Written by Lorna Stabler
The continued increase in the number of children in care in the UK has led to calls for reforms in the way the state interacts with families. There is debate around why there has continued to be this increase, with factors suggested such as demographics, poverty, risk-adverseness, austerity, increased expectations on parenting and an increased knowledge of children’s needs (e.g. Elliot 2019). At the same time, there is no consensus on the ways in which the trend for an increased use of care could be reversed.
To think about how to reduce the numbers of children in care it is important to look at what has previously impacted on this outcome. With this in mind, we at CASCADE conducted a scoping review as part of a package of work for What Works for children’s social care.
What we were looking at?
A scoping review is a systematic way of identifying what literature is available in a specific area. This scoping review identified key evidence clusters, gaps and uncertainties on what works in safely reducing the need for children and young people to be in statutory care. The review scopes the evidence across three areas:
- The safe reduction of the need for children and young people to enter statutory care;
- The safe reduction of the need for children and young people to re-enter care;
- The safe increase in children and young people’s re-unification with their family following a period on out-of-home care.
How we went about it?
There are six stages to designing the scoping review process:
- identification of the research question
- identification of relevant studies
- study selection
- charting of the data
- collation, summary and reporting of results
- consultation of relevant stakeholders.
This scoping review adopted a ‘realist’ approach to evidence mapping. Realist approaches consider the question of what works, for whom, in which circumstances, and in what way. So, the findings of the studies that were identified as relevant were summarised not based solely on whether they included data on what ‘worked’ to impact on the outcome, but also what data was available on who interventions may (or may not) work for, in which contexts they might work, and how they might work.
The main finding from the scoping review the summary of ‘intervention types’ and the spread of evidence across them. Intervention types are groups of interventions that, while under different labels, seemed to be theorised to work in similar ways. Eight intervention types were identified in the literature:
- family/child skills training
- service integration/coordination around the needs of families
- meetings that bring together families and professionals to share decision-making about the child’s safety
- changes to what workers do (practice change)
- changes in or new therapeutic approach
- structure change to the social care system
- interventions that directly or indirectly act to increase or decrease a family’s finances
- mentoring interventions
Clusters and gaps in evidence are mapped for each of these eight intervention types within the full report. We highlight the numbers of papers that test whether the type of intervention works to reduce the numbers in care and how these interventions work, for whom, and under which circumstances, as well as evidence around implementation and economic considerations.
The scoping review gave a starting point for research into reducing the number of children in care. From this, more in-depth reviews have been carried out into ‘promising’ areas of practice. However, the review also identified rich qualitative data in the literature that shows what might be important for interventions in children’s social care services to reduce the numbers of children in care. Importantly, it also showed where there are gaps in what is known, particularly around what is needed for interventions to be successfully implemented, and what the cost of these interventions might be.