The Health Information and Quality Authority (HIQA) has published an overview report of the inspection and regulation of children’s services in 2020.

HIQA found that while there were noticeable improvements across children’s services, the quality of key systems such as risk management, monitoring and quality assurance requires improvement. Staff shortages in some areas impacted on the timely provision of services to children.

HIQA’s Head of Children’s Services, Eva Boyle said: “2020 was an exceptional year due to COVID-19. Services endeavoured to facilitate children’s visits, and visiting arrangements were put in place in line with public health guidance, whenever possible. Our inspections found that governance and management improved in many of the services we inspected. Notwithstanding these improvements, variations remained in the quality of services provided to children, and there are opportunities to improve inconsistencies in the quality of services provided.”

Children who received centre-based care, including in children’s residential centres, secure care and in a detention school, received good quality and well-planned care. Through our ongoing monitoring of these services and engagement, providers successfully brought about effective changes which improved the quality and safety of care that was being provided.

Risk-based inspections of child protection and welfare services found that incremental improvements were made by services. However, further progress was required in improving the timeliness of children’s access to services including the completion of assessment of children. There were also shortcomings in the management of risk, monitoring and oversight of waiting lists, including retrospective allegations of abuse and in the quality of safety planning for some children.

Ms Boyle continued: “It has been a long-standing finding of our regulatory activity that high levels of risk are more prevalent in poorly governed and managed services.  Services that had effective governance and management structures in place were found to have had higher levels of compliance with the national standards than those services that had weaker governance arrangements”.

HIQA completed a programme of foster care inspections, which evaluated service’s arrangements to effectively manage the needs of children in foster care. This involved ensuring that children were being appropriately assigned to foster carers and assessing the systems in place to adequately prepare children who are leaving care.

Ms Boyle concluded: “HIQA is committed to the ongoing quality improvement of children’s services, and a range of quality improvement initiatives continued in 2020. For example, we continued our thematic child protection and welfare inspection programme which found that service areas had made noticeable improvements in the management of child protection and welfare referrals”.  

Listening to children’s voices during inspections is crucial in how we determine service performance. In 2020, HIQA continued to seek the views of children, both during inspections and outside of the inspection process. The majority of children who met with HIQA inspectors spoke positively about the service that they received, were aware of their rights and felt well cared for.

Ends.

Further information:
Marty Whelan, Head of Communications & Stakeholder Engagement
085 8055202, mwhelan@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.
• During 2020, HIQA conducted 44 inspections of children’s services including:
  • five inspections of special care units
  • 20 inspections of statutory residential services
  • six inspections of statutory foster care
  • one inspection of private foster care
  • one inspection of Oberstown Children Detention Campus
  • two risk-based inspection of a Tusla service area
  • and nine inspections of child protection and welfare services.
• On 1 January 2018, special care units became designated centres under the Health Act 2007 (as amended), requiring HIQA to determine if they were fit for registration by year end.
• A separate report will be published later this year with more detailed findings from inspections of foster care services from 2020-2021 in all 17 Tusla service areas.
• The overall findings from seven thematic child protection and welfare inspections are outlined in this report, with a separate more detailed report being published in due course on this particular 2019–2021 programme.