The Health Information and Quality Authority (HIQA) has today published an inspection report on the Child Protection and Welfare Service operated by the Child and Family Agency (Tusla) in the Carlow/Kilkenny/South Tipperary service area.

HIQA is authorised by the Minister for Children and Youth Affairs under Section 8(1)(c) of the Health Act 2007, to monitor the quality of services provided by Tusla to protect children and promote their welfare. HIQA monitors the performance of Tusla against the National Standards for the Protection and Welfare of Children and advises the Minister for Children and Youth Affairs and Tusla.

HIQA conducted a themed inspection of the child protection and welfare service in Carlow/Kilkenny/South Tipperary over four days in January 2019. This themed inspection aimed to assess compliance with the national standards relating to managing referrals to the point of completing an initial assessment.

Of the six standards assessed, five were identified as moderate non-compliances and one standard was found to be compliant.

Improvements were found in the screening stage of the child protection and welfare referral process. Since the previous HIQA inspection in 2017, an area screening team had been put in place to provide a central point of contact for both the receipt of and screening of all child protection and welfare concerns referred to the service. The team had developed standardised practices, such as screening tools. This ensured consistency of approach and practice across the team. Inspectors found that screening was mostly timely and there was an improvement in the consistent application of priority levels and categorisation of referrals. The content of preliminary enquiries, which were conducted by social workers following initial screening, was mostly comprehensive. However, inspectors found drift and delay from two up to 11 months in some cases in the completion of preliminary enquiries and this compromised the overall quality of this process. 

Initial assessments of children were mostly of good quality; however, children were waiting for initial assessments to commence. The area had increased their capacity to undertake initial assessments since the last HIQA inspection in 2017. A waiting list for initial assessment was in operation in the area. However, the volume of cases on the waiting list remained relatively unchanged or unimproved since last inspection due to the increased number of referrals. Inspectors also found that the systems for monitoring and oversight of the waiting list could not reliably measure risk to children or effectively mitigate against potential risk to children. This meant that children’s best interests and welfare, which are paramount in statutory child protection and welfare social work, were not promoted at the right time due to delays in the process. This required action. 

Measures to safeguard children who remained at home with their families required improvement. The process of agreeing, developing and reviewing safety plans was evolving in the area. Inspectors could not determine any standardised system of review of safety plans or structured time frames for the monitoring of their effectiveness.

The system in place for ensuring that all allegations of suspected abuse were notified by social workers to An Garda Síochána also required improvement and there were cases where notifications had not been sent as required. 

Other inter-agency contact and co-operation was good in the area. Since the last inspection, improvements had been made to ensure greater connectivity between the early intervention service, referred to as Prevention, partnership and family support (PPFS), and the child protection and welfare service.

A new integrated child care information system (NCCIS) had been introduced to the area in March 2018. Inspectors found that this was being effectively used for the case management of referrals. The system facilitated senior management to generate reports to inform them of key data and trends in relation to the capacity and output of the service. However, the system was not always used to monitor drift and delay in case work. 

The governance, monitoring and oversight of the management of child protection and welfare cases in Carlow/Kilkenny/South Tipperary required improvement. The local and regional management teams were implementing service improvement plans. However, there was opportunity for further review and development of these plans.

In addition, as with all inspection reports, the Child and Family Agency (Tusla) are required to provide an action plan to address the specific non-compliances outlined within this report. The action plan is published at the end of this report.