The Health Information and Quality Authority (HIQA) has today published an inspection report on Ballydowd special care unit. The purpose of a special care unit is to provide a short-term period of care in a safe and secure environment.

HIQA is authorised by the Minister for Children and Youth Affairs under Section 69 (2) of the Child Care Act, 1991 as amended by the Child Care (Amendment) Act 2011 to inspect children's special care services provided by the Child and Family Agency (Tusla). Inspectors monitor special care units against the National Standards for Children's Special Care Units and reports on its findings to the Minister for Children and Youth Affairs.

The report published today refers to a two-day unannounced inspection of Ballydowd in September 2017. Improvements had been made in some areas since the last inspection however, inspectors identified significant areas requiring improvement to ensure the service provided is delivered in line with the needs of the service.   

A comprehensive care planning process ensured that children’s needs were assessed using a multi-disciplinary approach, and were met in a timely manner. Children’s health and educational needs were met while living in the unit and staff provided child-centred care to children. The rights of children were protected and children had access to advocacy services if required. The system in place for managing complaints was effective, and there were safeguarding measures in place to protect children from abuse. Children told inspectors that they had good relationships with staff, particularly their key workers.

The management and governance systems ensured the day-to-day delivery of a good quality of care to children who are appropriately placed. However, there was a lack of strategic and operational planning to ensure a child-centred, effective and safe service was delivered in line with the needs of the service. 

Inspectors found that while the layout of Ballydowd facilitated secure care, the units were not homely, child-centred or sufficiently stimulating for the children living there. Refurbishment work had been completed in one unit since the last inspection; however, there was a missed opportunity to redesign the interior of the building to create a more child-centred secure care setting.  

Inspectors also found that not all children were appropriately placed in the service in line with their assessed needs. One child was inappropriately placed in a unit that did not have capacity to meet their needs for five months, until an alternative placement was found.

Since the last inspection, a large number of staff had been on sick leave due to injuries sustained at work. As a result of the high number of injuries, the special care unit had been subject to an inspection by the Health and Safety Authority. The report outlined a number of areas the units needed to follow up and management produced an action plan to address the deficits identified.

Staff had been trained in a specific model for managing behaviour that challenges and where children had been subjected to a restrictive practice, it was only used as a last resort following a risk assessment. 

The service has prepared an action plan to address the non-compliances identified on inspection.