There is an “urgent need” to build additional accommodation capacity within Tusla’s children’s alternative care services due to “inappropriate” placements, according to a new report from the Health Information and Quality Authority (Hiqa).
The watchdog said the accommodation of children in the care of the State in “inappropriate” and unregulated special emergency arrangements was of “significant concern”.
Hiqa’s report, based on its monitoring and regulation of the Child and Family Agency’s children’s services over the past 10 years, detailed “consistent challenges”, namely recruitment and retention difficulties and a significant shortage of appropriate residential and foster care placements for children.
As a result of the shortage, it noted that some children, many of whom had complex needs, were living in unregulated special emergency accommodation.
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At the end of 2023 there were 201 children’s residential centres (CRCs) nationally, 164 of which were non-statutory and operated by both private and voluntary providers which do not fall within Hiqa’s remit. As of the end of September 2023, there were 397 children in CRCs.
It noted that the number of statutory children’s residential services had not changed significantly over the years, and at the end of 2023, there were 37 statutory CRCs.
“It is increasingly apparent that there is a need to urgently build additional capacity within children’s alternative care services [children’s residential centres and special care units] in order to ensure that there is a range of appropriate regulated placement types available to meet children’s specific needs,” the report reads.
Eva Boyle, Hiqa’s head of programme for children’s services, said while there was an ongoing commitment to delivering good quality and safe services to children, Tusla faced a number of “consistent challenges”.
“Despite children living in unregulated care arrangements, the regulation of children’s residential centres has not been commenced,” she said.
Currently, the chief inspector in Hiqa has enforcement powers only for special care units, with the report calling for similar regulation for foster care and children’s residential centres “to help progress improvements in these services”.
“It was envisaged that Hiqa’s role would grow to include the formal regulation of all types of children’s residential centres, as Tusla services represent only 18 per cent [37 of 201 CRCs] of such services.
“However, at the time of publication, despite an increasing number of children living in inappropriate, unregulated care arrangements, the regulation of children’s residential centres has not been commenced and is with the department for consideration,” the report reads.
Separately, the report detailed how Tusla has been unable to recruit and retain a sufficient number of staff to “sustainably operate” its child protection and welfare (CPW) services.
As a result, thousands of referrals to CPW services, including hundreds of high-priority referrals, regularly do not have a named social worker assigned to them.
In 2023 there were 4,724 unallocated cases, 448 of which were high priority.
The “considerable and ongoing strain” among CPW services is amid year-on-year rises in referrals for over a decade, with more than 91,900 referrals received in 2023, compared with 43,600 in 2014.
“The unmanageable caseloads for social workers in some CPW teams is compromising their ability to ensure children’s safety is maintained and that risks to their safety are effectively managed,” the report reads.
Separately, 251 children in the care of the State died throughout the period of the review, from 2014 to 2024, while a further 104 serious incidents involving children known to child protection and welfare services were notified to Hiqa.
Inspections of Tusla’s Child Abuse Substantiation Procedure (CASP), meanwhile, found “significant delays” in assessing allegations, which Hiqa said impacted Tusla’s capacity to act quickly to safeguard not as-yet identified children who may be at risk.
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