Improving Outcomes of Services for Children in Need through Research that Changes National and International Policy and Practice

Submitting Institution

Loughborough University

Unit of Assessment

Social Work and Social Policy

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Studies In Human Society: Policy and Administration, Social Work


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Summary of the impact

Loughborough University's Improving Outcomes of Services for Children in Need research is a programme of interlinked studies that has had a substantial impact on the development of national and international policy and professional practice for the most vulnerable children. It has influenced the development of government policy on safeguarding children from abuse and neglect, placement in out-of-home care, and adoption throughout the United Kingdom and in Australia, Canada and countries in Western and Eastern Europe. The researchers have translated a number of findings into tools designed to shape professional practice: these include a computer application that introduces transparency into the comparison of costs and outcomes of services.

Underpinning research

The Improving Outcomes of Services for Children in Need programme of pioneering research is undertaken at the Centre for Child and Family Research at Loughborough University by:

Professor Harriet Ward CBE (overall programme lead), Centre Director; senior research fellow, 1999-2004; Professor of Child and Family Research 2004 to present;

Lisa Holmes (costs and outcomes lead), research associate/research fellow 2000-2011; senior research fellow/assistant director 2011-present;

Emily Munro (outcomes for babies in care; care leavers), research associate/research fellow 2002-2011; senior research fellow/assistant director 2011-2012

Samantha McDermid (costs and outcomes), senior research associate 2007-present;

Rebecca Brown (safeguarding children), research associate 2007-present.

The programme currently covers three streams: safeguarding children from abuse and neglect; exploring the costs and consequences of social work interventions; outcomes of services for vulnerable children and their families and transitions to adulthood from care.

Loughborough's research has been undertaken through a series of mixed method empirical studies involving cohorts of children looked after by local authorities, identified as suffering or likely to suffer significant harm, or requiring multi-agency family support services. In order to facilitate analysis of the research data we developed our own methodologies for tracking children's cost pathways over specific time periods and across a range of services [3.1] and for classifying families according to the likelihood of children suffering harm [3.2].

Our research findings with greatest impact have been: that outcomes of social work interventions should be measured with reference to children's progress across a spectrum of developmental dimensions [3.3]; that it is possible to identify a range of basic parenting practices that are necessary to children's successful development and that, with only minor alterations, these can be agreed on by populations as diverse as those of Sweden, the UK, Canada and Australia, including aboriginal peoples [3.3]; that the poor outcomes for children in care are related to long-term experiences of maltreatment prior to entry, compounded by care placements that are insufficiently specialist to meet their needs [3.1, 3.4, 3.5]; that instability and transience can characterise the lives of looked after children before, during and after care episodes [3.4, 3.6]; that delays in professional decision-making compromise children's chances of being successfully placed in substitute care [3.2, 3.4]; that methodologies can be developed that enable agencies to calculate and compare costs and outcomes of different configurations of children's services [3.1]; that the older children are at entry to care, the greater will be their experience of maltreatment, the greater the cost of care episodes and the worse their outcomes [3.1]; that classifying families according to the presence or absence of established factors associated with risks of maltreatment makes it possible to identify at an early stage those children who cannot safely remain with birth families without extensive support [3.2]; that those parents who are able to provide a permanent, nurturing home for a new baby after other children have been adopted will have fully overcome adverse behaviour patterns within a few months of the birth [3.2].

References to the research

3.1. Ward, H., Holmes, L. and Soper, J. (2008) Costs and Consequences of Placing Children in Care: London: Jessica Kingsley Publishers. (Academic book based on report to funders, peer reviewed at research proposal stage and prior to publication) ISBN: 978-1-84310-273-1

3.2. Ward, H., Brown, R. and Westlake, D. (2012) Safeguarding Babies and Very Young Children from Abuse and Neglect, London: Jessica Kingsley Publishers (Academic book based on report to funders, peer reviewed at research proposal stage and prior to publication) ISBN: 978-1-84905-237-5

3.3. Ward, H. (1995) Looking After Children: Research into Practice, London: HMSO (Academic book based on report to funders, peer reviewed at research proposal stage and prior to publication) ISBN: 978-0-11321-847-9

3.4. Ward, H., Munro, E., Dearden, C. (2006) Babies and Young Children in Care: Life Pathways, Decision-Making and Practice: London: Jessica Kingsley Publishers (Academic book based on report to funders, peer reviewed at research proposal stage and prior to publication) ISBN: 978-1-84310-272-4

3.5. Sempik,J. Ward, H., and Darker, I. (2008) `Emotional and behavioural difficulties of children and young people at entry into care', Clinical Child Psychology and Psychiatry, 13(2) 221-233 DOI: 10.1177/1359104507088344

 
 
 

3.6. Ward, H. (2009) `Patterns of instability: moves within the care system: their reasons, contexts and consequences', Child and Youth Services Review, 31(10), 1113-1118 DOI: 10.1016/j.childyouth.2009.07.009

 
 
 
 

Supporting grants

The programme was established at Loughborough in 1999 and has been supported continuously by grants since then. Funding since 1999 totals £5,084,071 and $310,955. The programme was initially part of the Department of Health core funded rolling contract at Dartington Social Research Unit, and was moved to Loughborough under continuing core funded arrangements (2002-2008) when the Dartington contract ceased. All other funding has been won by competitive tender. The six most important grants received at Loughborough are as follows:

2002-2008: £2,230,226 H.Ward (PI): DH/DfES: Core funding for research programme on Outcomes for Children in Need

2008-2012: £330,292 H.Ward (PI) Lisa Holmes (CO-I): Department for Children, Schools and Families: Extending the Cost Calculator to include all children in need and the Common Assessment Framework

2009-2015: £519,785 H.Ward (PI) : Department for Children, Schools and Families A prospective longitudinal study of very young children at risk of significant harm; extended with Rebecca Brown as Co-I as Experiences on Entering Education; extended with Rebecca Brown as PI as Extension to Age Eight.

2008-2013: US $ 310,955 H.Ward (PI) , Lisa Holmes (CO-I) : US National Institute on Drug Abuse: Oregon Social Learning Centre: Centre for Drug Abuse Prevention in the Child Welfare System (converting Cost Calculator for use in USA); funding source transferred to Rady Children's Hospital, San Diego, California in 2012

2009-2011: £758,429 H.Ward and Emily Munro (joint PIs) Department for Children, Schools and Families Evaluation of Right2Bcared4 pilots/Evaluation of Staying Put pilots

2006-2009: £249,964 H.Ward (PI) and Lisa Holmes (PI): Extension of the Cost Calculator for Special Educational Needs/ for Health and Mental Health Services and Analysis of Joint Commissioning (Knowledge Transfer Partnerships: ESRC and Coventry City Council/ and Cheshire County Council)

Other relevant grants received from the Department for Education, the Fostering Network, Local Government Association, Action for Children, Scope: £995,375.

Details of the impact

This programme of interlinked studies has had a significant and sustained impact on government policy and professional practice in promoting and safeguarding the wellbeing of children in need. Evidence of its international significance and reach is demonstrated by the fact that practice tools developed from our early research findings (the Looking After Children programme) have been implemented by all child welfare agencies in Ontario [5.1], are being utilised by all youth services in Quebec [5.2], and support approximately half of all children in care in Australia [5.3]; and that the costing methodology is being adapted for use in the United States [5.4].The programme's reach includes policymakers, practitioners and children and families receiving social care services in Australia, Canada, France, the Ukraine and the USA as well as in the UK [5.5]. Its national significance is evidenced by the award of a CBE for services to children and families to Ward in 2012.

The findings from the cohort studies concerning children's extensive needs at entry to care, unstable placements and insufficient attention to their education complemented those of other studies and informed the NICE guidelines on the Health and Wellbeing of Looked After Children [5.6] and the revised Guidance on the Children Act 1989; Ward was commissioned to draft parts of this Guidance [5.5].

The first cohort study identified relationships between poor planning, instability and adverse outcomes for infants in care and led to a subsequent interlinked study on outcomes for infants at risk of abuse. The research classification developed for this study has been translated into a practice tool for assessing risks of future harm, which is currently being piloted by the NSPCC with practitioners in eight local authorities. This study was also featured on a recent BBC Panorama programme (Baby P: In His Mother's Words, December, 2010) and is included in the Department for Education Overview of recent research on safeguarding children (co-written by Ward), 2000 hard copies of which have been distributed to all relevant agencies throughout the country to inform ongoing professional development programmes. The study has also informed the Munro Review of Child Protection [5.7], the Family Justice Review [5.8] the current adoption initiative [5.5] and the fourth report of the House of Commons Education Committee [5.9] to which Ward gave written and oral evidence, by invitation. Following the Family Justice Review [5.8] examples from the study are now used in the training of family justice professionals.

The linked cohort study exploring the relationship between costs and outcomes for looked after children led to the construction of the Cost Calculator for Children's Services, now developed as a computer application for use in agencies in England. The underpinning methodology and tool is being used by US researchers to measure changes in the child welfare system in California, pre and post implementation of new practice [5.4].

The ensuing programme on costing children's services has added transparency to national debates concerning value for money. The research team has been commissioned by the Fostering Network, the Local Government Association and Action for Children to utilise their innovative costing methodology to calculate the national costs of foster care provision and support foster care, the costs of implementing the Laming recommendations for improving the child protection service and the costs of providing short breaks for disabled children [5.10]. The team are also routinely invited by the Department for Education and the Ministry of Justice to update the costs of care and care proceedings to inform estimations and calculations submitted to comprehensive spending reviews; and statutory guidance such as that on the sufficiency requirement [5.5].

In the 1980s, children in care were regarded as a separate group for whom the state's responsibilities were largely assumed to be confined to meeting their basic physical needs. In Britain [5.5], Canada [5.1; 5.2] and Australia [5.3], the research has been influential in moving the debate forward to considering outcomes of care in terms of children's developmental progress and capacity to meet their potential. New evidence concerning the long-term consequences of abuse and neglect have enabled us to argue that the poor outcomes of care are related to the inability of the system to compensate for previous adverse experience and to call for more specialist provision for those who remain looked after, more proactive decisions for those for whom adoption is the best option, and more effective services to safeguard those who remain at home. The research has provided policymakers and practitioners with the evidence supporting these arguments [5.5, 5.6, 5.7, 5.8, 5.9, 5.10].

Sources to corroborate the impact

The following sources of corroboration can be made available at request:

5.1. Desjardins, L., Evans, S. and Haveman, D. (2010) `Supervisory role in the successful implementation of Looking After Children', An International Database and e-journal for Outcome Evaluation and Research, http:/www.outcome-network.org/paper/59, passim

5.2. Public Safety Canada (2012) Pilot Project to Implement the Looking After Children Approach in Québec, Evaluation Summary 2012-ES-30, p.3
http://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/lkng-ftr-chldrn/lkng-ftr-chldrn-eng.pdf

5.3. Barnardo's Australia (2011) The Looking After Children Project Australia
http://www.pdc.org.au/lac/category.php/view/id/55 and factual statement from CEO

5.4. Factual statement from Child and Adolescent Services Research Center, San Diego, California and Oregon Social Learning Center, Eugene, Oregon.

5.5. Factual statement from Department for Education

5.6. NICE (2010) Looked-after Children and Young People, NICE public health guidance 28, pp.97, 100, 102 , http://www.nice.org.uk/nicemedia/live/13244/51173/51173.pdf

5.7. Department for Education (2011) The Munro Review of Child Protection: Final Report A child-centred system cm 8062 London: The Stationery Office, pp 24, 46, 62, 121.

5.8. Ministry of Justice (2011) Family Justice Review Interim Report, London: MoJ, pp. 86,97

5.9. House Of Commons Education Committee (2012): Children First: The Child Protection System in England, Fourth Report of Session 2012-2013, HC 137, London: TSO, Vol I pp 20,25-27, 31-32, 50, 57-58, 74,76; Vol II pp Ev11-20; 178-9

5.10. Factual statement from Action for Children