Families must be vigilant about loved ones in care systems

It is naive to assume that vulnerable people, whether children or adult, won’t be abused or neglected just because you are paying for a service, says John Byrne

IN any care profession, there is a moral responsibility to protect vulnerable people.

There are five levels:

• The first is the staff’s responsibility to constantly evaluate themselves against best practice;
• The second is peer evaluation, whereby colleagues are aware of each other’s practice. This creates a culture of open and honest reflection and feedback (for better and worse);
• The third is managerial responsibility to oversee the practice of all staff
• The fourth is external regulation by monitoring agencies;
• And the last line of defence is the family of the service user, and/or the general public.

It does not matter whether we talk about residential child care, custodial care, nursing homes, disability services, schools, or creches. If we do not develop a robust system that pays attention to all five levels of client protection, we increase the likelihood of abuse or maltreatment of vulnerable people.

This week, RTÉ’s Prime Time programme raised a number of issues about the care and protection of children in a Dublin creche. These included garda vetting, food quality, staff ratios, registration of services, falsification of daily records, fire safety, and lack of basic care and compassion.

The programme showed how a staff member did not seem aware of her lack of basic care and compassion for the children. While the undercover reporter did try to reflect her observations to the staff member, they clearly were not heard.

The manager’s regulatory function was absent, because the manager was causing the problem. The external regulator, Tusla, did not identify the issues of concern during regulatory inspection and the parents using the creche did not adequately monitor/evaluate the care experience of their children.

If they had, they would have realised that the sleep room was overcrowded/cluttered and the food was of poor standard, etc.

Some people reading this may say that when you pay a fee to a professional service, you should not have to monitor that service yourself. In an ideal world, that would be true, but, unfortunately, experience has taught us that, wherever there are vulnerable people, there will always be someone willing to exploit them.

Assuming that will never happen, or that the ‘system’ can always keep everybody safe, is, at best, naive, and, at worst, fertile ground for abuse and/or exploitation.

While garda vetting has a place, all it does is highlight prior staff convictions on the island of Ireland. It is only the first step in a child-protection policy and it made no difference whatsoever to the quality of care provided by the service manager in this case.

It was stated that the creche has managed to operate one of its services for 14 months without a licence, and some analysts have questioned how that could happen.

Apart from Tusla’s obvious failing in that regard, people left their children in the creche without checking whether it was a registered service. If there were no customers at all, there would be no creche.

The falsification of records related to daily activity should never happen, but the relevance or requirement for these records should be questioned.

Many child-care staff have told me that they require the children to sleep at set times, so that they can catch up on paper work and daily reports, despite the fact that the majority of parents have little or no interest in the precise details of the child’s daily activity, provided the child is safe and well, and has had a good day.

The regulatory function of Tusla is also worthy of discussion, as is the privatisation of child care. The easiest thing is for a service provider to do the right thing during a scheduled inspection.

Why don’t inspectors randomly select footage from CCTV to inform their opinion of care standards since the last inspection? Doing so would have dealt with many of the issues highlighted in the RTÉ programme.

On the privatisation of care, I would suggest that the issue is not whether a service is operated for profit; the issue is whether the quality of care is compromised in the name of profit.

There are many excellent care services in the private, voluntary, and state sectors. Unfortunately, there are also very many that leave a lot to be desired.

Monitoring and regulation of services is where the discussion needs to focus, not on whether they are private, voluntary, or state-owned.

In summary, if we are serious about keeping our children safe, the logical thing to do, without being obsessive or paranoid, is never to assume that anybody is beyond question.

We all need to take individual and collective responsibility for the protection of our children and vulnerable adults. That means participating in their lives (by noticing and asking questions about their experience of care services), while holding service providers and regulatory agencies to account (by asking to see registration details and inspection reports).

Obviously, services need to function, and they cannot be inhibited by excessive family involvement, but parents and family members should be aware that Tusla cannot be in all of the services, all of the time. Nor can we reasonably expect that all staff will have the knowledge, confidence, and ability to do the right thing all of the time.

Child protection is a complex and arguably impossible task, but whatever we take from this experience, simply looking for someone to blame is not the answer.

All across Ireland, thousands of children receive excellent care on a daily basis, but there will always be room for improvement, and we all need to take some responsibility in that regard.

John Byrne is a lecturer in social care at the Waterford Institute of Technology. He is also a practising humanistic psychotherapist.