Care closer to home services are an established part of care for children and young people who are ill. They deal with complex and technical care and can prevent or reduce the length of acute hospital admission. Lack of readily available information about caseloads, case mix and costs may hamper their further development.

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Background Under the Children Act 1989, local authorities in Wales, UK, can issue care proceedings if they are concerned about the welfare of a child, which can lead to removal of a child from parents. For mothers at risk of child removal, timely intervention during pregnancy may avert the need for this and improve maternal/fetal health; however, little is known about this specific population during the antenatal period. The study examined maternity characteristics of mothers whose infants were subject to care proceedings, with the aim of informing preventative interventions targeted at high risk mothers. Methods Anonymised administrative data from Cafcass Cymru, who provide child-focused advice and support for family court proceedings in Wales, were linked to population-based maternity and health records held within the Secure Anonymised Information Linkage Databank. Linked data were available for 1111 birth mothers of infants involved in care proceedings between 2015 and 2018. Findings were benchmarked with reference to an age-deprivation-matched comparison group (n = 23,414), not subject to care proceedings but accessing maternity services during this period. Demographic characteristics, maternal health, reproductive history, interaction with midwifery services, and pregnancy and birth outcomes were examined. Descriptive and statistical tests of independence were used. Results Half of the women in the cohort (49.4%) resided in the most deprived areas. They were more likely to be younger at entry to motherhood (63.5% < 21 years-of-age compared to 42.7% in the comparison group), to have mental health (28.6% compared to 8.2%) and substance use issues (10.4% compared to 0.6%) and to smoke (62.7% compared to 24.8%) during pregnancy. The majority first engaged with maternity services within their first trimester of pregnancy (63.5% compared to 84.4%). Babies were more likely to be born preterm (14.2% compared to 6.7%) and, for full-term babies, to have low birthweights (8.0% compared to 2.8%). Conclusion This novel linkage study highlights multiple vulnerabilities experienced by pregnant mothers who have experienced care proceedings concerning an infant. Policy and practice colleagues require a clearer picture of women’s needs if child protection and health services are to offer effective services which prevent the need for family court proceedings and infant removal.

The full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. Mind-mindedness in Looked After Children AbstractThe studies reported here aimed to test the proposal that mind-mindedness is a quality of personal relationships by assessing mind-mindedness in parent-child dyads where the relationship has not spanned the child's life or where the relationship has been judged dysfunctional. Studies 1 and 2 investigated differences in mind-mindedness between adoptive parents (ns 89, 36) and biological parents from the general population (ns 54, 114). Both studies found lower mind-mindedness in adoptive compared with biological parents. Study 2's results showed that this group difference was independent of parental mental health and could not fully be explained in terms of children's behavioral difficulties. Study 3 investigated differences in mind-mindedness in foster carers (n=122), biological parents whose children were subject to a child protection plan (n=172), and a community sample of biological parents (n=128). The level of mind-mindedness in foster carers and parents who were involved with child protection services was identical and lower than that in the community sample; children's behavioral difficulties could not account for the difference between the two groups of biological parents. In all three studies, non-biological carers' tendency to describe their children with reference to pre-adoption or placement experiences was negatively related to mind-mindedness. These findings are in line with mind-mindedness being a relational construct.Key words: mind-mindedness; adoption; fostering; behavioral difficulties; child protection 2 Mind-mindedness in Looked After Children Mind-Mindedness in Parents of Looked After ChildrenMind-mindedness (Meins, 1997) indexes caregivers' attunement to their children's mental and emotional states. In infancy, mind-mindedness is assessed from caregivers' tendency to comment in an appropriate manner on their infants' thoughts or feelings (Meins, Fernyhough, Fradley, & Tuckey, 2001;Meins et al., 2012) or from caregivers' meaningful interpretations of their infants' early non-word vocalizations (Meins, 1998). In children beyond infancy, mind-mindedness is assessed in terms of parents' tendency spontaneously to focus on mental characteristics when given an open-ended invitation to describe their child (Meins, Fernyhough, Russell, & Clark-Carter, 1998).A growing body of research has shown that both the infant observational and preschool describe-your-child measures of mind-mindedness relate to various aspects of child...

PurposeDrawing on a wider study about the effectiveness and costs of different models of multi‐agency transition services, this paper aims to present new evidence on the ways in which such services meet the priorities and concerns of young people identified in previous research.Design/methodology/approachThe evidence is based on qualitative interviews with 130 managers and staff in five transition services across England, and a quantitative survey of parents and young people receiving these services (pre‐transition), or having received the services in the last‐two years (post‐transition). In total, 110 pre‐transition and 33 post‐transition parents, and 73 pre‐transition and 24 post‐transition young people, completed questionnaires. Statistical analysis included calculating frequencies and mean values for the responses that measured met and unmet need, and qualitative results were analysed thematically. The consequence of, and reasons for, the low response rate to the family survey are also discussed.FindingsThe research found examples of good practice and innovative services to meet young people's needs. However, provision of such services was patchy, and unmet need for transition support remained high in all the priority areas studied both during and after transition: ranging from 52 to 84 per cent in parent reports and 59 to 82 per cent in young people's reports.Originality/valueWith the onset of public service cutbacks, the paper concludes that improved multi‐agency commissioning of services, based on the priorities and concerns of disabled young people, and greater engagement of transition services with a broader range of agencies, will help to address these deficiencies.