HIQA finds teen care centre ‘in crisis’
The young people at the centre on a day in October included:
* A 16-year-old girl from the HSE West area who was there for 11-and-a-half months. She had previously been in two residential care homes and six foster placements.
* A 17-year-old who had been there for 10 months from the HSE South area and had previously been in two residential care centres.
* A 16-year-old from HSE Dublin North East who had been there for eight months and previously had been in three residential care homes, a foster care home and a special care unit (SCU).
In October, a week after being told two young people had run away after one got her hands on a set of keys, inspectors paid a visit.
A thorough investigation found the centre was simply not functioning adequately — and indeed was found to be in crisis and in breach of the most serious rules and regulations.
The unit was staffed by 22 full-time permanent childcare leaders and one part-time temporary childcare leader. It also had 14 agency staff that provided cover for staff leave or illness. Unit records showed many staff were not suitably qualified and Garda checks were not in evidence for some agency staff.
Some agency staff had not received induction training and some had not received training in Children First guidelines.
Inspectors found that the frequent and inconsistent use of agency staff did not provide a stable environment for the children, and this was confirmed by children interviewed during the inspection. It was also found that this did not provide a consistent and satisfactory quality of practice from shift to shift. This was confirmed through interviews with unit staff and external professionals working with the children.
Key management staff were not in place and on the day of inspection, the unit was being run by an acting manager, who wanted to step down from the role, and who was supported by two “acting” deputy managers.
Inspectors stated that the impact of the “lack of effective local management” on the delivery of care to the children and on staff practices was “considerable”.
They were told that the HSE intended to fill the acting posts on a permanent basis early in 2012.
Inspections found a litany of failures and breaches of care practice including:
* Practices were of a poor standard and institutionally driven, such as locking the children in their different bedroom sections by 7.30pm. This practice was unknown to all of the children’s families and the professionals working with them.
* The staff team were not confident, correct or proficient in their classification of child protection concerns.
* Reporting of significant events was not always prompt, or in accordance with national standards, HSE policy and special notification arrangements for individual children.
* Extreme challenging behaviour by some children was not dealt with appropriately by the staff.
* There was unnecessary and excessive reliance on the gardaí to manage children’s behaviour.
* Children were not routinely consulted and had little influence on daily routines and practices.
* Unit records were not accessible to children because staff lacked a clear understanding about the child’s right to access information.
* The space available within the unit did not provide the children with sufficient assured privacy.
The children who were interviewed by inspectors said that although they did not want to be there, they understood why they were there and thought it would be of value to them and to their futures. They also told inspectors, that they had built good relationships with some of the staff team.
They said that they did not always feel consulted by the staff or listened to when they raised issues they felt were important. They confirmed that they had access to a female doctor when they needed it, liked the food they were given, could get snacks when they wanted them, had enough pocket money, and adequate clothes and toiletries.
However, they said they did not always feel safe in the SCU, and mentioned particularly bullying and assaults by other residents.
The report states that this is unacceptable.
“All children in care, irrespective of the setting, have a right to feel safe and have their welfare and development promoted. Bullying should be reported as a child protection concern, and staff should be aware of its impact and equipped to deal with it.
“It has a potent impact in enclosed environments, where children are in close proximity to each other 24 hours a day.”
The unit staff did not adequately record sanctions applied or consequences for children who displayed unacceptable behaviour, as required by the national standards.
They did not refer serious instances of bullying as child protection concerns or adequately record how bullying was dealt with by the staff team.
The children interviewed told inspectors they had experienced incidents where the staff were not in control in certain situations. Unit records did not provide evidence of managers monitoring staff practices in relation to the management of behaviour.
The consequence for the children of these findings was they did not receive a consistently good standard of effective, safe care.
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