HIQA casts doubt on future of Cork care unit

A teenager who absconded from a special care unit (SCU) in Cork for three weeks was at “huge risk” upon her return but was inexplicably placed in isolation for long periods, a HIQA report into a high-security unit for girls in Cork has found.

Following HIQA’s most damning report ever written about a service, published late last year, a follow-up inspection of the centre for troubled teens took place last month.

And while inspectors found improvements at Gleann Álainn, outside Cork city on the grounds of a psychiatric hospital in Glanmire, the report called into question the long-term future of the service.

The report found:

* There were seven unauthorised absences from the SCU since the last inspection in October 2011.

* Single separation had been used on 13 occasions in relation to five children since that time.

* One child was singly separated for a period of eight days and on another occasion for 23 days.

* There was no record of how this single separation was authorised and if it was reviewed in accordance with departmental guidelines on single separation.

* Children said there were occasions where they felt unsafe and this related to incidents of alleged bullying, targeting and assaults by other residents.

The crisis-hit centre came in for a range of criticisms, with the report stating that “several external professionals” told inspectors that while they acknowledged progress, their confidence in the service to be sustainable and improve was poor.

“There was an increase in accountability and responsibility by managers and staff,” HIQA said. “However, considering the significant concerns in relation to safety, security and management highlighted in the last report, the ability to sustain this progress is paramount, as the unit has a significant amount of work ahead to ensure that it provides a safe service which is underpinned by a strong, resilient management and staff team.”

Also of “serious concern” was a pattern of crisis within the special care system, which had knock-on effects resulting in the “erosion of all systems at every level” within Gleann Álainn.

However, inspectors were satisfied there had been progress in respect of each of the recommendations made in the last inspection report.

It was noted that:

* Staff team’s confidence in their classification of child protection concerns had improved.

* Recording and reporting of significant events had also improved.

* The children had access to a dedicated unit psychologist.

* Children had a clearer understanding about their right to access information and the re-structuring of care files had made them more accessible to children.

Frances Fitzgerald, junior minister for children, welcomed improvements at the centre but “noted that some of the HIQA recommendations have only been partially met”.

According to a statement from her office, she has “noted the report’s comment that sustaining high standards in this complex area is challenging for the HSE and requires a sustained input across the national service”.

The report described how a reduction in capacity from seven to five girls had provided more private space within the unit for the children. However, the report noted that six full-time HSE staff are on long-term sick leave and are being replaced by long-term agency staff on a full-time basis.

HIQA said it would carry out another follow-up inspection in three months.

Fianna Fáil has called for a “comprehensive plan” to overhaul the special care system.