Early exposure to adversity, such as abuse or neglect, is associated with poorer outcomes across social, education and health domains. Children in care (referred to as looked-after children in the UK) are a vulnerable group who experience adversity serious enough for the state to intervene in family life and place them under the supervision of child protection services within the home or, more frequently, to remove the child and place them in out-of-home care (OHC). In England, placement in OHC can be voluntary (i.e. with parental consent) or mandated by a court. Some looked-after children have complex health needs and are voluntarily placed in temporary care in order to provide respite to their parents, but the majority of children in OHC are removed from their parents for reasons related to abuse or neglect.

Being in OHC is an indicator of serious childhood adversity and a predictor of future adverse health, education and social outcomes. For example, children in OHC have poorer mental and physical health than their peers, are more likely to engage in risky behaviours such as smoking, drinking and drug-taking and have higher rates of teenage pregnancy and premature death. The causes of these adverse outcomes are complex and there is considerable heterogeneity among looked-after children. Some variation in outcomes has been associated with key characteristics of the care children receive while being looked after (e.g. age at first entry, setting, duration, stability) or with their exit from the social care system (e.g. destination, re-entry). For example, children in foster care have better mental health outcomes than those in residential group care, and psychiatric disorders are more common among children who experience multiple placement moves. It is therefore important to determine the prevalence among the child population of being placed in OHC and to explore how different types or patterns of care are associated with outcomes, both in childhood and in later life.

Many studies of looked-after children in the UK are based on surveys; however, these may have selection and/or recall biases, and an alternative administrative data source that can be used is the Children Looked After Return (CLA). The CLA offers an important resource to improve understanding about the characteristics of children placed in OHC, how patterns of care vary across the country and are changing over time, and the relationships between the type or pattern of care and subsequent outcomes.