Title: Exploring the barriers and enablers to effective engagement with care leavers.
Funder: Health and Care Research Wales (Welsh Government)

Abstract: Background: The increasing number of children who are care experienced across Wales, the highest rate per population per head across the UK, is a significant cause for concern (Taylor- Collins & Bristow, 2021). The needs of care experienced children are also becoming more complex, with UK evidence reflecting that care experienced children often achieve poorer outcomes across education (DfE, 2013; Barnado’s, 2019; Furey & Harris-Evans, 2020), mental health (Smith, 2017) and social outcomes, including serious concerns around links to offending and criminal activities (Farmer Review, 2017). Despite the growing body of research, there continues to be gaps in our understanding of the factors that influence level of engagement with professionals. Young people transitioning to live independently continue to report feeling unprepared, often experiencing the void in ‘gradual planning’ experienced by non-care experienced young people (Furey & Harris-Evans, 2021). A view shared by the young adults consulted with during the preparation of this research bid. The meaning of ‘engagement’ within this context means the experiences of care leavers of ‘working with’ or ‘engaging with’ support and services offered on a multi-agency basis. Understanding the enablers of and barriers to engagement with services, including the impact on the experiences of support both offered and provided to care leavers will assist us to develop engagement approaches that are evidence-based, bespoke and adaptable to a broad range of intersectional needs. The aim is to also reduce the likelihood of social exclusion. Aims of the research: The research question specifically asks: What are the key barriers and enablers for engagement with care leavers? Hence, the aim of this study is to explore the key barriers to engagement, whilst identifying, exploring and advancing our knowledge to enable multi- agency engagement with care leavers. The research objectives focus identifying and exploring t he nature of the enablers and barriers to engagement experienced by care leavers and professionals, and advancing knowledge to produce the development of a practice model focused on enabling effective engagement with care leavers. The following approach will be adopted to address the research question:- a) A rapid literature review. b) Establishing a project advisory and steering groups to co-produce the research design. c)Focus groups and semi-structured interviews with care leavers and practitioners. d)Production of a practice model focused on creating an engagement framework and toolkit. e)Development and delivery of training events to disseminate the practice model and toolkit. f)Social Return on Investment of Engagement Framework & Toolkit. Our literature review will help to establish an initial logic model, to identify the key mechanisms and outcomes of existing engagement practice models. This will also help identify the relevant stakeholders likely to experience measurable outcomes because of the intervention. We will evaluate the social value generated for relevant stakeholders that experience change because of the intervention. From interviews with stakeholders, relevant and significant outcomes will be identified, for example, improved mental well-being, engagement with employment, increased social connection, reduction in loneliness, improvement in confidence. We will quantify the magnitude of change following the intervention, using valid and reliable questionnaires.

Lay abstract: Aims and Objectives: The aim is to explore What are the key barriers and enablers for engagement with care leavers? The results of this analysis will have generalisabilty for multi-agency services engaging with and supporting the needs of care leavers. In addition, the aim is to evaluate how much social value is generated by adopting the new engagement framework and toolkit with care leavers, in particular the influence of the new model on targeting resources and achieving the wellbeing outcomes of care leavers accessing services. Background: Little is known about the ‘lived experiences’ of care leavers in terms of the enablers and barriers to accessing multi-agency services, including the social isolation, stigma and shame experienced when labelled a ‘care leaver’. The sense of being understood and listened to are regarded as key elements to promoting a good relationship with care leavers (Stein & Wade, 2000). It is indicated that young people have voiced their wish for better communication from services (Children’s Commissioner, 2017), but there is limited evidence of what an effective engagement model looks like in practice. There is a pressing need to evaluate engagement with care leavers to determine the uses and limitations of multi-agency engagement, to measure the effectiveness and understand how the most effective elements can be replicated and implemented as part of an engagement practice model and toolkit. Gaining a robust sense of how care leavers understand and conceptualise the uses and limitation of the PA, social worker role and other key agency roles will assist in fostering a better understanding of their engagement needs, including their rationale for engagement and non-engagement or disengagement with services. Highlighting some of these issues can also focus not only the barriers experienced by young people but also the barriers experienced by professionals. This proposal directly addresses these issues and has reach across and beyond Wales. Design: Four work-streams are planned: WS1: Rapid review of literature and co-production of project in partnership with key stakeholders and care leavers. WS2: Qualitative stage: Focus groups and interviews with care leavers and professional stakeholders. WS3: Production of a practice model focused on creating an engagement framework and toolkit. WS4: A social return on investment analysis of operationalising the use of the practice framework and toolkit. Public involvement: A Patient and Public Involvement (PPI) group has already been formed. Care leavers have been consulted as part of the process and have shared their wish to be part of the project advisory group and the project steering group. Key stakeholders, including the Heads of Children Services of four participating local authorities and key multi-agency partners across these areas have agreed to be members of the project steering group. Dissemination: The research team will organise a national symposium to present findings to targeted policy audiences such as the Children’s Commissioner for Wales, Minister for Health and Social Services, senior members of participating local authority areas and other key multi-agency partners. Findings will also be published in an open-access journal, and be presented at national and international conferences e.g. European Conference for Social Work.

Research activity codes: 8.2 HEALTH AND WELFARE ECONOMICS;7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE;DISPUTED AETIOLOGY AND OTHER