The Health Information and Quality Authority (HIQA) has today published a report on Ballydowd Special Care Unit. Special care units are secure residential units for children aged 11 years to 17 years. Children are placed in a special care unit by a court when their behaviour poses a risk of harm to their life, health, safety, development or welfare, and the placement is needed for the child’s care and protection. 

An unannounced inspection was carried out in October 2022 to assess compliance with the Health Act 2007 (Care and Welfare of Children in Special Care Units) Regulations 2017 and the National Standards for Special Care Units. Of the nine standards inspected, one standard was compliant, two standards were substantially compliant and five standards were non-compliant. While there were governance structures in place to plan, review and monitor the delivery of care provided to children, these required improvement. 



Improvements relating to workforce planning, skill-mix of staff, and the recruitment, training and supervision of staff were required. Following this inspection, the provider was requested to provide assurances in relation to the non-compliance found against Regulation 14: Staff members and others working in the special care unit, which posed risk to the service and satisfactory assurances were received prior to the completion of the final report. 



Overall, this inspection found that the provider promoted a child-centred approach to care which encouraged children’s participation in decisions about their lives and the service being provided to them. Children were consulted with and made decisions regarding the service and supports they received. However, improvement was required to ensure that care practices were consistently promoted, protected the rights of all children and kept them safe.



Inspectors found the use of restrictive practice in the centre was proportionate to the identified risks. 



Safeguarding procedures required strengthening. Although child protection concerns were appropriately reported in line with Children First: National Guidance for the Protection and Welfare of Children (2017), there were some delays in the completion of investigations in relation to staff. This placed a strain on staff resources and delayed opportunities for children to be met, as part of the investigation, in order to complete the necessary enquiries and to ensure due process. 



While the centre had risk management systems in place, these were not always effective in reducing risk in the centre. Managers identified all risks in the service but these risks had persisted over time, such as risks associated with staffing shortages and inexperienced staff.  



The provider submitted a compliance plan to address the non-compliances identified by this inspection. The report and compliance plan are available at the link below.