The Health Information and Quality Authority (HIQA) has today published reports on the three special care units operated by the Child and Family Agency (Tusla). Special care units are secure residential designated centres for children aged 11 to 17 years. Children are placed in a special care unit by a High Court order, 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. 

Inspectors conducted full announced inspections of these three centres in June 2024, to inform a decision on the registered provider’s application to renew the registration of the special care units. Each inspection assessed compliance with 29 regulations. Across the three special care units, inspectors found that children received good quality care and support that was child centred, rights based and responsive to children’s individual needs. There were good oversight and risk management measures in place in all three services to ensure the safety of the children living there. 

At the time of inspection, due to staffing shortages, none of the centres were operating at full capacity in line with their statements of purpose. This was a long-standing issue for these services which had not been addressed despite efforts undertaken by management and the provider to recruit staff. Furthermore, all special care units were required to make improvements to fire safety measures in the centres. 

The registered provider had commenced a review of the national set of policies and procedures in 2023; however, at the time of the inspections, this had not been completed as required by regulations. 

The North Dublin service was found to be compliant with 25 regulations and substantially compliant regarding four, this service was operating at 50% capacity. Inspectors found that the staff and management team were committed to helping children to grow and learn, and strived to achieve the best possible outcomes for them. Children who spoke with inspectors expressed a positive view of the service they received and reported feeling safe living in the centre. Overall, there were good levels of compliance, with improvements required in relation to fire safety.

The West Dublin service was found to be compliant with 23 regulations, substantially compliant with four and not compliant with two. The service was operating at 60% capacity. Children were positive about the care they received and told inspectors that they felt safe and listened to. There was good quality regular supervision for staff. While risk management systems were in the main effective, improvement was required in some areas and these were identified on the risk register. For example, the risk associated with a lack of onward placements for children, staffing issues and safeguarding issues. While measures to protect children from the risk of fire were in place, enhancements were required in some areas to ensure the service fully complied with regulations.

The service based in the Mid-West was found to be compliant with 19 regulations, substantially compliant with eight, and non-compliant with two regulations. It was operating at 75% capacity at the time of inspection. Children who spoke with inspectors reported that they did not want to live there but that it was “okay”. At the time of the inspection, it was only possible for three children to be accommodated in the service, due to both staffing levels and the use of one bedroom as a safe room. Inspectors found that supervision of staff was regular and of good quality; however, there were gaps in the frequency of supervision for managers. Plans to address these gaps were in place. There was improvement in the provision of training for staff and this was found to have a positive impact on the service provided to children. Improvements in fire safety measures were required to ensure full compliance. 

Tusla submitted a satisfactory compliance plan to address the regulations that were deemed substantially compliant or not compliant for each of the three special care units. 

Notes to the Editor:

• 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.