The State's health watchdog has found that children and families in the Louth-Meath area who need access to Tusla’s child protection and welfare services face long wait times, with “some cases drifting for long periods”.
“The quality of safety planning was poor in the majority of cases as plans were limited in detail to evidence how the area is assured that children were safe,” a risk-based assessment in the Health Information and Quality Authority (Hiqa) report concluded.
In a child sex abuse case that was awaiting an initial assessment at the time of the inspection in April this year, inspectors found that the safety plan put in place in May 2021 “had not been monitored or reviewed since that time”.
“A senior manager told inspectors that this case and similar child sexual abuse cases, which were primarily prioritised as medium- or low-risk cases, had been escalated to their line manager as the team did not have capacity to work some of these cases.
“Inspectors found that as a result of that escalation by the team leader to their line manager, a clear plan was put in place to address risks and manage these cases. However, significant drift had occurred and children and families involved in these cases had waited long periods for a service.”
Tusla released a statement to say that the problems had arisen in part due to a lack of staff and capacity, and said that it had work to do to ensure that “children and families in Louth Meath receive a timely service”.
On the first day of the inspectors’ fieldwork, there were 124 cases at preliminary inquiry stage, of which 21 were waiting for allocation.
Of those waiting, from the time they were referred to the time they were waiting for a preliminary inquiry ranged from one to four months (16 cases), six months (three cases), eight months (one case) and 10 months (one case).
There were 168 cases awaiting the start of an initial assessment, of which 111 were awaiting for a social worker to be allocated.
Tusla’s standard business processes outlines that an initial assessment is completed within 40 days from the date of the initial report into Tusla.
The delays from the point of referral to waiting for the allocation of an initial assessment ranged from four to 13 months, the report said, “indicating persistent and significant delays in completing preliminary inquiries”.
Long wait times “across the stages” of the child protection and welfare process, according to the Hiqa report, meant that children were not receiving the service they required in a timely manner.
The report said: “The principal social worker for one team provided inspectors with a ring binder which held handwritten review records primarily for 2021.
“These records did not always clearly record how cases were progressing from week to week, or reflect robust decision-making during the review process.
“On the basis of the sample of files reviewed, it was clear that the protocol for the management and review of wait lists was not being implemented as required.”
It added: “… The service area was not in adherence with Tusla time frames for initial assessments and best practice, with some cases drifting for long periods.
“The reasons for delays were not consistently recorded on the initial assessment form and actions to ensure children’s safety while they waited were not always timely.”
In a statement, Tusla said the screening of referrals, which is the first step taken by a child protection and welfare service to identify children who are at risk, was completed “in a timely manner” and records evidenced immediate actions taken to ensure the safety of children when required.
Eilidh MacNab, regional chief officer with Tusla in Dublin North East, said: “Oversight by HIQA assists us in striving for the best possible standards.
“However, on this occasion, due in part to challenges in the areas of staffing and capacity, we have not reached the expected standards. These issues being experienced by the agency are a common concern for many other European social and healthcare providers.”
The Hiqa report noted the “ongoing gaps and stretched workforce capacity”.
Responding to how it is managing this, the State’s child and family agency said: “Tusla continues to be proactive in its recruitment efforts – for example thtough bespoke graduate social care worker and social worker campaigns and offers of employment to all social work graduates.
“Locally, we have taken a number of steps to address these issues, and a significant recruitment effort is under way in the area and this will increase capacity and improve timeframes.
“While there are many examples of the good practice in the area on a day-to-day basis, and the majority of those who we work with reported positive experiences, we have further work to do to ensure that children and families in Louth Meath receive a timely service.”