The Health Information and Quality Authority (HIQA) has today published a report on Ballydowd Special Care Unit, which is operated by the Child and Family Agency (Tusla). Special care units are secure residential designated centres for children aged 11 to 17 years. Children are placed in a special care unit by a High Court order, when their behaviour poses a risk of harm to their life, health, safety, development or welfare, and the placement is needed for the child’s care and protection. 

This risk-based inspection focused primarily on the management of incidents within the unit, staffing, restrictive practices and protection. Five regulations were examined, three of which were compliant and two were substantially compliant.

There was strong governance and oversight in the special care unit, which ensured timely notification, response and review of incidents and practice issues. Complaints were managed effectively. Inspectors reviewed records on the use of restrictive practices and found that good-quality care and support were provided to children during times of escalated or challenging behaviour. Staff were diligent and committed in their efforts to reduce the impact of difficult situations. Child protection concerns and allegations against staff were noted to have good management oversight. All child protection concerns were reported as required, and staff had completed mandatory safeguarding training. 

Despite some of the actions taken and controls put in place by management, the shortage of adequate and appropriate staffing remained a risk within the special care unit. This had an impact on the daily living and activities of children, which were not always prioritised according to their individual needs, but instead by the availability of resources, like staffing. 

Tusla submitted a satisfactory compliance plan to address the regulations that were deemed substantially compliant for the special care unit.

Notes to the Editor:

• HIQA inspects against the Health Act 2007 (Care and Welfare of Children in Special Care Units) Regulations 2017 and the National Standards for Special Care Units, which apply to special care units in Ireland.