<p>Children and young people in Out of Home Care (OoHC) are amongst the most vulnerable and traumatised in our society. Meaningful engagement of these young people in services can be met with several barriers. To date, few studies have assessed whether programmes such as leisure time football can be effective in enhancing health and well-being, and offer an effective model for engagement of young people in mental health services. To assess the effects of a five-aside football programme (delivered in one Health &amp; Social Care Trust in Northern Ireland) on health and well-being of young people and their carers. To offer ideas on how the programme could be developed to improve access to physical and social activities for children in care.&#xa0;A cross-sectional qualitative research design. Two focus groups were conducted immediately after a football session with an all-male sample, one with five male children (aged 12–22 years old) in OoHC, and the second with their male carers (<i>n</i> = 5). General Inductive Analysis (GIA) was used for thematic analysis and applied to focus group transcripts. A trauma-informed approach was applied in the design and conduct of the focus groups.&#xa0;Five main themes emerged from the focus group with young people, including: physical, psychological and social health benefits; motivation and enjoyment to participate each week; benefits beyond the football pitch; challenges of participation. Seven main themes emerged from the focus group with carers. Two themes were similar to those raised by the young people, namely: physical, psychological and social health benefits; and motivation to participate. Relational engagement was a primary outcome, for example carers viewed key barriers to participation, but felt that their professional relationship with the young person improved, as well as enhancing their relationship with other carers. The carers suggested improvements, but were also cautious of making any changes to the programme. Carers reported that safeguarding and risk assessment were perceived to be too stringent, but a necessary requirement. The programme was viewed positively in terms of engagement levels of young people, as was the transition of positive experiences “on the pitch” to (their) “off the pitch” experiences, alongside improved relationships and communication with young people.&#xa0;Football can improve relational engagement and effectiveness of service provision between carers and young people in OoHC, whilst offering health benefits. The provision of five aside football for children in OoHC is a low-cost, scalable initiative to complement existing therapeutic approaches.</p>