Hiqa: Kids in care unit put selves at risk

One of the country’s three special care units for children has been found to have a range of deficiencies and inadequate resourcing of its management structure, with Hiqa finding not all children living there were safe.

The inspection of Coovagh House by the watchdog found six instances of major non-compliance with standards and 15 of moderate non-compliance, with the Health Information and Quality Authority expressing concerns about teenagers absconding and placing themselves in danger.

A Hiqa inspection of another unit, Glenn Alainn, also found some shortcomings and Tusla said it would decide whether Gleann Alainn would continue to operate as a special care facility by the end of the year.

Coovagh House has capacity for four children aged between 11 and 17 and was previously criticised by Hiqa.

According to Hiqa: “Not all children were safe as some children continued to put themselves at risk in the community.”

The report said: “There were 35 incidents of children ‘missing from care’ since the last inspection in August 2016.

"Inspectors reviewed a sample of Significant Event Notifications in relation to these incidents and found that during these incidents, children had placed themselves at significant risk and therefore the staff team were unable to ensure their safety.

“The social work department, who were managing the children’s care plan acknowledged that some children continued to place themselves at risk despite significant intervention by Tusla, which had not been effective over the long term.”

Oversight of complaints was poor, with 21 made in the previous year but no indication as to whether they had been resolved. A separate log maintained by Tusla showed 22 complaints, with 13 still open.

It found the living environment was not fit for purpose and had not improved significantly since a 2016 inspection highlighted deficiencies.

A door to a child’s room removed in February had not been replaced by the time of this unannounced inspection in July. Hiqa also found the building was not in full compliance with fire safety legislation and staff had inadequate fire safety training.

It said management arrangements had not been adequately resourced and the unit had been operating without a dedicated unit manager and support management team for a significant period of time.

The report also said: “The significant care practice deficits identified by the unit manager included needlessly locking doors throughout the children’s unit and using the CCTV as a method of supervising children, in lieu of directly engaging with children. This was a significant failing identified during the incident under review.”

Data also showed 14 incidents of physical intervention, nine cases of single separation, and 40 incidents of structured time away.

There were examples of good practice and improvements in some areas but Hiqa issued an action plan regarding the issues raised in the report, but another shortcoming included some cases where there was not a timely referral to mental health services.

Tusla said it had addressed many of the issues raised regarding both units since the inspections, including staff appointments and undertaking a review of mental health services in the units and upgrading decor and facilities.