Core 10: The Change Makers' Manual

Healthcare & Wellbeing


What can we do to improve outcomes for care leavers? by Graeme Currie

Warwickshire Partnership NHS Trust, Barnardo’s, and the National House Project. The aim is to ensure that innovative services that 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. 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’. For innovative services to have the greatest effect on life experiences, any intervention is best co-produced with care leavers themselves. The National House Project, a social enterprise, is exemplary in this regard. It works with local authorities to ensure that the housing care leavers move into is suitable for young people. This includes providing the 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. 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 and housing. Distribution of leadership across the myriad 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 the sharing of resources. 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. 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 it requires that local professionals and care leavers consider what needs to be adopted so that the intervention works, and what can be adapted to fit with the local context. Warwick Business School research focused on care leavers is ongoing, and the issues identified above are now being considered in service improvements 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 the 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 that its impact will improve services for the most vulnerable children and young people – a fitting objective for our Change Maker values at WBS. Our research must travel onwards and upwards if the life trajectory of the young people we seek to help is to do the same.

C are leavers typically 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 experience a journey to adulthood that is both homelessness, be socially excluded, or 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 for care leavers 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), involves working with a range of care providers, including Birmingham City Council and Birmingham Children’s Trust, North Tyneside Council, Leeds City Council, Coventry and

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