An inspection of a health-board-run children's residential centre in the midlands has found that three girls have been absent from the unit without permission on more than 200 occasions. One was sometimes "missing for days on end".
The report compiled following the inspection said staff were unclear as to where the young people went when they left the centre. However, it said, there was "information to suggest that they sometimes found themselves in unsafe situations".
These unauthorised absences from the unit, which opened in 2002, raised concerns around child protection issues, the inspectors said.
The inspection of the unit, which is not named to protect the identities of the children in care, was carried out by the Irish Social Services Inspectorate. The inspectors arrived unannounced at the centre, which offers medium- to long-term care for children between 13 and 17. It is run by the Midland Health Board.
The inspectors' report said the three adolescent girls, two aged 16 and one 13, were absent without permission on 22, 82 and 100 occasions respectively.
"The first of these had not been absent without permission for five months up to the time of inspection, and the problem appeared to have been resolved in her case.
"The second young person continued to leave the centre without permission and was sometimes missing for days on end. The third also continued to leave, but tended to be missing for shorter periods," it said.
It added that care staff and social workers were actively attempting to understand and remedy the situation. The inspectors were satisfied they were giving the safety of the young girls "due consideration" but said measures had to be strengthened.
The report said the health board had developed a draft policy on unauthorised absences, which gave guidance for staff on how to deal with them and emphasised the importance of risk assessments.
"Though the policy was supposed to have come into operation last June, inspectors could not find any evidence of formal risk assessments having been carried out in relation to young people in the centre," the report said.
"The policy on unauthorised absences ought to be amended. In a situation where a young person is consistently leaving a centre without permission and putting herself at risk, the process of risk assessment should be a multidisciplinary task, with the social work department taking a lead role in bringing together relevant professionals."
On staff vetting procedures, the inspectors said Department of Health requirements that three references be taken up in relation to staff working in children's residential centres were met in relation to only four of the 18 staff. The report recommended that the centre ensure that all checks required by the Department are carried out on new staff.
The report also said that, while there was a no-smoking rule in the centre, the girls were permitted to smoke outside the back door.
"Some staff were smokers, and there was no clear policy that they should not smoke in front of the young people. Inspectors recommend that there should be," it added.
Despite these concerns the inspectors found the centre offered a good standard of care. Staff were described as a cohesive, experienced and relatively well-trained team.