HSE and Tusla had ‘negative effect’ on disabled girl abandoned at birth

The Health Service Executive (HSE) and the child and family agency Tusla are reviewing the cases of almost 500 children with disabilities in care, following an investigation.

The Ombudsman for Children publishes findings today that the actions of both agencies had “a negative effect” on a girl, named “Molly” in the report, with Down syndrome and severe autism in foster care.

The report recommends gaps in supports and services to children with disabilities in care be addressed and a respite action plan be drawn up for all children with disabilities.

With reference to Molly, it recommends a stable transition to residential care be ensured if she is moved.

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“Our recommendations have implications not just for Molly but for approximately 471 other children with moderate or severe disability in foster care in the State,” says the report.

According to the report, both Tusla and the HSE accept the recommendations and will engage with their respective Government departments.

“The HSE ... is committed to working closely with Tusla to review Molly’s case as well as the other 471 children.”

Deteriorated

During the course of the investigation Molly’s situation deteriorated to such an extent it was recommended she be removed and placed in permanent residential care. Her foster family opposed this.

She is a teenager who has been with her foster family since she was four months old, having been “abandoned” by her biological parents at birth, says the report.

“Molly is dependent on her foster carers in all areas of her care, including feeding, toileting, bathing and dressing ... Molly’s foster mother, who complained to us, made clear that Molly has brought love and positivity to their lives but she is also completely dependent.”

The foster mother was “financially, emotionally and physically drained...a result of lack of support” and described the “immense toll on her immediate family” of having to care for and advocate for Molly.

The Ombudsman for Children found a failure by both Tusla and the HSE to recognise or adequately respond to the particular needs of children who both have a disability and are in care.

“Tusla operates a standardised approach to children in foster care, regardless of whether they have a disability. Similarly the HSE operates a standardised approach to children with a...disability, regardless of whether they are in care.”

Lacked specific training

Impacts on Molly included that Tusla social workers lacked specific training in supporting children with disabilities in care; they struggled accessing specific HSE disability services for Molly and struggled supporting her foster family to parent her.

“Several social workers interviewed described feeling ill-equipped with regard to supporting Molly and her foster family ... Molly’s foster carer experienced difficulties and delays in accessing day-to-day supports and services. This represents an unjustified barrier to a child in care with a disability reaching their full potential.”

Tusla’s system of requiring all foster parents to request funding for each expense meant foreseeable costs – such as specialised liquid diet, specialised bedding, petrol for numerous medical appointments – had to be requested individually, placing “undue financial, administrative and, potentially, psychological” burdens on the family.

HSE services for families with children with disabilities are “in severe shortage” exacerbating challenges faced by foster carers of such children.

“This can result in the destabilisation of an otherwise sound fostering arrangement.”

Molly’s intellectual disabilities liaison nurse (ILDA) was meant to visit her every six months. However, the report stated: “Molly did not receive any home visit for a 14-month period between 2006 and 2008.”