Big failings in care units for children

SIGNIFICANT failings in the management and staffing of special care units are compromising the state’s capacity to meet the needs of the vulnerable children they house, a report has found.

Inspectors from the Health Information and Quality Authority (HIQA) described one of the units, Coovagh House in Limerick, as being “in crisis,” noting “grave concerns regarding safety of children and staff”.

Coovagh House was one of three special care units assessed as part of HIQA’s National Overview Report of Special Care Services provided by the HSE. The other two units are Ballydowd in HSE Dublin North East and Gleann Álainn in the HSE South.

All three house children detained on foot of court orders for their own safety or the safety of others. The report by the independent health watchdog found:

* 20 out of 109 staff in the units were unqualified.

* Staff levels were compromised by a high level of sick leave and a recruitment embargo.

* On occasions, permanent staff were outnumbered by agency staff, contributing, inspectors said, to “a lack of cohesive practices and consistency in the units”.

* There was little evidence of an effective ongoing staff development and training programme, as required by the National Standards for Special Care.

* Professional supervision for staff had lapsed significantly.

Inspectors warned that the “HSE strategy of using agency staff to provide appropriate levels of care staff in special care units must consider the impact and implications of ongoing changing personnel on this group of vulnerable children”.

In particular, inspectors found Coovagh House was in crisis. At no time since it opened in 2003 has it catered for its full complement of five children. At time of inspection, it housed just two boys.

HIQA found that there had been significant property damage to both Coovagh House and Ballydowd.

The HSE had given a commitment to close Ballydowd in November 2009 after HIQA declared it unfit for purpose, but it remains open. In its report HIQA said its inspectors were told there had been a 50%increase in the national demand for special care placements in 2010 and it was not possible to close Ballydowd, keeping it, and a second unit, the Solas Unit, open pending a new national model of special care and high-support provision.

However, the new national model has not yet materialised and while Coovagh House and Ballydowd are now managed nationally, Gleann Álainn in the HSE South is managed locally.

The HSE said it welcomed the HIQA reports pointing out that of the total of 56 recommendations only two had not yet been addressed, 29 were met in full and 25 were met in part.