The Health Information and Quality Authority (HIQA) has today published two inspection reports on the foster care services operated by two private foster care providers. The reports refer to Oak Lodge Fostering Service, operating in the Child and Family Agency’s (Tusla’s) South Region, and Care Visions Fostering Ireland, operating in Tusla’s Dublin Mid-Leinster Region.

HIQA is authorised by the Minister for Children and Youth Affairs under Section 69 of the Child Care Act, 1991, as amended by Section 26 of the Child Care (Amendment) Act 2011, to inspect foster care services provided by Tusla, to report on its findings to the Minister for Children and Youth Affairs and to inspect services taking care of a child on behalf of Tusla, including non-statutory providers of foster care. HIQA monitors foster care services against the 2003 National Standards for Foster Care.

As part of its 2017 and 2018 monitoring programme, HIQA is conducting thematic inspections across all 17 Tusla service areas and in all six private foster care providers, which focus on the recruitment, assessment, approval, supervision and review of foster carers. These thematic inspections are announced and cover specific standards relating to this theme. Due to concerns arising during these two inspections however, these inspections also included Standard 19, Management and monitoring of foster care services.

In an announced inspection of Oak Lodge Fostering Service in January 2018, of the seven standards assessed, one was compliant, one was substantially compliant and the remaining five were all identified as major non-compliances. There was a lack of oversight and management of the service, and auditing, risk management and notification systems required improvement. The management and oversight of concerns, allegations and complaints was not adequate and there were inadequate systems in place to ensure that allegations were reported in line with Children First: National Guidance for the Protection and Welfare of Children (2011).

While fostering assessments were comprehensive, they were not always timely. All foster carers were supervised and supported by a link social worker, and foster carers reported receiving good support from the service. However, the quality of supervision required improvement, and the oversight of respite arrangements in particular required improvement. 

The service had a training strategy in place and provided foundational training to all foster carers prior to approval as carers; however, this was inadequate as it did not include training on child protection and safeguarding. While foster carer reviews were up to date, they were not always carried out in line with standards, as they were not chaired by a social worker at a managerial level. The service had effective recruitment campaigns and held several recruitment campaigns throughout the preceding year.

In the inspection of Care Visions Ireland in January 2018, inspectors found that they were non-compliant in all of the seven standards assessed. Of these, two were identified as moderately non-compliant, and five were majorly non-compliant.

Care Visions was last inspected by HIQA in November 2016, and at that time there had been significant risks identified in the management of child protection and welfare concerns. The protocols around the management of complaints and allegations were still not adequate on this inspection. Management systems were not effective and had not brought about improvements within the service, for example the actions identified following the previous HIQA inspection had not been implemented by the service within the identified time frames.

Since the last inspection, there had been significant changes in the management team, structure and systems, and the key role of head of service had changed personnel four times. The recent appointment of an interim managing director and head of service were positive events as they were both experienced managers, but at the time of inspection they were only familiarising themselves with the service.

There remained significant challenges for the service with an inexperienced social work team, the pool of foster carers available within the service and the geographic spread of the foster carers. While the staff team showed commitment to improvements and to the foster carers, the lack of experience within the social work team and changes in management caused disruption to the service. This had impacted on the delivery of the service improvement plan.

The service had a number of safeguarding arrangements in place including all foster carers having an allocated social worker, An Garda Síochána (police) vetting for staff and foster carers, and Children First training. However, inspectors identified serious risks and escalated three cases at the end of inspection. These risks included no Garda vetting for adult children of a foster carer where a child was placed, there was no safety plan in place for a child placed with foster carers where concerns about the carers were known to the social work team and, in another case, no visits had occurred with the foster carers two months following a significant event. The interim managing director provided a satisfactory response to address the risks.

Overall, the assessments of foster carers were of poor quality. During 2017, there had been 15 placement endings, the majority of which were unplanned. The quality of supervision and support provided to foster carers was mixed. While the frequency of visits from link workers had improved in the second half of 2017, the children placed with foster carers were not always met with as part of the visit and the record of the visit was not adequate. Care Visions’ methods of assurance around case management and oversight were not adequate to ensure that concerns were picked up on in a timely manner and received the appropriate response.

Reviews of foster carers were not carried out in line with the standards. While foster care reviews were taking place, two were outstanding and additional reviews were not always taking place following an allegation of abuse or serious concern. The current system to carry out foster care reviews was not in line with the National Standards.

At the time of these two inspections, Tusla did not have service-level agreements in place with either of the two fostering services. The Tusla monitoring office carried out an audit of Care Visions fostering service in July 2017 in which they set out significant deficits with the service. Following the risks identified in this audit, Care Visions took the decision to suspend new placements for an unspecified length of time in July 2017. The Tusla monitoring office wrote to the service in November 2017 to seek clarity on the governance and management arrangements in place and met with the interim managing director and head of service in January 2018. Care Visions confirmed at the end of the inspection that they remained closed to admissions.

However, HIQA found that Tusla social work teams continued to request placements from this service throughout the latter half of 2017, and up to and including the time of inspection, despite the findings in Tusla’s monitoring report.

Subsequent to the inspection, HIQA wrote to Tusla in regard to their governance and oversight arrangements to ensure that children placed with these services were being provided with safe, quality care that met their needs.

The chief operations officer of Tusla provided a written response to HIQA outlining the arrangements he had put in place to ensure appropriate oversight of private foster care services, and to confirm that no requests would be made for placements until Tusla is satisfied that children placed with Care Visions are being provided with safe, quality care.

The providers have submitted action plan responses to address the non-compliances identified on inspection.