Children’s services facing ‘extensive demands’, says Hiqa report

Health watchdog highlights ‘lengthy’ waiting lists for families awaiting Tusla services

Hiqa received 79 pieces of unsolicited information last year from members of the public who had a concern about services. Photograph: Christopher Furlong/Getty

The State’s health watchdog has said there are “extensive demands” across some service areas for children to receive initial assessments of their protection and welfare.

In its annual overview report on inspection and regulation of children’s services, the Health Information and Quality Authority (Hiqa) said there was “no national approach” being taken by Tusla last year to manage waiting lists for children and families awaiting services.

Hiqa said risk-based inspections of child protection and welfare services found children and their families experienced variance in the quality and timeliness of the services they received, resulting in “delays in screening, preliminary enquiries and initial assessments”.

“There are extensive demands across some service areas for children to receive initial assessments of their protection and welfare, with lengthy waiting lists in place in the areas where risk-based inspections were carried out,” it said.

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“There was no national approach being taken by Tusla to manage waiting lists for children and families awaiting a service from Tusla.”

Hiqa found that while there were “marked improvements” across many children’s residential centres, areas such as monitoring and oversight, quality assurance and risk management differed in a number of service areas and needed to improve.

“Notifications of serious incidents involving children who are known to Tusla’s child welfare and protection services, including the deaths of children in care, are issued to Hiqa’s children team by Tusla within 48 hours of the death or serious incident happening,” the report says.

“During 2019, the children’s team received 28 notifications of serious incidents, including the deaths of children in care. Local reviews are carried out by Tusla following such incidents. These review reports are forwarded to Hiqa once completed.”

Hiqa also received 79 pieces of unsolicited information last year from members of the public who had a concern about services provided.

The report says at the end of 2019, the number of cases open to the child protection and welfare service was 24,827. Open cases are where referrals are either waiting for a service or are being actively worked on by Tusla.

Of the total number of open cases, 5,291 were not allocated a social worker and of those, 653 were high priority cases.

Meanwhile, 482 out of 5,461 children living in foster care did not have a named social worker allocated to their case.

Challenges

Mary Dunnion, Hiqa's director of regulation and chief inspector of social services said risks in some children's services remain and "without doubt Tusla continues to face a number of key challenges".

“These challenges primarily relate to the pace of implementing a workforce strategy that both involves attracting more social workers into the service and retaining current social work staff,” she said. “There is limited capacity to meet the demands placed on social workers.”

Hiqa said an announced inspection of Oberstown Children Detention campus last year focused specifically on the use of restrictive practices and the delivery of programmes to address offending behaviour.

“Although the majority of young people were positive about their stay in Oberstown Children Detention Campus the opportunities it provided them in particular to help break a cycle of offending behaviour and to manage their feelings in a better way, some were concerned about eventually leaving the campus and where they would live,” it said.

Inspectors found young people were provided with a good standard of care and it was evident that there were improvements to the quality of their lives through the opportunities made available to them.

“However, poor quality records did not always show how the young peoples’ rights and best interests were consistently promoted as required whenever restrictive practices were used,” the report added.

Hiqa said although restrictive practices had reduced in 2019 compared to the year before, the use of such practices “remained significant”.

Sarah Burns

Sarah Burns

Sarah Burns is a reporter for The Irish Times