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 Dublin South West, Kildare, West Wicklow 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 Dublin South West, Kildare, West Wicklow over three days in April 2019. This themed inspection aimed to assess compliance with the national standards relating to managing referrals from receipt to the point of completing a preliminary enquiry.

Of the four standards assessed, all were found to be in major non-compliance.

At the time of this inspection, inspectors found the Tusla service area of Dublin South West, Kildare, West Wicklow had introduced a number of key changes over the previous 12 months. These changes, which were still not fully implemented at the time of inspection, included changes in senior management in the area, the adoption of a national approach to child protection and welfare, the introduction of mandatory reporting, changes to the national standard operating procedures and the roll out of the National Childcare Information System (NCCIS). Additionally, staffing deficits remained high across the entire Tusla service area. 

Over the six weeks prior to the inspection, the management of the area identified two significant areas of risk and put a three month crisis management plan in place to address them. These significant risks were: 

• the backlog in processing and uploading new referrals onto NCCIS 
•  the operation of waitlists at the preliminary enquiry stage. 

Inspectors found that effective measures had been put in place to reduce the backlog of referrals waiting to be put up on the system. However, there remained significant problems with the operation of waitlists at the preliminary enquiry stage. There were no systems in place to formally review cases on a waitlist for preliminary enquiry. Additionally, cases were closed to the service without the required checks taking place and the rational for closing being either completed or recorded on NCCIS.

Child protection and welfare referrals were not being managed in line with Tusla standard business processes. Although screening was taking place, referrals were not consistently screened within 24 hours as set out in Tusla’s business processes. Overall, the quality of preliminary enquiries was poor. While the categorisation and prioritisation of referrals was largely accurate, the timeliness was poor. Children experienced significant delays in the completion of preliminary enquiries. In addition, basic checks were not consistently completed as part of preliminary enquiries.

Inspectors reviewed cases which showed good co-working with An Garda Síochána; however, the service area was not routinely notifying Gardaí of suspected crimes of wilful neglect or physical or sexual abuse against children in a timely manner.
There were examples of good social work practice. The majority of children at immediate and serious risk received an appropriate response from staff in order to safeguard them. In addition, there were innovative and effective measures in place to divert families to external agencies where a welfare response was more appropriate. However, as children did not receive a service that promoted their welfare and protected them from harm in a responsive manner, this impacted on the timely development and implementation of safety plans.

The oversight of child protection and welfare cases was poor in the area. Formal supervision and quality assurance systems were not effective at providing assurance that the service was being safely delivered. Risk management in the area was not effective at identifying all risks and putting measures in place to mitigate them. 
Tusla has provided an action plan response to address areas for improvement identified on inspection. The action plan is published at the end of the report.