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Reports: Good quality foster care, but some unapproved carers

HIQA said it was concerned about the lack of urgency given to some investigations by the HSE of allegations made against foster carers.

NEWLY-RELEASED CHILDREN’S inspections show that though the quality of foster care is high, some children have been living with unapproved carers.

The report from the Health Information and Quality Authority (HIQA) is its first overview report of inspections of foster and children’s residential services in Ireland.

It reviewed the reports of 33 full inspections that it carried out in 2012 of children’s residential centres run by the Health Service Executive (HSE) for vulnerable children, mostly aged between 12 and 18 years, as well as HIQA inspection reports of eight HSE foster care services in the same period.

The Children’s Rights Alliance has urged immediate action on the findings, saying that children in the care system “are among the most vulnerable children in the State, and many have past experiences of abuse and neglect”.

High quality social work

Phelim Quinn, Director of Regulation with HIQA, said that in foster care services, inspectors found examples of high quality social work practice which supported the safety of children and improved their lives.

He said that healthcare provided to children and their attendance at school improved, while children’s choices were considered and their dignity and privacy were respected.

However, he noted that “these improvements in their lives were dependent upon the quality of foster carers who were not always adequately supported or monitored”.

HIQA found that children did not always have written information on their rights or on the complaints process, and were dependent on individual social workers for this.

HIQA found that in 2012:

  • Not all children in foster care had a social worker
  • ƒNot all foster carers had a link social worker (link social workers support carers in caring for children)
  • Assessments were not carried out in a timely manner.

It also “noted with concern” the lack of urgency given to some investigations by the HSE of allegations made against foster carers.

The report states that some children “continued to live in households where the carers had not been approved as foster carers, even where
allegations had been upheld against adults in the home”.

In a number of the areas inspected, there were also insufficient numbers of foster carers. Staff shortages impacted on the HSE’s capacity to deliver a safe high quality fostering service in some areas, said HIQA.

Quinn said that in some instances, foster carers were offered very little training in dealing with vulnerable children with extremely challenging behaviour.

Although recruiting more foster carers will mitigate threats to the stability of foster care placements, ongoing needs assessment of children and young people who are at risk of coming into care should inform any recruitment process.

In the majority of cases, services for children in the 33 residential centres inspected by the Authority in 2012 were safe.

Improvements

While HIQA found evidence of “dedicated and committed staff”, its inspectors noted that many improvements in the service were still required. The system was found to be under significant pressure and in some instances these pressures were placing children at risk.

Not all staff had up-to-date Garda Síochána vetting, staff had difficulty with responding to some children’s behaviour, while the relevant requirement on children being absent from the centre without permission was met in only 61 per cent of inspection reports.

According to Quinn, a proactive national strategy is now required by the HSE National Office for Children and Family Services to meet the needs of children and young people.

HSE response

The HSE welcomed the report, saying its Children and Family Services are implementing a major programme of reform and development in preparation for the establishment of the Child and Family Agency.

The HSE is pleased to see that the changes that are being put in place to improve services are being reflected in the findings of HIQA inspections and that the overall quality of services is good.

It said that it is working closely with HIQA to learn from the inspection process and to ensure the highest possible quality of care services.

The problems identified in the report “are being addressed”, while a national protocol has been developed for all children’s residential centres and independent risk assessments have been carried out by independent fire safety specialists, said the HSE.

Some centres have closed and necessary works are being carried out in other centres to ensure compliance with national standards, while fire safety training is being provided by HSE Fire Prevention Officers.

Regarding the difficulties being faced in dealing with children with challenging behavior, the HSE has put in place a major new national specialised clinical service to provide multidisciplinary consultation, assessment and focused interventions to young people who have high risk behaviors associated with complex clinical needs.

On the shortages in availability of foster carers, the HSE launched a national fostering awareness campaign ‘Change a life, Become a Foster Carer’.

Gordon Jeyes, HSE National Director, said the report provides a benchmark for the HSE “as we compare our own understanding of our services with HIQA validation”.

“The picture is an improving one,” said Jeyes.

Read: Mental health needs of vulnerable children in Ireland ‘not being met’>

Read: Child care court reports show drug abuse, violence and mental illness>

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