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.