Listening to what matters to children in care
In health and care, professionals are often trained to focus on problems, risks and needs. But sometimes, one simple question can shift the entire conversation:
“What matters to you?”
For Katie Oates, Community Nurse in the Children in Care (CiC) team at Lincolnshire Community Health Services NHS Trust, that question became the starting point for something powerful.
Inspired by a talk by Tommy Whitelaw about the importance of understanding what matters to people, rather than focusing solely on illness or problems, Katie Oates began exploring this approach within her work with children and young people in care. As part of this, she started asking young people the simple but powerful question, “What matters to you?” during their review health assessments.
Over the course of a year, 82 young people aged between 8 and 18 shared their answers.
Some offered a single word. Others spoke openly and deeply about relationships, identity, safety, hopes, and fears. Together, their responses reveal something important: personalised, strengths-based care begins with listening.
Katie: “By asking “What matters to you?” we’re not only gathering information but also giving young people a voice and an opportunity to be truly heard.”
Read Katie’s report about this work
Moving beyond labels
Children in care are often defined by systems, assessments and categories. Yet Katie’s approach reminds us that young people are far more than their circumstances or care status.
One 15-year-old girl captured this perfectly:
“Food, family. Just because you have a label (Child in Care), not a cereal box family - just how it is (my family). Book supplies, and doing well in exams.”
It is a striking reminder that personalised care means seeing the whole person, not the label attached to them.
Katie deliberately kept the question open and unprompted, giving young people time and space to answer in their own way. Responses were recorded exactly as spoken, ensuring their voices remained authentic and unchanged.
Some young people initially struggled to answer. Others appeared surprised that anyone had asked at all.
A nurse colleague of Katie’s reported that when she had asked a young person 'What matters to you?", they had responded: “Oh, I don’t know. No one has ever asked me that before.”
That single sentence says a great deal about the importance of relational, personalised practice. Sometimes the most meaningful intervention is simply creating the opportunity for someone to feel heard.
Relationships matter most
The strongest theme running through the young people's responses was relationships.
Across nearly every conversation, they spoke about family, carers, friends, community and connection. Katie’s findings show that what matters most is rarely material possessions - it's people.
Many of the young people described wanting to feel safe, loved and connected.
A 13-year-old girl said: “Family, feeling safe, someone to talk to, company, being happy, school and friends, eating well and sleeping well, relaxation and exercise.”
A 17-year-old boy shared: “Family (friends) mean everything to me… My community matters the most.”
These reflections reinforce something often overlooked in traditional care models: relationships are not an optional extra. They are central to wellbeing.
For children and young people whose lives may have included disruption, loss or instability, trusted relationships provide security, identity and hope. A strengths-based approach recognises and builds on these existing connections rather than focusing solely on deficits or difficulties.
The importance of belonging
Alongside relationships, many of the young people's responses highlighted a deep need for belonging.
They spoke about foster carers as family, about valued friendships, communities, pets, favourite toys, and familiar routines.
One Community Nurse described a young boy who responded to the question not with words, but by running upstairs and returning with a “massive cuddly caterpillar” that clearly meant the world to him.
These moments matter because they reveal how children create comfort, safety and identity through the people and things they love.
Belonging is not always about grand gestures. Often, it is found in everyday connections - a favourite object, a pet, a foster carer, a trusted friend, a boxing match, or the hope of going to university.
Personalised care pays attention to these details because they tell us who a person is.
Hearing the emotion behind the words
Some of the young people's responses were joyful and hopeful. Others revealed vulnerability, uncertainty and pain.
One 17-year-old boy said: “Don’t know anymore, don’t know who I am anymore.”
This young person was particularly vulnerable and due to move the following day, reflecting uncertainty and distress about his situation.
Another young person, who found the wider health assessment difficult, refused to answer every other question - except this one. When asked what mattered to her, she showed a photograph of her brothers.
These moments demonstrate why personalised conversations matter. Standard assessments can sometimes miss the emotional realities underneath. Asking open, human questions creates space for feelings, fears, and priorities that may otherwise remain hidden.
Strengths-based practice is not about ignoring difficulties. It is about understanding people in the context of what gives their life meaning, connection, and resilience.
Supporting hope, identity, and future aspirations
Many young people also spoke about the future.
Career ambitions, education, success, self-respect, and stability appeared regularly in the responses. Young people talked about “doing well in exams”, “going in the army”, “going to uni”, and “future success.”
A 16-year-old girl responded with: “Move forwards rather than go back.”
This highlights another important principle of strengths-based care: recognising aspirations, abilities and potential - not just challenges.
Too often, systems unintentionally focus on risk and limitation. But these responses show that young people in care hold ambitions, dreams, and hopes like anyone else. Supporting those aspirations is part of helping people build confidence, identity, and independence.
Small question, big impact
What makes Katie's approach so powerful is its simplicity.
There was no complicated intervention or large-scale programme. Instead, it was a meaningful shift in conversation - from talking about young people to listening to them.
In her report, Katie notes that revisiting the question over time could offer valuable insight into how young people’s priorities and emotional needs evolve as their circumstances change.
She also reflects on an important challenge for fellow health and care colleagues:
“I think as professionals we can so often assume what we think should matter to them.”
This is where personalised care becomes transformational. It moves beyond assumptions and creates genuine partnership.
It recognises that people are experts in their own lives.
Conclusion: Listening differently
Katie’s “What Matters to You?” work offers a powerful reminder that the foundations of good care are often simple: asking 'What matters to you', taking the time to listen, being truly curious, building relationships, and being kind.
The responses from children and young people in care consistently point toward the same themes - love, safety, belonging, connection, and hope.
They remind us that personalised and strengths-based approaches are not abstract ideas or policy language. They are about understanding what gives people meaning and making that central to care and support.
Above all, this work shows the value of asking human questions and truly hearing the answers.
Perhaps the most powerful summary came from a 10-year-old girl, whose words captured the heart of the entire project:
“Love, sharing, and being kind to each other.”
