The Health Information and Quality Authority (HIQA) has today published two inspection reports on children’s residential centres operated by the Child and Family Agency (Tusla) in the South and Mid-West services areas respectively. 

HIQA is authorised by the Minister for Children, Equality, Disability, Integration and Youth under Section 69 of the Child Care Act, 1991 as amended by Section 26 of the Child Care (Amendment) Act 2011, to inspect children’s residential care services provided by Tusla. HIQA monitors Tusla’s performance against the National Standards for Children’s Residential Centres and advises the Minister and Tusla.

HIQA conducted these announced inspections in September and December 2022. These inspections primarily focused on the leadership and management of the centres and how effective they were in ensuring that a good quality and safe service was being provided to children. Additionally, they focused on the care and support children received and if this was of a good quality and ensured children were safe. 

South service area

The first inspection took place in September 2022. This was a residential respite service opened earlier in 2022 and this inspection was the first inspection that took place in the centre. The centre provided respite care to children and young people living at home or in foster care aged between five and 17 years of age. Of the eight standards assessed, two were found to be compliant, five were substantially compliant and one standard was not compliant. 

The service was still evolving at the time of the inspection. The inspection found that centre staff had formed positive relationships with the children, their families and foster carers, and ensured children had opportunities to do the things they enjoyed. The staff team worked closely with foster carers, social workers and other professionals in getting to know the children and their individual needs. 

The inspection found some areas of immediate risk concerning the management, safety and quality of the service which required urgent attention by the provider. These issues were promptly addressed by service managers with assurances given to HIQA that actions were taken to address these risks, strengthen reviews of children’s care and provide additional training for staff. The location of the centre was not suitable, and the layout of the building itself was not homely, which detracted from the quality of care provided.     

The centre’s management and front-line team were, overall, suitably experienced in residential care, however, their knowledge and training for caring for younger children required updating. There were also gaps in Tusla’s policies, procedures and guidance for the provision of respite, with staff relying on mainstream policies which were not always appropriate. Approaches to the delivery and review of care and risk management required further development for younger children and those with high and complex needs.   

Mid-West service area

The inspection in the second centre was conducted in December 2022. Of the nine standards assessed, six were compliant, two were substantially compliant, and one was not compliant. The centre provided a respite and support service for children and young people, who are living at home or in foster care, aged between five and 17 years of age.

This premises offered a warm, positive, child-friendly environment and was decorated with warm colours and artwork created by children. The inspection found that the staff and managers provided a good quality respite service to children that supported the particular needs of each individual child. Staff and managers were committed to providing stability, hope and opportunity to each child. Staff and managers worked collaboratively with social workers in relation to the overall plan for each child.
 
Children were safe in the centre and there were clear systems in place to ensure concerns about children were reported in line with Children First: National Guidance for the Protection and Welfare of Children (2017). Staff were knowledgeable of their responsibilities in reporting child protection concerns. However, there was drift and delay in seeking updates on child protection concerns and in the use of the centre’s escalation procedure in responding to this. The managers and staff provided different platforms for children to have a voice in the planning of the day-to-day service.

Improvements were required in the monitoring, recording and review of the use of restrictive practice in the centre. 

Both providers have submitted plans outlining how they intend to come into full compliance. The inspection reports and compliance plans can be found at the link below.