DOI: 10.1136/bmjph-2025-004219 ISSN: 2753-4294

Unplanned placement changes in children’s homes: an observational study of national administrative data on children in care and providers in England

Rick Hood, Allie Goldacre, Emma Martin, Hannah Tempest, Caroline Coady, Keith Clements, Edward Jones, Rebecca Vincent, Chao Wang

Introduction

Unplanned placement changes often indicate disruption and breakdown in children’s care arrangements while they are looked after by the state. Children in children’s homes in England are known to have high rates of placement instability, but little is known about unplanned moves and the role that provider characteristics play. This study aimed to identify the factors associated with higher and lower rates of unplanned placement change for children placed in a children’s home in England.

Methods

Secondary analysis was undertaken of national administrative data of all children placed in a children’s home in England between 2019 and 2023, who were continuously in care for at least 1 year during that period. The outcome was an unplanned placement change within the first 12 months. Regression analysis was used to calculate the effects of child-level and provider-level variables.

Results

11 730 children had a total of 16 520 placements during the observation period. An association with higher rates of unplanned placement change was observed for children aged 15–16, children from mixed heritage backgrounds, children assessed in relation to risks outside the home, and children who had already experienced multiple moves. Placements in local authority owned ‘in-house’ children’s homes had lower rates of unplanned change than those in outsourced provision. Higher levels of staff turnover and use of agency staff, lack of a registered manager and a shorter period of operation were all associated with higher rates of unplanned placement change.

Conclusion

Our results shed light on the relevance of provider factors when it comes to placement breakdowns and raise concerns that some of the most vulnerable children in care are being placed in unsuitable forms of provision. However, these findings should be considered in the context of wider systemic problems with sufficiency in the English care system.

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