Safely reducing the need for children to enter care
The number of children entering care has increased substantially over the last 20 years. In 1997 in England there were 50,900 children in care and this had risen to 72,670 in 2017, an increase of 43 per cent.
This has led to considerable public expression of concern, including the publication of the recent Care Crisis Review from the Nuffield Foundation. Of course, preventing entry into care is not always the right thing to do. But we need to be confident that children are only in care when that is the best option for them and that their family have been offered the best possible opportunity to stay together.
To identify ways to safely reduce the need for children to enter care the Centre looked at existing research. We also did some research of our own with various local authorities, including those that seem to be bucking the national trend. We did this through local authority interviews and surveys as well as analysis of local authority data.
We also did some research of our own with various local authorities, including those that seem to be bucking the national trend. We did this through local authority interviews and surveys as well as analysis of local authority data:
This scoping review identifies key evidence clusters, gaps and uncertainties on what works in safely reducing the need for children and young people to enter into statutory care. The review scopes the evidence across three areas:
- The safe reduction of the need for children and young people to enter statutory care;
- The safe reduction of the need for children and young people to re-enter care;
- The safe increase in children and young people’s re-unification with their family following a period on out-of-home care.
The review focuses on the “safe” reduction of the number of individuals in care rather than the absolute reduction, while ensuring the correct identification and support of those requiring statutory intervention.
The aim of these studies was to inform the research and reviews being planned for the What Works Centre up until 2020 and beyond. We explored local authority variation in the rates of children coming into care; we identified approaches / interventions local authorities think are effective in reducing the need for care; and we discussed with the local authorities what they see as helping or hindering them when in trying to safely reduce the need for children to be looked after.
How we went about it
There are six stages to designing the scoping review process:
- identification of the research question
- identification of relevant studies
- study selection
- charting of the data
- collation, summary and reporting of results
- consultation of relevant stakeholders. This scoping review adopts a realistic approach to evidence mapping. Realist approaches consider the question of what works, for whom, in which circimstances, and in what way. Evidence reviewed can then be considered in relation to the EMMIE frame work. This framework has primarily been employed with systematic reviews which use defined search terms to search for all published research on a subject and analyse the findings, or appraisals of existing reviews and we understand this to be the first example of its use within a scoping review.
There were three methods used for these studies: local authority interviews, a survey and analysis of local authority data.
Reducing the need for children to come into care: A survey of approaches used by local authorities in England: The survey consisted of a mixture of open and fixed response questions requiring quantitative and qualitative analysis. We drew on some measures used in a previous survey and then adapted these in line with the aims of this study to to provide a list of potential interventions or approaches. In total, 60 responses were received from local authorities.
Reducing the need for children to enter care: Telephone interviews with local authorities in England: We conducted telephone interviews with principal social workers or and other senior staff in 29 English local authorities to discuss barriers and facilitators to reducing the need for care. We identified authorities by looking at their trends in children looked after rates, between 2012-13 and 2016-17: those with high increases, those with decreases and those with little change.
Exploratory analyses of the rates of children looked after in English local authorities (2012-2017): This study involved secondary analysis of existing, aggregate, national and local authority level data on children in care. The data were extracted from several sources and were amalgamated into one database for analyses. Out of the There are 152 local authorities in England. In total, 151 local authorities were considered in the analyses. Isles of Scilly was excluded as no children were looked after by the local authority between 2012-3 and 2016-7.
Reducing the need for children to enter care: Mapping the evidence – a systematic scoping review: The main finding from the scoping review is the spread of evidence across eight intervention types. The interventions were reviewed to assess gaps and clusters of EMMIE evidence in the literature. These eight interventions were:
- family/child skills training
- service integration/coordination around the needs of families
- changes to what workers do (practice change)
- changes in or new therapeutic approach
- structure change to the social care system
- meetings that include the family and relevant workers meeting in one place and discussing and planning together around a child’s safety
- interventions that directly or indirectly act to increase or decrease a family’s finances
- mentoring interventions
Clusters and gaps are mapped for each of these eight intervention types within the full report. We highlight the numbers of papers that test whether the type of intervention works to reduce the numbers in care (Effect) and how these interventions work, for whom, and under which circumstances (Mechanisms and Moderators), as well as evidence around implementation (Implementation) and eEconomic (Economic) issues.
Narrative summaries describe the key clusters and gaps in the evidence base in relation to what works to reduce the numbers in care.
Reducing the need for children to enter care: A survey of approaches used by local authorities in England: 81.7% of the local authorities surveyed thought a whole systems approach effective in reducing the numbers of children in care. The most popular whole systems approach was Signs of Safety. The next most popular approaches selected were ‘edge of care’ services akin to intensive family preservation services (61.7%), early help (56.7%) and family group conferences (43.3%). Further information on the key findings can be found in the summary.
Reducing the need for children to enter care: Telephone interviews with local authorities in England:
Factors seen as reducing the need for care were:
• early help
• financial investment
• supportive leadership
• constructive scrutiny
• organisational culture
• good partnerships
Challenges in reducing care were said to include:
• population changes
• impact of austerity
• professional anxiety
• new and emerging forms of harm
• tensions between social work and the family courts
• workforce issues.
Exploratory analyses of the rates of children looked after in English local authorities (2012-2017):
This study identified three factors that were associated with a decrease in the rates of children in care:
• A decrease in poverty in the area
• Better Ofsted ratings
• Participation in the Innovation programme
When looked after children rates and their change over time were considered at a regional level, it could be seen that local authorities in London showed a regional trend of reduction over time, whereas those in the North showed a trend that was increasing over time. Further information on the key findings can be found in the full report.
The What Works Centre will consult on the scoping review findings with the children’s social care sector in England via policy and practitioner panels and continued knowledge translation events. Stakeholders will be invited to assist in the appropriate interpretation, presentation and accessibility and usability dissemination of review findings to a diverse range of policy and practitioner audiences. The scoping review will be used by the review team to identity a range of potential research questions and future systematic reviews. The findings, subsequent systematic reviews and engagement with the sector will also inform the research agenda for the Centre.
The study findings have been used by the Centre to identity the first systematic reviews to be carried out by the What Works Centre. There will be reviews on the two most common approaches being implemented in LAs:
• Signs of Safety
• Intensive Family Preservation Services
There will also be reviews on the intervention themes identified in the scoping review:
• Family/child skills training
• Service integration/coordination
• Change in what a worker does (practice change)
• Change in or new therapeutic approach
• Structure change
• Meetings that included the family and relevant workers (such as family group conferences)
• Interventions that change a family’s finances
The Centre’s Change Projects will pick up on other themes raised in these early exploratory studies, such as the impact of poverty (devolved budgets) and good partnerships (social workers in schools) in safely reducing the need for children and young people to enter care.