The Health Information and Quality Authority (HIQA) has published an overview report of the thematic inspection of the Child and Family Agency’s (Tusla’s) child protection and welfare services between 2019 to 2021. 

Thematic inspections aim to promote quality improvement in a specific area of a service. These inspections focused on defined points along a pathway in child protection and welfare services provided by Tusla; from the point of initial contact or reporting of a concern to Tusla through to the completion of an initial assessment. Service areas inspected under this programme were areas that demonstrated high levels of compliance with the standards.

The report summarises the key findings of a thematic monitoring programme of child protection and welfare of 12 child protection and welfare services and includes the views of children, young people and their families.

HIQA’s Head of Children’s Services, Eva Boyle, said: “Our programme of inspections found that significant progress was made across all 12 services areas throughout the inspection period, with excellent child-centred and innovative practice initiatives evident during inspections. The service areas inspected embraced the concept of quality improvement and inspections showed that services were focusing on achieving this through implementing quality improvement plans.”

Listening to children’s voices is vital in determining the performance of a service. Overall, children spoke positively about their experience of the social work service they received, and both children and their families expressed satisfaction in relation to their experiences of child protection and welfare services. However, a minority of parents spoken with expressed dissatisfaction with the service they received.

Examples of good practice were evident in all services areas inspected. The majority of service areas had developed service improvement plans, incorporating specific actions to achieve improvements to services. Service planning was used effectively to ensure services were child centred, and good quality service planning was seen in the majority of service areas inspected. All service areas had defined management structures in place with management teams that were committed to improving the quality of service delivery. Communication systems were effectively used in 11 service areas, with good quality and regular communication meaning that service and quality improvements were successfully implemented. However, there were aspects of services that required improvement. 

Improvements were required in the completion and timeliness of notifications of suspected abuse by Tusla to An Garda Síochána. Delays in notifying the Gardaí were found in eight service areas, with delays ranging from four weeks in three service areas and up to 10 months in two service areas. The reasons for these delays were not always recorded or clear from the files of the children in question. 

Ms Boyle continued: “Staff vacancies were a challenge across the majority of service areas and this negatively impacted on service provision, with permanent vacancies in eight out of 12 service areas inspected. Continuity of staffing is important for service areas so as to promote better outcomes for children and families who are in receipt of a child protection and welfare service, and a stable workforce is required to allow services meet the demands placed on them.”

The use of waiting lists in child protection and welfare services indicates that children and families will not receive a timely service. The operation of waiting lists by service areas required greater consistency in oversight to ensure that risks associated with waiting lists did not escalate into a more significant issue, such as children and their families not being assessed or receiving the right service when required.

Ms Boyle concluded: “It is evident that Tusla is striving towards achieving consistency and equity in service provision to children and their families, with service areas focused on achieving quality improvements. However, further work is required to ensure that children and their families availing of a child protection and welfare service can do so in a timely manner and receive the right service at the right time.”
HIQA continues to monitor all 17 child protection and welfare service areas and have commenced an inspection programme focused on children who are on the child protection notification system. 

The full report and infographic is available to download below
Ends.

Further information:
Eimear Smith, Communications Manager
085 8804362, esmith@hiqa.ie  

Notes to Editor:

• HIQA is responsible for regulating and monitoring the quality and safety of adult and children’s health and social care services across Ireland.
• HIQA is authorised by the Minister for Children, Equality, Disability, Integration and Youth under Section 8(1)(c) of the Health Act 2007 to monitor the quality of services provided by the Child and Family Agency (Tusla) to protect children and promote their welfare. 
• In 2018, HIQA published a statutory report, Report of the investigation into the management of allegations of child sexual abuse against adults of concern by the Child and Family Agency (Tusla) upon the direction of the Minister for Children and Youth Affairs (June 2018). This programme of thematic inspection was developed out of a commitment made by HIQA in the statutory report, to work in consultation with Tusla and relevant stakeholders to develop a programme of thematic inspections focused on the improvement of quality in child protection and welfare services. 
• HIQA monitors Tusla’s performance against the National Standards for the Protection and Welfare of Children and advises the Minister and Tusla.
• Tusla is organised into four regions: the West, the South, Dublin Mid Leinster, and Dublin North east. In total, there are 17 service areas nationally.
• Between October 2019 and March 2021, HIQA conducted thematic inspections across 12 of the 17 service areas. The other five service areas were monitored by HIQA in parallel to this programme (Dublin South Central, Dublin South West/Kildare/West Wicklow, Carlow/Kilkenny/South Tipperary, Dublin North and Cork).
• The key activities of thematic inspections involved:
  • the observation of practices
  • the analysis of data submitted by the area and the area’s self-assessment
  • meeting with or telephone conversations with children and their parents and or guardians
  • interviews and meeting with area managers, principal social workers and other managers
  • focus groups with social workers
  • the review of the relevant sections of the files of children in care as they relate to the focus of the inspection
  • the review of documentation including the area’s service improvement plan relating to the management of referrals.
• HIQA has commenced a focused programme of inspection of the management of cases placed on Tusla’s child protection notification system which will continue throughout 2022.