As of 1 January 2018, HIQA is legally responsible for the monitoring, inspection and registration of all special care units for children in Ireland.

Where there are serious concerns about the safety of a child, the Child and Family Agency (Tusla) may seek a Special Care Order through the courts, to place the child in what is called ‘special care’. Children receive the additional help and supports they need. Special care is a building where the external doors are locked. Children attend school on the grounds of the special care unit.

Special care units are prescribed as 'designated centres' in the Health Act 2007 (as amended by the Child Care (Amendment) Act 2011). HIQA has, among its legal functions, the responsibility to regulate the quality and safety of services provided in special care units.

Our inspectors are trained to undertake regulation-based inspections, ensuring that services meet the requirements set out in the Health Act 2007, regulations and the national standards, in order to be registered to operate. During inspection, we attempt to speak with as many children as possible, and with their families and or other important people in their lives. This includes carers, staff, social workers or guardians ad litem (a person who represents a child’s views). It is really important to us that children who use these services are safe, respected and listened to.

We also speak with staff members, the person in charge and the person who represents the provider service.

We want to know that children living in special care units:

  • are safe,
  • their rights are respected,
  • are included in decisions about their care,
  • have a good quality of life,
  • are provided with care that matches their individual health and social needs.

When we inspect services, we look at what is written down about children and how they are being cared for. Inspectors look at children’s files to see what is going well for them, and if there are any things that the service could do to make their lives better. We also look at complaints that have been made about the service to see if children have been unhappy with anything and what was since done to improve the service.

This involves monitoring, reviewing and risk-rating all information submitted. Information submitted may contain details on how the service providers respond to events such as serious injury, allegations of abuse or outbreaks of infection. We also monitor, review and risk-rate information submitted by third parties in relation to the special care units and follow this up with service providers, as required.

We also receive unsolicited information by persons who may have a concern about the care provided. Inspectors review all of this information and use it to inform our work. Our aim is to ensure that good care is provided to the children, and we take necessary action to enforce this when required.

We then publish our inspection reports on our website. These reports provide information to the public on what it is like to live in the special care unit and assess if a special care unit provides consistently good care.

Sometimes reports may not be published due to the potential for identifying the children, particularly in a small residential centre. Whether a report is published or not, Tusla and or the service provider will receive a copy of the report, which can also be made available to children living in the centre and or their families.