For over a decade, UK policymakers have responded to global ambitions to protect children from exploitation and other forms of extra-familial risks and harms by recommending that social workers coordinate local responses. This has required a significant shift in the design and delivery of social care services. In this article, we report findings from a three-year Institutional Ethnography of six social care sites that used three innovation frameworks to facilitate this shift. We identify corresponding points of progress and challenge regarding the ability of these sites to create systems in which responses to extra-familial risks and harms were reflective of the dynamics of this harm-type; relational; and interagency. While site progress illustrated improvements in service, delivery challenges indicated an absence of shifts in service foundations. By discussing our findings in dialogue with psychosocial theories, we uncover a direct relationship between day-to-day practice shortfalls and often unseen ‘ruling relations’ that govern safeguarding systems of Anglophone countries. At a time when further UK policy reform is anticipated, we draw a line in the sand and recommend national and international policymakers looks beyond service improvement and commit to reform system foundations to effectively safeguard young people abused beyond their homes.