Hiqa finds failure to act for at-risk children

Serious risks to children remained at a Tusla Midlands service a year after it was excoriated for not knowing if it had acted on 900 cases of at-risk children notified to it by gardaí.

The ongoing risks were identified in January and March this year by inspectors from the Health Information and Quality Authority (Hiqa) and included:

  • Failure to allocate a social worker to a number of high priority cases, including adult retrospective cases which were known to the department for a number of years;
  • One duty team was run predominantly by agency staff with less than two years experience and no direct line manager;
  • Just one of 27 standards assessed was met;
  • One in five of 53 cases sampled was escalated by Hiqa for review due to lack of timely or appropriate action by Tusla.

Hiqa had been due to carry out the inspection in April 2015 but deferred it until January this year after Tusla reported 932 notifications of suspected abuse or welfare concerns made to the Laois/Offaly area during 2007-2013 by gardaí where it was not known if the welfare of the children had been assessed by social workers. Most of these cases have since been dealt with.

Data given to Hiqa showed 1,100 out of 4,439 referrals received in the 12 months prior to inspection were not screened within the service’s own timeframes. Screening involves the social worker establishing if the referral is appropriate to the service. Of 2,997 referrals which required an initial assessment, less than half (41%) were completed in the 12 months prior to inspection.

Further data showed that in the three months prior to the January inspection there were 435 cases awaiting allocation to a social worker.

On a positive note, Hiqa found that overall, once children were allocated to social workers, the majority got an adequate, and, if at serious risk, timely service.

“However, there were children and adults of concern that were awaiting the allocation of a social worker, mainly at the duty intake stage of the service. This meant some risks to children could not be identified and assessed for long periods of time and this potentially placed them at risk,” inspectors said.

They also found that there was no consistent system in place to review, manage, and implement the findings of serious incident reviews. Five children had died who had varying levels of involvement with the service in the previous 24 months but some staff were unaware of child deaths or their review. Inspectors also identified “unmanageable caseloads” with some social workers dealing with an excess of 60 cases, while others dealt with 20.

Inspectors found significant delays assessing risks in relation to retrospective abuse. An internal audit in November 2015 had identified three retrospective cases as requiring the immediate intervention of a social worker, but this had not occurred by January 2016. The area inspected covered the counties of Laois, Offaly, Longford, and Westmeath.

In a comprehensive response to the report’s findings, Tusla said yesterday that “significant progress has been made throughout the child protection and welfare services over the last 12 months” while conceding there was still room for improvement.

Jim Gibson, chief operations officer, said a range of measures have been implemented, “including strengthening the management structure, allocating additional staff to reduce backlogs and activating a robust action plan to address key areas for improvement”.

Specific improvements include a new tracking system for Garda notifications and acknowledgements and the setting up of a governance group for adult retrospective abuse.


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