Hiqa to review Tusla over concern for at-risk children

Serious concern over the safety of children at risk has prompted the State's health watchdog to review national governance at Tusla, the Child and Family Agency.

The Health Information and Quality Authority (Hiqa) said an overview of its inspections last year revealed inconsistencies over the safety and quality of children’s services were a cause of major concern.

The authority found significant delays in assessing the needs of children and families where there were reports of suspected abuse or neglect.

This issue was escalated as a serious concern to the national senior management team in the agency. In addition, there was evidence vulnerable children at risk of harm did not have timely access to social workers or vital supports.

As a result of these inconsistencies, the authority said it was concerned national and local management systems may not be adequate in order to provide consistently safe services.

Hiqa says it will shortly begin a national review of governance of the agency, which took over responsibility for child and family services from the HSE in January 2014.

The agency was established to provide a greater focus on improving children’s services following a series of high-profile scandals, including the deaths of young people in care.

Significant variation

Hiqa's head of regulation Mary Dunnion said its inspections showed significant variation in the performance of the agency in different service areas. While there were long waiting lits for initial assessments by social workers in four out of the five service areas inspected, there was no waiting list in the Kerry area.

“Hiqa is concerned about the inconsistencies in the safety and quality of children’s services nationally,” she said.

Records obtained by The Irish Times earlier this year showed thousands of reports of abuse, neglect and welfare concerns over children at risk were waiting to be allocated a social worker.

An internal report presented to the board of Tusla said backlogs were so acute in some areas that hundreds of extra staff are needed to bring numbers back to “manageable” levels.

Child-centred practice

But Hiqa also found examples of good practice and progress in improving some services. Many children in both residential and foster care were well cared for and inspectors found examples of excellent child-centred practice, including seeking children’s views and ensuring they were involved in decision-making. Children also told inspectors they felt listened to and made informed decisions with the support of their social workers.

Some services, however, weren’t able to meet the needs of young people with challenging behaviour. The authority said it remained concerned about the use of restraint or seclusion involving children detained in special care units and detention schools.

Ms Dunnion said while there was evidence of improving services and good practice, it will continue to work with providers to promote improvement in the safety and quality of services.

Some centres for children with disabilities also faced challenges meeting the needs of young residents. Of the 65 inspections carried out in disability centres during 2014, escalation and enforcement issues were taken in 15 services, while a further eight had immediate action plans issued to them by the authority relating to health and safety concerns.

There was also evidence of poor medication management, inappropriate placements of children and poor management of some centres. Two notices of proposal to cancel registration were issued due to concerns about the fitness of the provider to provide safe care to children.