There were 278 incidents in which a child in care was injured last year, led by 172 cases in which the young person harmed themselves, while there was also one incident of child abuse at a residential centre.
The data, released by the Child and Family Agency under Freedom of Information, also shows that one child in foster care was recorded as wrongful exposure to a traumatic event – in that case, the child witnessing a domestic violence incident. The figures also show two cases of Covid-19 in residential care and 12 cases of the virus in foster care settings.
The cases are recorded on Tusla's National Management Incidents System (Nims) and show an increase in comparison to figures recorded in 2019.
The incidents are categorised according to the care settings, be it residential or foster care, and whether the injury or illness sustained required first aid, or was more serious and needed medical treatment.
In residential care, there were 137 incidents involving children where first aid was required, including the case of child abuse. The main cause of injury was "self-injurious behaviour", with 109 cases, while there were 11 incidents recorded under violence, harassment and aggression.
The remaining handful of cases were spread between slips, trips and falls, "bacteria" and "organism unknown", among others, while one case of Covid-19 requiring first aid was recorded.
Another case of Covid-19 in residential care was more serious and required medical treatment. A recently published Hiqa report on its monitoring of children's services in 2020 stated that "one special care unit experienced an outbreak of Covid-19. The unit responded well to this outbreak and this ensured there were no interruptions to service delivery, and the spread of the virus was curtailed."
As for other more serious incidents in residential care, there were 89 in total, including 56 where a child hurt themselves, with 11 incidents of slips, trips and falls and six involving violence, harassment and aggression. Other incidents included one crash, one 'organism unknown' and one incident involving chemical products.
There were fewer incidents in foster care – seven recorded cases needed first aid, including five cases of the virus, while there were 45 that needed further medical attention, including seven cases of Covid-19.
Medical attention was also required in the case where a child in foster care witnessed an incident of domestic violence, while there were 22 incidents involving slips, trips and falls, seven where a child harmed themselves, one crash and three involving violence and aggression.
The release also includes details regarding injuries to staff at residential facilities, while Tusla's recently-published annual report also carried the larger number of notifications made on Nims regarding staff.
According to the FOI data, there were 63 incidents where staff members sustained an ‘injury or illness’ requiring first aid, 57 of which involved violence, harassment and aggression, and 44 more serious incidents requiring medical treatment, led by 31 violent and aggressive episodes.
Incidents involving foster carers are not recorded on the National Incident Management System as they are not employees of Tusla.
Tusla said young people in care have often experienced significant trauma and this can sometimes lead to "unregulated behaviours", which can result in violence and aggression, self-harm and, in some cases, suicidal ideation.
It said those working in residential settings and foster carers receive training to deal with these incidents and each child has the support of a social worker. In secure settings, care staff are supported by the agency's assessment consultation and therapy service (Acts), and the centres are staffed on a 24-hour basis.
It also said Tusla's children's residential care services have now implemented the Welltree model of care, first introduced in 2018.