The Health Information and Quality Authority (HIQA) has today published a report on Coovagh House Special Care Unit. HIQA inspects against the Health Act 2007 (Care and Welfare of Children in Special Care Units) Regulations 2017 and the National Standards for Special Care Units, which apply to special care units in Ireland. 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. 

HIQA conducted an unannounced inspection of the special care unit on 19 March 2024 following the receipt of information which indicated escalating risks in the service. These included incidents of physical restraint that were not in line with the Child and Family Agency’s (Tusla’s) approved behaviour management methods and the introduction of close protection personnel (security) within the designated unit. 

The inspection was carried out to determine compliance with eight regulations including: positive behaviour support, protection, governance and management and risk management. Of the eight regulations assessed, the registered provider was found to be substantially compliant with three and not compliant with five.

An individual programme of care was in place for each of the children living in the centre at the time of inspection and records reviewed by inspectors were appropriately detailed, up to date and clearly represented children’s individual needs and circumstances. Children had access to the Assessment Consultation Therapy Service (ACTS), who provided support specific to their individual care needs. Children who spoke with inspectors said they were happy with the care and support being provided in the unit.

There was a clearly defined management structure that identified lines of authority and accountability; however, this management structure was not being operated in line with the regulations, standards or Tusla’s policies. Management systems in place were not adequate and did not ensure the service was safe, consistent and effectively monitored. The management of a number of serious incidents involving the use of close protection personnel were not in line with the designated unit’s interim policy and procedure. Child protection and safeguarding risks were not consistently identified during management reviews of serious incidents and the management response to identified risks did not adequately consider safeguarding issues relating to the use of unapproved behaviour management techniques. 

Due to the identification of significant risks, the service entered an escalation process following the inspection. Assurances were sought to ensure adequate and sustained arrangements were implemented to improve and maintain compliance with the regulations. The registered provider submitted a satisfactory compliance plan to address the deficits and risks identified as part of this inspection.

The report and compliance plan are available at www.hiqa.ie.