Deaths in care linked to high referral rates and staff shortages

A report into the deaths of children either in care or known to the care services has referred to social work departments being under serious pressure with high referral rates and experiencing staff shortages that “inevitably impacted on their ability to provide a good quality service”.

The 2017 annual report by the National Review Panel (NRP), chaired by Helen Buckley, refers to 22 deaths of children and young people in care or known to the child protection system — four fewer than in the previous year. Eight of those deaths were as a result of natural causes and three others from suicide.

According to the report: “Two common factors prevailed in a substantial number of cases; inadequate assessment and categorisation of cases as ‘child welfare’ when there were, in the opinion of the reviewers, fairly evident risk factors. In some cases, it was considered that the impact of parental drug use and domestic violence and sometimes a combination of both was not fully evaluated. Information was not always collated or shared between key stakeholders.

“It was notable that some social work departments were under serious pressure with high referral rates and staff shortages that inevitably impacted on their ability to provide a good quality service. This was visible where aspects of casework ‘drifted’ and particularly impacted where transfer of responsibility for cases between areas was required.”

However, the report also highlighted evidence of very good practice, even as it referred to “practice and policy challenges” for Tusla, such as the need to improve assessment practice, particularly in relation to investigation of physical abuse but also in relation to the impact of domestic violence and substance abuse.

It also referred to communication difficulties between social work departments and the HSE public health nursing service, and said: “The practice of categorising cases as child protection and child welfare belies the very permeable boundaries between situations of risk and situations of need and has implications for the way a case is processed.”

Dr Buckley said: “All of these matters pose challenges for Tusla social work services which cannot resolve family difficulties in isolation and need to bring awareness of the wide range of children’s needs to their assessments.”

In addition, five new reports relating to deaths were published by the NRP, including one in which a boy was stillborn in circumstances where his mother, who had been using cocaine, was resistant to social work and service intervention. In another case of a young man who died by suicide aged 19, the NRP found shortcomings at social work and child and adolescent mental service level.

Brian Lee, director of quality assurance in Tusla, said the agency is continuously working to improve services.

tusla.ie/national-review-panel