Residential care home has 25 staff looking after just one child

Catherine Shanahan

A report on the inspection of the residential care unit in the south-east, carried out in May by the Irish Social Services Inspectorate (ISSI), said: "At the time of inspection, a staff team of 25 (including 15 childcare workers, a teacher, housekeeper and administrator) were providing residential care to one young person who went home for two days at the weekend, and after-care to one other young person." The unit has a capacity for five young people.

"In the meantime, the short-term unit could not open because it was four or five short of a full complement of staff. This is a situation that ought not to be allowed to continue," the report said.

The cost of looking after a single child in high support care is approximately 10,000 a week. Two previous occupants of the unit had been discharged, one in December 2004 and the other in February 2005. There had been no admissions to the unit in the year leading up to the inspection.

The ISSI report said the unit in the south-east "was overstaffed, considering that only one young person was living in it, while the short-term unit could not open because it did not have its full complement of staff." A 13-year-old had resided in the unit for 14 months.

It noted that as part of a regional overhaul of the service, the plan was for the unit to deliver a high support service to children and young people living in the community with a limited, respite residential facility. However, the report said inspectors were concerned at the length of time it was taking to complete this process. It said the service was being run down in anticipation of the change of purpose.

A spokesperson for the Health Service Executive (HSE) South Eastern Area said the sole occupant of the unit has been discharged since the inspection, but 15 staff were still based there. She said they were providing a family support service and will be absorbed into a new extended service, catering for up to 12 children, which the HSE South Eastern Area plans to open in late September. It will have an annual budget of £1.5 million.

The inspection of the unit part of an inspection of all 13 high support units (HSUs) in the country on the theme of management of behaviour was critical of the unit's approach.

"In certain situations, the actions of some members of the care staff team exacerbated rather than calmed volatile situations. This came about through an approach to behaviour management that was unduly rigid and rule-bound and did not take sufficient account of the young people's concerns and difficulties," the report said.

It said the acting manager had recognised this and "considerable efforts had been made to change practices within the staff team, through staff training and the input of a team facilitator."

However, the report warned: "If the unit is to provide a high support residential service in the future there needs to be much greater clarity about the manner in which that service is to be provided.

"There needs to be a coherent model of care, a multi-disciplinary team to implement it, stability in the management of the unit and a commitment from all members of the care staff team to improve the service provided to the young people."