Summary of the impact

For the most part, looked-after children have poorer physical and mental health than other children, and do less well educationally. Their employment prospects are poorer and they are over-represented amongst young offenders. But this is changing for the better in Northern Ireland, where research at Queen's has helped to improve the stability and quality of placements provided to looked-after children, and the support given to them when they leave care. The 2010 Demos report on children in state care in the UK used illustrations of best practice from Northern Ireland.

Underpinning research

In 2012, 2,644 children were looked-after in Northern Ireland (NI). This equates to 44 per 10,000 children compared with 37 per 10,000 in England. Looked-after children do less well than their peers on a range of educational, health and social outcomes. This is, in part, attributable to their experiences before coming into care: most will have experienced significant harm due to child maltreatment. However, the quality and stability of their placements, and the support provided to them when they leave care, are also important.

Researchers at Queen's have conducted a series of studies focused on the needs of looked-after children; the use of various different types of placement (foster care, residential care, adoption, home-in-care) and how they could be improved; and how care leavers could be better supported.

Early studies (1987-92) by Pinkerton and Kelly (now retired) revealed decisional drift, assumptions that lacked evidence (e.g. the undesirability of long term foster care compared with adoption) and lack of information about children leaving care. The implementation of the Children (NI) Order 1995 reinforced the need to research patterns of care, the decision-making processes underpinning them, and the support provided to families, carers and children before, during and following care. The following studies illustrate the work.

Northern Ireland Leaving Care Project (1992-5, PI: Pinkerton, Professor). Based on a postal survey of staff and follow up interviews with staff and young people, this study presented the first detailed account of care leaving in NI, and a baseline of the personal characteristics, `care careers' and outcomes of a cohort of 95 young people leaving care (Reference 2).

South Belfast Leaving Care Service (PI: Pinkerton, with Higgins and Devine, Research Fellows) was one of six linked studies of need conducted from 1995 to 1999, across a range of contexts. The research concluded that, whilst it might mean different things at different times, the principles of family support were relevant to all families and children, irrespective of their circumstances. For example, connectedness with neighbourhood may take different forms for care leavers and those attending a family centre, but is important for both (Reference 3).

Leaving and After Care Pilot (2004, CI: Pinkerton). This evaluation of 4 pilot projects explored different after-care service models: intensive support, supported lodgings and `drop in'. It documented the advances achieved, placing them within the context of further imperatives for legislative and systemic change e.g. the Children [Leaving Care] Act [NI] 2002. (Reference 3) The Care Pathways and Outcomes Study (2002-10 PI: McSherry, Senior Research Fellow) is one of two flagship studies conducted by the Institute of Child Care Research. It is a rare longitudinal study of children in care, and unique within the UK. (Reference 8). It was conducted in 3 phases.

Phase 1 (2000-3) examined the stability of placements for a population of children under 5 years of age at 31st March 2000. Event History Analysis was used to examine the predictive relationship between children's background characteristics and placement type over a two year period. Age of entry to care and geographic location were the strongest predictors of either being adopted or returned home. The study also suggested a marked increase in the use of adoption (Reference 7).

Phase 2 (2003-06) examined children's progress from the perspectives of parents or foster carers (depending on where they were then placed), and how parents/carers were themselves coping. Findings indicated that adopted children were doing marginally better than children in long-term foster care, with both groups faring markedly better than those returned home.

Phase 3 (2007-10) explored the experience of care from the children's perspectives. Placement stability was found to be more important than placement type. Surprisingly, the health profile for adopted children was poorer than that of children in other long-term placements (Reference 8).

Supported Accommodation — Service Review (2010, consultant Pinkerton) Unpublished internal review of a successful, interagency high support service showing need for further attention to integrating voluntary sector provision within statutory sector systems.

References to the research

Details of the impact

• Impact on user involvement

The early research helped secure government funding in the late 1990s for two voluntary sector organisations promoting the needs of care-experienced young people: Voice of Young People in Care (VOYPIC) and First Key (NI). First Key NI was later consolidated within VOYPIC.

`Research at Queen's was important to making the argument for setting up VOYPIC and has continued to help shape our agenda.' VOYPIC (Director). Queen's research features on VOYPIC's own research resource — their `Library in the Sky'.

• Changing the way policy makers and practitioners think

One early impact of the studies conducted at Queen's was to change the way that policy makers and practitioners thought about the care system (Reference 1). This was not just an `academic' change, but one with implications for service development. For example, Pinkerton's pioneering 1996 study documented the poor outcomes of care leavers in NI, including their low rates of educational achievement, housing insecurity, unemployment and early parenthood. The study introduced concepts such as `care career' and `outcomes', encouraging policy makers and service makers to think about the `whole system' and the impact of service provision across the child's lifetime in care, and beyond.

Together with later research on the needs, care experiences and outcomes of looked after children (Reference 6) research at Queen's reinforced for policy makers the importance of understanding the individual needs of children in care within the complex social and emotional worlds of their placements.

`The care population and the population of children on the edge of care is not a homogeneous group but in fact consists of different smaller groups with differing needs for whom a variety of services need to be available.' DHSSPS (2007) Care Matters in Northern Ireland p.18. http://www.dhsspsni.gov.uk/care-matters-ni-3.pdf

Importantly, these studies also established connections between the situation in NI and INTRAC — a global network of researchers concerned with care leavers — established following a seminar at Queen's in 2003 (Reference 9).

• Impact on the research infrastructure in Northern Ireland

A very significant impact of the early research conducted by Pinkerton, Iwaniec and Kelly was the establishment of a research centre at Queen's. This was the decision of the then Department of Health and Social Services, in partnership with the Health and Social Services Boards (responsible for commissioning services) and Queen's. It was to be a University-based research centre connecting with similar centres across the UK, Ireland and internationally, but focusing on high quality research to inform the policy making process around child welfare in Northern Ireland (see Reference 1, Chapter 13). This centre is now the Institute of Child Care Research.

• Impact on service development

Queen's researchers strive both to develop and use a strong legislative and policy mandate. This ensures that practitioners and service designers better understand, and more effectively manage, children and young people's pathways through care in ways that provide stability and boosts their capacity to cope. Queen's research on children in care therefore makes its impact as part of a regional child welfare system into which it is well embedded, as the following quotes illustrate:

`The Queen's work on adoption provided the regional underpinning to the policy direction agreed for adoption (Adopting the Future) which we hope will legislated for next year' DHSSPS (Adoption Lead)

The international engagement with other policy centres led to Northern Ireland policy makers being introduced to research by Chapin Hall (University of Chicago), demonstrating the benefits of extending support to care leavers beyond the age of 18. This, combined with Pinkerton's work on care leavers in NI, resulted in the Northern Ireland government committing to funding the GEM (Going the Extra Mile) Scheme (piloted 2006, formally launched 2010).

`The work at Queen's has been a crucial part of developing the evidence informed leaving care policy and practice we are striving for. It has helped provide the local and international evidence for initiatives such as the GEM Scheme promoting post care continuity and stability by enabling young people to remain with foster carers.' NI Health & Social Care Board (Leaving & Aftercare Lead)

NI was the first of the four UK jurisdictions to introduce such support. The progress that has been made regionally was recognised by the 2010 Demos Report on Children in State Care in the UK which used Northern Ireland as an illustration of best practice (http://www.demos.co.uk)

• Impact of the Care Pathways and Outcomes Study

McSherry's team have carefully tailored reports of this ten year longitudinal study to different audiences in an endeavour to disseminate the findings widely and in ways that maximise impact. Audiences include politicians, policy makers, service providers, social workers, carers, and children looked after (see http://tinyurl.com/pzswy35 for a cartoon based account of this complex study).

The specific impact of the Care Pathways and Outcome Study was apparent in the response to the publication of the findings from its most recent phase (Reference 8) which was launched by the Northern Ireland Minister for Health and Social Services at a British Association for Adoption and Fostering/ICCR partnership event:

`I want to congratulate the research team at Queen's University for undertaking this important study. It is vital that we carefully consider the key messages emanating from such research to inform future policy and determine best practice on how to meet the long term needs of children in care.' Health and Social Services Minister

The current Research Director of the Department that funded this study, and other key stakeholders, also provide evidence of the impact of this study in NI:

`While this study provides a positive contribution to the experiences and outcomes of looked-after children, it also focuses on those areas which require significant attention from policy makers; service managers and practitioners. It provides an evidence base for decision making in relation to the health and wellbeing of young children being looked after.' Director of Health and Social Care Research and Development.

`We are delighted to hear about the particular progress in the numbers of children being adopted in the Northern and Southern Health and Social Care Trust areas. Their use of specific organisational structures and specialist staff to help with adoption is welcomed by BAAF.' Chair of British Association of Adoption and Fostering, NI.

`This report must be considered highly important for policy and practice in Northern Ireland given its breadth, the similarity of the groups and the variations in decision making.' Adoption Manager in the Eastern Health and Social Services Board.

`This booklet is extremely relevant to social work practitioners, solicitors and the courts and an essential addition when considering the children of today.' Assistant Director of the Northern Ireland Guardian Ad Litem Agency.

`This is a timely and important report for both policy makers and practitioners ... To promote the outcomes that we desire for our Looked After Children and Young People, it is important that we take on board the key messages emanating from this report.' Head of Services, Western Health and Social Services Board.

`These findings have influenced our policy in terms of ensuring that birth parents are supported when children return home from care.' Director of Social Work, Southern HSCT.

• Wider impact

At the same time, the `whole child/whole system' perspective was being further developed at Queen's. An article by Pinkerton, explaining this perspective on leaving care, was included in an issue of Development and Transition, a journal published by the United Nations Development Programme/London School of Economics and Political Science. This was then circulated world-wide through the Better Care Network, UNICEF — Child Protection Section.

Keynote presentations have been made to policy makers and practitioners at conferences and seminars in Australia (Melbourne), Taiwan (Taipei), US (Chicago) and South Africa (Cape Town). The work also attracted Doctoral students from Romania, Ukraine, Ghana and China. The first of these now chairs a project in Brasov which uses the concept of the `care career' and conceptual tools developed by Pinkerton to inform its work. The tools include the `leaving care coping wheel': this provides practitioners and service designers with a useful, visual, representation of everything that needs to be in place to address the needs of care leavers (e.g. guidance and support, practical and social skills), and the importance of linked support from a number of agencies. Another project in Cape Town, initially aiming to provide a residential aftercare service chose instead to develop a mentoring project on Pinkerton's advice. The work of the Ghanaian PhD graduate (Frimpong Manso) has been used to demonstrate `promising practice' for promoting the 2009 UN Guidelines on Out of Home Care.

Sources to corroborate the impact

Personal Sources

• Department of Health, Social Services and Public Safety: Adoption Lead.
• NI Health and Social Care Board: Leaving and Aftercare Lead.
• Southern Health and Social Care Trust: Director of Social Work.
• Voice of Young People in Care: Director.
• British Association of Adoption and Fostering (Northern Ireland): Director.

Documentary Sources

• GEM Scheme Regional Guidance on the Provision of Financial Support to Carers who continue to Support/Accommodate Young People Aged 18-21 years engaged in Education, Training, Employment or Prevocational Initiatives (2010) Belfast: DHSSPS.
• Black, L. (2011) Research and information service briefing paper: Adoption. Belfast: NI Assembly, http://tinyurl.com/on3d2v4
• Demos Report http://www.demos.co.uk
• Parenting Bulletin http://tinyurl.com/nousdxe