HSA review into special care unit prompted by staff injuries

A new inspection report into one of the country’s main children’s special care units has outlined how the Health and Safety Authority had to conduct a review due to the high number of staff injured while at work.

The report by the Health Information and Quality Authority (Hiqa) paints a generally favourable picture of the Ballydowd special care unit in Lucan, Co Dublin, which at the time of the inspection was home to six young people aged between 11 and 17 years detained there under High Court care orders.

While it was fully or substantially compliant in half of the 30 standards assessed, and only majorly non-compliant in three areas, the report highlights some deficits.

One child with significant needs that could not be met while living in the unit was placed there in a single-occupancy arrangement, as there were no appropriate alternative placements within Ireland. There was a delay in finding the appropriate follow-on placement and “issues with this placement escalated following a Tusla directive to place another child alongside this child, despite recommendations to the contrary from all professionals involved with the child”.

The second placement subsequently did not occur, but “the planning for it caused the child in the unit to experience significant distress”, and the first child remained in a secure care setting for approximately five months during which her needs could not be met.

Twelve staff members had left the service since the previous inspection, with 13 newly recruited, a staff turnover rate of 26%.

“The number of staff who were on extended leave was 12 and the number of staff who were on sick leave due to injuries sustained at work since the last inspection was 16,” states the report.

The “significant” level of assaults prompted an inspection from the Health and Safety Authority. Hiqa said: “Supports were in place for staff following incidents, however they were not sufficient.”

The report also states that gardaí were called to the unit to support the management of behaviour on 15 occasions. Some issues involving record keeping, fire safety, and staff supervision were also noted.

An action plan was issued and Tusla said it was improving the services and standards at the two units covered by the report, including developing a “more homely environment”.


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