Children’s services publication statement 10 January 2019
Today, the Health Information and Quality Authority (HIQA) has published five inspection reports on children’s residential and respite and support services. HIQA monitors services used by some of the most vulnerable children in the state against the National Standards for Children’s Residential Centres to provide assurance to the public that children are receiving a service that meets the requirements of quality standards, and to provide advice to the Minister for Children and Youth Affairs and the Child and Family Agency (Tusla).
These reports refer to three unannounced full inspections of residential services (centre ID numbers 4166, 4176, and 4189) and two unannounced inspections of respite and support services (centre ID numbers 4175, and 5764) throughout the country. Inspectors found a varied level of service was being provided to these children, with some services adequately meeting children’s needs and other services requiring improvement to meet the standards.
Overall, inspectors found that children were safe and well looked after and had a good quality of life. Children’s rights were promoted and children were involved in decisions about their care. One centre had won a Tusla Investing in Children Membership Award in 2017 which recognises and celebrates examples of imaginative and inclusive practice. Children had an allocated social worker, but not all children had up-to-date care plans in three of the five centres. This meant that the plan in place for the child may not have met the child’s current needs. In another centre, the quality of the care plans was not adequate, for example, they lacked detail around the plan for family contact. Agreements for children placed in respite services were not always in place.
There was variance in the quality of aftercare planning in two of the residential centres. Children were supported by staff to gain independence skills. The majority of young people aged 16 years or over in one of the residential centres had been allocated an aftercare worker and were working on aftercare assessments and plans, while in another centre none of the four children were actively engaged with their allocated aftercare worker. Inspectors wrote to the area manager of the relevant social work department about the lack of aftercare provision for one child and the area manager responded with assurances that the young person was subsequently allocated an aftercare worker. However, three young people spoken with during these inspections told inspectors that they were worried about what would happen when they turned 18, as they had no indication of where they would live or the supports they would have.
Staff were responding well to behaviours that challenged. However, records of work undertaken with children in relation to managing these behaviours required improvement in two residential centres. Poor records impacted on the staff team’s ability to be consistent in their responses to children, for example in relation to house rules or in the consistent implementation of clinical recommendations. Restrictive practices (such as alarms on children’s bedroom doors, locked kitchen door at night time and room searches) were in use in three of the centres. Inspectors found that risk assessments for the use of alarms on bedroom doors were not undertaken for individual children, and so the centre had not demonstrated why this restrictive practice was required for each child or the risk it was a control for. In another centre, there were insufficient records in relation to the locking of the kitchen door at night to facilitate assessment and oversight of the practice to determine its necessity.
The majority of centres had appropriate safeguarding arrangements in place but children in one centre told inspectors they did not always feel safe due to some of the behaviours of other children. Inspectors raised this concern with the centre manager and interim services manager who set out actions to mitigate the risk. All child protection concerns had been referred to Tusla child protection services in line with Children First (2017). Staff, in the majority of centres, were aware of the protected disclosure policy.
Improvements had been made in relation to the physical premises of one of the residential centres since the previous inspection which had a positive impact on the homeliness and atmosphere within the centre and the children told the inspectors that it was a very nice place to live. However, there were deficiencies in fire safety training and drills within this centre and in another centre fire safety records required improvement. A child from one centre told inspectors that their bedroom ‘was the nicest bedroom they had ever had’.
Further improvements were required in the governance and management of the centres including risk management, monitoring and oversight, staff supervision and training.
All of the services have provided action plan responses to address the non-compliances identified on inspection and timelines for implementing these actions.