' advice will sought to help identify what information and in what format(s) will be of the most value to their organisations. Young people with experience of services will be invited via organisations which are user-led, such as Voices from Care, or which have strong relationships with service users, such as Tros Gynnal Plant.

The work has the potential to have important impacts on practice. It can inform care pathways, aiding decisions on whether children are best living with birth families or being in care, clarifying risk and protective factors and identifying the characteristics of children most and least likely to benefit from care. There is currently a policy concern in Wales about the relatively high numbers of children in care. This has led to the setting up of a Ministerial Advisory Group on outcomes for children that Scourfield is a member of. The project will feed into this group. The research can also inform assessment frameworks, for example, if it is possible to identify clusters of risk factors and associated outcomes, this will enable more effective, efficient and sensitive assessment frameworks to determine care pathways. We will provide recommendations to Welsh and UK governments on how to improve data collection and entry systems for CIN and SSDA 903 so that better routinely collected data is available in future years.