NEW REPORTS FROM the Health Information and Quality Authority give an insight into foster care and children’s residential services in Ireland.
Overall, HIQA said it found evidence of dedicated and committed staff, who were appropriately qualified – but it noted there were considerable challenges for services, and that improvements were still required.
Management and staffing
While suitably qualified managers were in place, and sufficient staff, deficits were identified in the frequency of staff supervision.
There was evidence that managers did not identify and manage all risks and some essential training had not been provided or undertaken.
The monitoring standard was met in 72.7 per cent of centres. However, the HSE failed to meet this standard for over 18 per cent of the centres inspected by HIQA.
Inspectors found that this was because the HSE did not have sufficient monitoring officers in place in all areas, due to staff vacancies and the recruitment moratorium.
As a result, monitoring officers were not providing external scrutiny of significant events, notifications and use of restraint as well as reviewing general compliance with regulations.
In the majority of cases, there was evidence that children were consulted about the day-to-day running of the centres and had access to information about themselves.
Overall, complaints were well managed, but in some instances staff were not always clear about the difference between formal and informal complaints, and not all complaints were recorded. There was a risk that such complaints might not be taken seriously or dealt with effectively.
Contact with families
Children maintained good quality contact with their families in 94 per cent of inspections, and in general children were supervised and visited by social workers.
But the standard on aftercare was only met in 33 per cent of inspections and there were also deficits in preparation for leaving care. “Considering the vulnerability of young people who are leaving the residential care system, this is an area of concern,” said the report.
The authority was also concerned about the fact that during 2012, there were some difficulties identified in accessing specialist psychological and mental health supports for children This standard was collectively not met or met in part in nearly half of the inspections.
Children’s needs in terms of food and nutrition were met, and there was evidence that children’s race, culture, religion and gender were respected and that consideration was given to the needs of children with disabilities.
The standard in relation to the use of restraint was met in 82 per cent of cases, which HIQA said was “particularly encouraging” as the inappropriate use of physical restraint can pose a threat to children’s rights and safety.
But inspectors said staff were challenged in responding to and managing some children’s behaviour.
In some centres, children and young people engaged in significant risk-taking behaviour but not all had risk assessments or crisis intervention plans in place.
This may be associated with gaps in specialist supports for the children and compounded by deficits in the training, support and supervision of staff.
It was of concern that this standard was met in only 24 per cent of inspections during 2012, and that otherwise it was met in part.
The deficits in this area related to the incorrect classification of incidents as ‘significant events’ rather than as child protection concerns. There was a risk that allegations or concerns about possible abuse might not receive the appropriate response.
One report noted that a child protection concern had not been reported by staff members to the relevant social worker.
However, children told inspectors that they felt safe and knew who to talk to if they had a concern.
This standard was met in full in only 55 per cent of inspections, but reflected an “upward trajectory” in terms of children’s attendance and achievements in school due to the support and encouragement of staff.
There were four centres where children were not attending school and had not been doing so for significant periods of time.
In 67 per cent of inspections during 2012, it was noted that children’s health needs were being met in line with the standard and they all had access to general practitioners (GPs).
The main issue related to the lack of continuity in the historical healthcare records for the children, particularly immunisation records.
The HSE had not always been successful in recruiting foster carers from a range of backgrounds to meet the needs of children from different nationalities, ethnicities and religions.
Foster carers “were respectful and sensitive to children’s needs in this regard”.
However, international best practice would indicate that children should be placed with foster carers from their own cultural backgrounds and community wherever possible.
Children were encouraged to keep family mementos and family members were involved in significant events such as birthdays.