Under-staffing stops children getting key help

The independent chairwoman of the HSE’s child deaths in care review has warned below-requirement social worker levels are preventing vulnerable people from accessing potentially life-saving help.

Trinity College associate professor in social work and social policy Helen Buckley said ongoing under-staffing of the vital service must be addressed if the concerns are to be resolved.

Speaking to reporters after the publication of the latest HSE National Review Panel reports, Dr Buckley said low staffing levels outlined in the documents “would have affected early intervention” in ultimately tragic cases.

She said operating such a vital system when in some situations just 70% of positions are filled is a “risky” business.

She said she was not aware of any “high-risk” case that was missed for this reason. However, she stressed the bigger concern is that fewer serious incidents that require early intervention are being put on waiting lists because of the staffing problems — a situation which can cause high-risk issues to develop.

Citing a number of case files published yesterday, two of which are detailed below, Dr Buckley said some children and teens have been failed by the system and “it is clear action should have been taken earlier”.

The stance was mirrored by Paul Harrison, head of policy and strategy at the HSE’s children and family services, who said that while progress is being made, “significant learning” must still be taken from the latest reviews.

He accepted “there are difficulties in keeping the [social worker] staff complement”, and that the wider system can be “slow enough in terms of replacing” people who have left.

He said there is “no doubt there is a pressure on services”, but insisted the issue was not “a simple equation”, noting that if the number of social workers increased overnight, the number of people in need of help would mean referrals to the service would rise just as quickly.

Among the most worrying concerns raised in the HSE review documents are issues relating to the vetting of families helping children in care, check-ups, social worker staff levels, and management of case files — all of which relate to staffing cuts.

The 2012 annual document said that “in one third of the published [individual case] reports, the social work departments were challenged in their capacity to deal with the pressure of work being referred to them”.

It added that “the lack of guidance on... assessment was identified in over half of the published [case file] reports and this had an observable effect on later actions taken”.

“A combination of these factors appeared to delay allocation to social workers in 50% of the cases.”

It also warned the ability of social work departments “to manage the rate of referral was significantly compromised”, with the “knock-on effect” that cases could not be allocated within clearly stated time frames.

The issue, it said, meant some cases were “never really conducted with the required thoroughness”, risking potentially tragic outcomes for the vulnerable children and teens involved.

Since the HSE’s National Review Panel of child deaths in care was established at the request of the Health Information Quality Authority in Jan 2010, the deaths of 71 children and teens known to HSE services have been recorded.

A previous report into the matter, which led to the creation of the review team, found almost 200 children and teens lost their lives between 2000 and 2010.

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