How do we improve outcomes for care leavers?

Care leavers typically experience a journey to adulthood that is both accelerated and compressed compared to their peers in the general population.

They are likely to experience multiple, bewildering transitions that evoke feelings of instability, powerlessness, unpreparedness, abandonment, and mistrust.

At the same time, the services available to help them remain limited in capacity and remit, while inter-agency working is poor.

Care leavers are then more likely to have a conviction, become a teenage parent, experience homelessness, be socially excluded and have mental health problems.

On the other hand, they are less likely to achieve academically in school, attend higher education, or enter into stable employment.

These poor outcomes are troubling, but are not surprising. Nor are they impervious to intervention.

Our research, supported by funding from the Economic and Social Research Council (ESRC), is working with a range of care providers including Birmingham City Council and Birmingham Children's Trust, North Tyneside Council, Leeds City Council, Coventry and Warwickshire Partnership Trust, Barnardo’s, and the National House Project. The aim is to ensure that innovative services which enhance the life course of care leavers are implemented, sustained, and scaled up.

Our findings highlight four key lessons that our partners have taken on board to benefit care leavers.  

Why service innovations need the right funding

The service innovations that we examined in our partner providers have widely given rise to some outstanding outcomes for care leavers.

However, it is apparent that many of these innovations only enjoy fixed-term funding. Providers thus need to sustain the innovation beyond the fixed period..

One solution is to embed it in mainstream children and young people’s services, showcasing the business case for long-term cost reductions on the basis that care leavers require less intensive social care intervention as they progress through life.

Such an approach has aided Birmingham City Council and Birmingham Children’s Trust in sustaining their service innovation ‘Preparation for Adulthood’

Involve care leavers in service design

For innovative services to have greatest effect on life experiences, any intervention is best co-produced with care leavers themselves.

National House Project, a social enterprise, is exemplary in this regard. They work with local authorities to ensure that the housing care leavers move into is suitable for young people.

This includes providing services that care leavers need to support good health, education, and employment outcomes, but also their identity and attachment to the communities in which they live.

A core element is that any group of care leavers moving into a house are allowed to co-design that space and identify services, so it addresses their specific needs.

Alongside this, the National House Project has cultivated an increasingly influential social movement of care leavers that advocate at national level for better care leaver services.

In a similar vein, Barnardo’s ‘Triangles’ intervention puts care leavers at the centre when working with professionals, first to identify the problems care leavers face in their local setting as they transition into adulthood, then to design bespoke solutions and draw in the relevant agencies to resource these.

Integrate different support services

The different services required by care leavers to smooth their transition to adulthood require integration of care across many organisational and professional boundaries. This includes social care, health, education, housing.

Distribution of leadership across the myriad of organisations and professionals involved, so that their efforts are aligned in a synergistic direction, helps ensure integration.

In turn, this requires the alignment of performance measures to which organisations and professionals are subject, and sharing of resource.

Furthermore, it requires that different professionals, even if they do not share the perspective of others, at least understand how other parties perceive problems and solutions to care leavers’ transition into adulthood.

It goes without saying that this invokes a needs for a significant cultural shift in what are long-established siloed ways of working.

Encourage other providers to adapt and adopt successful schemes

Finally, as innovation is scaled up, we cannot assume the original intervention is cut and pasted with fidelity.

A template type approach is unlikely to work as an innovative service intervention moves from one organisation to another.

The metaphor that is most apt to describe the process of scale up is that of ‘translation’. Any service innovation is likely to be adapted, as it is adopted by different providers.

For example, the intervention ‘Breaking the Cycle’ that originated in Birmingham is likely to be relevant in Coventry, but to land successfully there requires that local professionals and care leavers considers what needs to be adopted so that the intervention works, and what can be adapted to fit with local context.

WBS research focused on care leavers is ongoing and the issues identified above are now being considered in service improvement for children and young people with special educational needs and disabilities (SEND). This is part of the wider RISE Partnership, which is hosted by the National Children’s Bureau and the Council for Disabled Children and funded by Department for Education in the UK.

Within this partnership I lead the development of a What Works Centre for SEND service improvement. Obviously that only started recently, but we are more than hopeful of its impact on improving services for those most vulnerable children and young people - a fitting objective for Warwick Business School's Change Maker values.

Our research must travel onwards and upwards, if the life trajectory of the young people we seek to help is to do the same.

Further reading:

Lynch, A., Alderson, H., Kerridge, G., Johnson, R., McGovern, R., Newlands, F., Smart, D., Harrop, C., and Currie, G. (2021) "An inter-disciplinary perspective on evaluation of innovation to support care leavers’ transition", Journal of Children's Services

Currie, G., Gulati, K., Sohal, A., Spyridonidis, D., Busari, J. O. (2021) "Distributing systems level leadership to address the COVID-19 pandemic", British Medical Journal Leader

Mousa, M., Boyle, J., Skouteris, H., Mullins, A. K., Currie, G., Riach, K., Teede, H. J. (2021) "Advancing women in healthcare leadership: A systematic review and meta-synthesis of multi-sector evidence on organisational interventions", eClinicalMedicine

Graeme Currie is Professor of Public Management at Warwick Business School.

His interdisciplinary research with colleagues, focused on impacting health and social care challenges, has produced evidence-based change in frontline NHS and social care services, benefiting staff and patients in areas such as maternity, musculoskeletal disease, mental health and cancer services.

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