The Health Information and Quality Authority (HIQA) has published an inspection report on the foster care and child protection and welfare services operated by the Child and Family Agency (Tusla) in the Carlow Kilkenny South Tipperary service area.

HIQA conducted a risk-based inspection of the Carlow Kilkenny South Tipperary service area, located in Tusla’s South region, between 19 to 23 October 2020. A total of 12 standards were examined across both the foster care and child protection and welfare services. Of the eight child protection and welfare standards assessed, four standards were substantially compliant, three standards were moderate non-compliant, and one standard was major non-compliant. Of the four foster care standards assessed, one standard was compliant, two standards were moderate non-compliant and one standard was major non-compliant.  

Child protection and welfare

The service had made good progress to improve its performance in accordance with the required standards, legislation and policy. However, there were gaps in the governance of retrospective cases and the management of safety planning for children and families on a waitlist for a service. These gaps posed risks and required immediate attention. 

Managerial oversight had improved in the area for the social work service and there were strengthened governance arrangements to ensure compliance with screening, preliminary enquiry and initial assessments. Risk management systems required improvement, as appropriate controls were not in place for all identified risks and the escalation of risks did not always ensure an effective response. 

The management of retrospective allegations of abuse was poor and the waiting list for this service which was not effectively managed. In the absence of standard operating procedures and guidelines, there was a lack of clarity for social workers in relation to their responsibilities to assess and progress some of these cases. The determination of priority for allocation of cases was flawed, as high-priority cases remained on the waitlist without appropriate safeguards put in place in all cases. The system for ensuring potential risks to children were promptly identified, required improvement.

While further improvements were required with respect to the timeliness of completion of preliminaries enquiries, good progress had been made and the quality of preliminary enquiries had improved. Referrals were screened promptly. Staff members were knowledgeable about categories of abuse, thresholds of need and prioritisation levels and records indicated that social workers made good evidence- based decisions regarding the appropriate next steps for children and families. 

Children who required immediate care and protection due to a risk of serious harm were responded to promptly, they received a timely service and safety planning was good. 

There was good practice found in the review of cases requiring ongoing social work intervention which promoted children’s safety and welfare. While the service had reduced waiting lists for child protection services, there continued to be a significant wait for children and this was not effectively managed. Measures in place for the oversight of cases awaiting a service did not ensure basic checks with network supports or regular check ins with children and families were completed. Assurances were sought from the area manager with respect to the management and oversight of cases on a waiting list for services. 

Social workers and their managers had made definite progress since the last inspection in improving the quality and timelines of initial assessments. Inspectors found good quality assessments with clear analysis of risks and children’s needs. Managerial oversight was evident and timeliness of assessments had improved. Further progress was required to ensure that all assessments were completed in line with the time frames required by Tusla. 

While local and regional management team had implemented various measures to improve case management within the service, gaps remained. Oversight and monitoring arrangements required further improvement to ensure children and families experienced more timely and responsive action and intervention. 

Foster care
Significant progress had been made with respect to aftercare service provision and improvements identified by inspectors were also reflected in the experience of children, carers and allocated social workers. The provision of aftercare services to young people was timely, comprehensive and managerial oversight had improved to ensure good quality service delivery. 

While the area was not yet compliant with its statutory responsibility to ensure children in care were visited regularly by a social worker, improvements had been made. The majority of children had been visited in the months prior to inspection and there was a plan in place to ensure this continued, as required. Where children were visited the quality of these visits was good. 

Children continued to experience changes in social workers in the months prior to inspection and children’s own views shared with inspectors were reflective of this. Some improvements had been made to ensure children had one consistent professional in their lives and significant improvement was found in the system of allocating children to a social worker. There was improved monitoring of the impact of changes in social workers on children and systems in place ensured children’s needs and experiences were at the centre of such decisions. 
The joint protocol for interagency collaboration between Tusla and the HSE had been implemented in the area, and social workers coordinated specialist services to ensure that children received specialist services in a timely way. 

Management oversight of care planning and review processes required improvement as not all care plans were up to date. Child-in-care reviews were not taking place within statutory time frames for all children and there was no clear plan in place to address this failure. Therefore, the waiting list for child-in-care reviews was expected to increase. Despite improvements with regard to quality, participation and consideration of all children’s needs in the care planning and review processes, there was a lack of capacity within the service to ensure compliance for all children and a slow rate of progress since the previous inspection.

The service area submitted two compliance plans which outlined plans to address the risks, including immediate measures to address the risks relating to care planning processes and oversight of retrospective cases. The inspection report and compliance plans can be found at www.hiqa.ie. The compliance plan will continue to be monitored as part of HIQA’s ongoing regulatory activity.