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Measuring the wellbeing of children in care: Views from the frontline and opportunities for change

Past experience of abuse, neglect and difficult familial relationships present serious challenges to the mental health and wellbeing of many children in care. The process of being taken into care can also be traumatic for children, as can some in-care experiences such as being moved between different foster or children's home placements regularly or at short notice (Munro and Hardy, 2006).

The risks posed by these experiences are borne out, for example, by higher prevalence of mental health problems amongst children in care. Indeed, the last major prevalence study (Meltzer et al, 2003) found children in care to be over five times more likely than their peers to have a mental disorder.

Local authorities are 'corporate parents' (Department for Education, 2015a, p15) of children in their care. They are, in most cases, the bodies which took the decision to apply to court to remove these children from their birth families. They can therefore be seen as having a responsibility to promote the child's wellbeing, to ensure that they grow up happy and healthy. As such, local authorities have a legal duty to safeguard and promote the welfare of these children, including through the promotion of physical, emotional and mental health. The role of local authorities has also recently been strengthened through the introduction of corporate parenting principles (see policy context, below).

Given this responsibility and duty, it is important that local authorities have some means of measuring the wellbeing of children in care. However, no wellbeing measures are adopted or used consistently at the national or local level. As a consequence, it is difficult to track outcomes related to wellbeing of children in care. This in turn hinders any attempt to assess the extent to which care is helping children to progress or to plan improvements to services based on this. This has led to calls for the Government to measure and report annually on children in care and care leavers' wellbeing (Alliance for Children in Care and Care Leavers, 2016).
With funding from The J Paul Getty Jnr Charitable Trust, the National Children's Bureau (NCB) conducted research exploring the measurement of wellbeing of children in care. The research aimed to explore:

  • How professionals and children and young people in care define wellbeing;
  • What indicators, tools and/or measurements are used in wellbeing assessments of children in care in England;
  • How indicators of wellbeing work in practice; and
  • What works and any challenges associated with indicators of wellbeing.

The research consisted of a literature review, online survey and telephone interviews of professionals as well as consultation with five children in care councils.

The online survey was distributed between August 2016 and January 2017 to a wide range of professionals working with children in care. A total of 114 people responded to the survey. Nearly two fifths (39 per cent) were designated, named or other specialist nurses working with looked after children, whilst 11 per cent were social workers. Other respondents included children's rights workers, researchers, project/support workers and virtual school staff. Fourteen of the professionals who completed the survey also took part in follow-up interviews by telephone.
For more information on the research methodology see Appendix A.

The remainder of this report is structured as follows:

Chapter Two describes what the existing evidence tells us about wellbeing and the measurement of wellbeing for children in care and sets out the policy context in which this research has been carried out.

Chapters Three to Six outline the findings from our primary research. Topics include how professionals define wellbeing, the specific tools and measures they use, how, when and by whom this is done, and how results are used.

Chapter Seven discusses the key challenges in measuring the wellbeing of children in care, as identified by study participants. It also explores some of their reflections on what needs to be done to this effectively.

Our conclusions and recommendations include actions for national government, local authorities and their partners, and professionals.