Trauma-informed Care in Children’s Homes: A Realist Co-production Development Study

Research question How, when and why can a theoretically-informed evidence-based trauma-informed care intervention tailored for children and young people in care improve care quality and experience? Background Young people in children s homes are extremely vulnerable and the care system is in need of reform.

Care experienced young people have often experienced multi-type traumas and require trauma-informed care. However, no tailored intervention for the unique setting of children s homes exists.

Employing realist methods and co-production, this project will explore how existent literature and lived experience can translate to form a new and much needed trauma-informed care intervention for children's homes.

Aim: To co-produce, pilot, and evaluate a new trauma-informed care intervention for use in children s homes to promote wellbeing and recovery. Objectives: 1.

Co-produce a tailored intervention for children in residential homes through a rapid realist review (WP1) and experience-based co-design (EBCD; WP2) 2.

Pilot and evaluate the intervention across local authority homes in Salford, Greater Manchester, using a realist evaluation approach to identify how, why, and in what contexts the intervention could support the recovery and wellbeing of CYP in care (WP3a) 3.

Develop an implementation toolkit for future service-based research across a wider range of settings and contexts (WP3b) 4.

Promote positive change for children s homes and vulnerable CYP through an appropriate dissemination, pathways to impact and communications strategy.

Methods Over 25 months, four iterative work packages will work to create and evaluate a new trauma-informed care intervention across children's homes in Salford with the aim of significantly improving care experience and outcomes.

The project will begin with a rapid realist review to develop an initial programme theory of the intersections between trauma-informed care, adversity, resilience and residential care.

Concurrently, experience based co-design will be employed to identify priorities for care with the young people and staff of the children's homes in Salford.

Together, these two approaches to knowledge generation will inform the development of a trauma-informed care intervention for this unique setting, which will then be piloted across the homes through a realist evaluation. Learning and experiences of the project will be shared through a multimedia dissemination portfolio to maximise impact.

The project will be supported by a Lived Experience Advisory Group of young care leavers and an impartial critical stakeholder panel.

Timelines for delivery The rapid realist review and experience based co-design elements will occur concurrently during the first nine months of the study.

The realist evaluation will take place over the following 12 months, concluding with the refinement of the intervention and implementation toolkit.

In order to gather sector wide feedback throughout the study, the dissemination process will be iterative and benefit from our existing networks, concluding with a range of diverse events for maximum reach and impact.

Anticipated impact and dissemination This project has the potential to challenge and revolutionise practices and quality of care across the children's home sector.

The team will work with regional and national stakeholders to explore how to improve the transparency and quality of trauma-informed care within homes for children.