HIQA Inspection of the Oberstown Children's Detention Campus: Discussion

This morning we will hear from representatives from the Oberstown children's detention campus with regard to the HIQA inspection report of August 2017. I welcome the director of the facility, Mr. Pat Bergin, and the chairperson of the board of management, Professor Ursula Kilkelly. I thank them for attending and for waiting out both our private session and the fire alarm. Before we commence and in accordance with procedure, I am required to draw the witnesses' attention to the fact that, by virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to the committee. However, if they are directed by the committee to cease giving evidence on a particular matter and they continue to so do, they are entitled thereafter only to a qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person, persons or entity by name or in such a way as to make him, her or it identifiable.

Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the House or an official either by name or in such a way as to make him or her identifiable. I also remind members, and indeed witnesses, to please switch off their mobile phones or else switch them to flight mode. Phones interfere with our sound system and make it difficult for the parliamentary reporters, and the media, to follow our meeting. I further advise the witnesses that the submissions or opening statements they make to the committee will be published on the committee website after this meeting. I understand that the witnesses will make a short presentation here today, which will then be followed by questions from committee members.

I now call Mr. Bergin to make his opening statement.

Mr. Pat Bergin

I thank the Chairman. Oberstown children's detention campus is the national detention facility for the care of young people referred to us by the courts on remand or detention orders. We provide a safe and secure environment for young people, help them address offending behaviour, and prepare for a positive return to their families and communities. The campus is a modern facility with new buildings and services and our programmes are based on best practice in the care of young people who offend.

Young people who come to Oberstown have generally experienced significant adversity and disadvantage in their lives. They are usually between 15 and 17 years of age, male, and have had many significant associations with the care system. They have struggled with poor experiences in education, many suffer from mental health problems and addiction, and have often experienced trauma or loss. Our young people have been through many of the state services and supports, often unsuccessfully, and present with challenging behaviour and complex unmet needs. Our job in providing them with care, education and protection is challenged by these factors, but at Oberstown it is our mission to ensure that young people detained at the campus are supported to move away from offending behaviour to make a more positive contribution to society. We do this having regard to our values of respect; learning and reflection; working together; honesty and integrity; and commitment to quality care and support.

I am pleased to be here today to report on progress at the Oberstown campus since my last appearance before this committee in October 2016. My role as director is to manage Oberstown children's detention campus to ensure we provide the highest standards of care for young people in a safe environment for staff, fulfilling the requirements of the Children Act 2001. I work under the guidance of a board of management, the chairperson of which, Professor Ursula Kilkelly, is also in attendance today, and the Irish Youth Justice Service in the Department of Children and Youth Affairs.

Although licensed to accommodate 54 young people, Oberstown currently has a daily population of approximately 40 young people, with a third of these young people on remand orders.

We now accommodate young people on detention orders separately from those on remand, which has proven to be a very positive development in providing a safe environment for staff and young people. Those young people who serve longer sentences also enjoy a care regime that is in line with their needs and circumstances.

Last March, Ireland reached a milestone in ending the placement of young people in adult prisons when the Minister for Children and Youth Affairs, Deputy Zappone, and the Minister for Justice and Equality commenced the relevant legislation. Oberstown played a significant role in achieving this objective by creating the conditions to-----

(Interruptions).

I am sorry, Mr. Bergin, but there is feedback, so I might ask members to withdraw their phones from the vicinity of the microphones.

Mr. Pat Bergin

My apologies. Oberstown played a significant role in achieving this objective by creating the conditions to enable the campus to take these additional, older young people and we are pleased to have made our contribution to this historic development.

There have been many other positive developments on the campus in the past year that have been important steps in achieving the Oberstown vision statement. These improvements have helped to consolidate the operation of Oberstown as a safe and secure campus for the detention of young people, operating to best practice. Notwithstanding this progress, challenges remain and will to an extent always be part of a facility that is charged with detaining young people with a history of difficult behaviour.

Oberstown is inspected by the Health and Information and Quality Authority, HIQA, on an annual basis. In March, it completed an announced inspection of Oberstown over a four-day period with up to five inspectors involved in various aspects. As part of the inspection, inspectors met children, staff and professionals from other agencies. They observed practices and reviewed documentation such as children's placement plans, policies and procedures, minutes of staff meetings, management meetings and board meetings, children's files and staff files.

During this inspection, HIQA found that, of the ten standards assessed, there was compliance with two, moderate non-compliance with six and major non-compliance with two. Immediate action plans were issued in respect of two issues: safeguarding a child in terms of the safe administration of a prescribed medicine; and ensuring that measures were in place to store medicines securely. I provided a written assurance that appropriately addressed the inspectors' concerns.

Inspectors found that the context in which Oberstown operated continued to be one of major change and that many new structures had been put in place since the previous inspection. These included new governance arrangements, the recruitment of new senior managers and the development of a human resources section.

Inspectors reported that there was a positive atmosphere in the residential units and observed warm interaction between children and staff. Children received adequate emotional and psychological care. They also noted that the approach to the management of behaviour was subject to review at the time of inspection, risk was well managed, policies and procedures were in the process of being reviewed, and the cohort of residential staff had been increased and was adequate.

A comprehensive action plan addressing the compliance issues noted by HIQA was developed by Oberstown following the inspection and is currently being implemented by the campus. All of the issues highlighted by inspectors were already being addressed as part of ongoing work to improve and develop the campus.

One of the areas of concern that the report raised, and that has been a matter of particular attention and scrutiny, is the use of single separation. At Oberstown, we continue to improve our record keeping, monitoring and, most importantly, use of single separation in line with national and Oberstown policy. It is important to note that single separation is used upon admission, for behavioural concerns, contraband and individual programmes. When used for behavioural concerns, there is a clear policy framework in place that staff and the organisation must follow. Oberstown is closely tracking monitoring and evaluating the use of single separation.

In October, the board adopted a statement on restrictive practices to underscore the importance of using single separation and other restrictive practices as a measure of last resort. The restrictive practices statement acknowledges that, from time to time, young people may display challenging behaviour that poses a risk to themselves, other young people, staff or the security of the campus. In such exceptional circumstances, it may be necessary to use restrictive practices to protect a young person or persons from harm, to prevent injury to staff, to prevent damage to property and to protect Oberstown security. Importantly, the board's statement makes clear that it considers it essential to minimise the use of all restrictive practices and ensure that they are used only in line with policy and procedure and are closely monitored and reviewed.

Turning to other areas of progress, I have been working with the board of management on the development of a three-year strategic plan for the campus. This was approved by the board in September and will be launched next month. The plan has five key strategic goals: the care of young people; a skilled and supported workforce; high standards and continuous improvement; communication; and systems and accountability. Each goal has a plan and progress is being made to implement a number of objectives under each.

In terms of ensuring a safe work environment for staff, the campus has a senior management team that focuses on positive care and security, management of risks and enhanced safety while leading the campus into a new period of development. A new deputy director with responsibility for risk and safety has been appointed and the operations of the central hub have been reviewed, with particular focus across the campus on health and safety. Dedicated staff on the campus are now tasked with developing an awareness of risk assessments, investigations and the individual's responsibility to keep everyone safe. Steps have been taken to improve physical and dynamic security with the adoption of a health and safety roadmap and a facilities management company has been appointed to provide external support in this regard, with the effect of enhancing response times and completing timely and effective remedial building works.

Looking to the staff's well-being, a peer support initiative - the critical incident management system, CISM - is being implemented across the campus. CISM is an on-site service providing support to staff involved in workplace critical incidents. A team of trained peer supporters provides a confidential, easily accessible and highly responsive "psychological first aid" service for fellow staff who are experiencing emotional distress arising from a difficult event at work. A critical incident stress management policy and a mental health and well-being guide have also been developed.

The board of management has approved a communication and engagement plan that aims to improve our internal and external communications with staff, young people and their families, and other external stakeholders. The committee may also be aware that we are publishing research and other data. Since April, we have been publishing monthly campus statistics regarding occupancy and providing an age breakdown.

In recent weeks, we published a more in-depth report on the characteristics of young people placed on the campus for the first three months of 2017. As well as offering insights into offending and sentencing, the data collated from this snapshot study highlight the level of adversity and trauma young people in detention have experienced, including the loss of parents, neglect and abuse, and multiple care placements. The data also demonstrate the multiple overlapping risks and needs that young people in detention have and the many professionals and services with which they have been involved. By gathering these data, we hope to inform our services and ensure that there is an understanding by all stakeholders and the public of the service we are attempting to provide and the young people we care for in Oberstown.

A number of other initiatives include the introduction of a programme of embedding restorative practices into the culture of the campus. The aim of restorative practice is to develop community and manage conflict and tensions by building relationships and repairing harm. The programme of training is being delivered by the Tallaght West Childhood Development Initiative, TWCDI. A feature of the programme is that training is provided to young people, equipping them with strategies for dealing with conflict and violence.

We also have a joint initiative with Le Chéile, which is providing mentoring for families of young people on the campus in preparation for their release. This unique and innovative programme allows parents and young people who are involved with Oberstown the opportunity to avail of mentoring and family support services in the community. A part-time worker is based on campus to support the project and this service will be in operation for two years. Youth Advocate Programmes, YAP, Ireland continues to engage directly with young people on campus in preparation for them leaving the campus. It has been on site for approximately two years.

The national reconfiguration of the Tusla assessment consultation therapy service, ACTS, on campus is a positive opportunity to develop further the inter-agency approach incorporating the HSE mental health services and the campus. We plan to have a more integrated approach to the clinical services available to young people in place in early 2018. This opportunity is a development welcomed by all agencies working at the campus.

We are also committed to ensuring that the views of young people are heard and taken into account in matters that affect them, both individually and as a group. The board of management recently signed off on an Oberstown strategy for participation with young people.

In this regard, consultation with young people is ongoing with regular meetings of a campus council made up of young people. The campus council provides a safe space where young people can actively express their views on issues that affect them. Young people have the chance to influence and hear back from key decision-makers in areas of importance, chosen by them. All of these achievements are building blocks to ensure that in time Oberstown becomes an international centre of excellence from both a youth justice and a children’s rights perspective.

Committee members will be aware that in late 2016 and early 2017, a number of reviews of Oberstown were undertaken. In light of the volume and complexity of the recommendations emanating from these reviews, in March 2017 the Minister for Children and Youth Affairs established a review implementation group chaired by Professor Ursula Kilkelly, chair of the board of management at Oberstown, with representation from Oberstown management, staff, trade unions, the Irish Youth Justice Service and an external expert in child development.

Since its establishment, the review group has considered the 120 recommendations emerging from all of the reviews, classifying them according to priority, required resources and owner. Following a period of intense scrutiny and review, work in Oberstown is now focusing on the implementation of these recommendations. Designed to enhance the level of care provided to young people and to ensure that Oberstown is a safe place to work, the implementation process is complex, costly and resource-intensive. Aided by the work of the review implementation group and supported by the strategic planning process, it is important this work is co-ordinated and systematic, and brings to a close the expert input of all reviewers in order to ensure that the young people in Oberstown have the best possible care and education as part of their experience of the wider youth justice system.

I thank the committee members for the opportunity to update them on progress and developments at Oberstown. I extend an invitation to them to visit the campus at any time to see the facility in operation. Professor Kilkelly and I would be happy to take any questions members may have.

I welcome Mr. Bergin and Professor Kilkelly. I apologise in advance as I will be leaving in about 15 minutes. If the responses are not finished by then, I hope that my colleagues will follow up on some of the questions I will put.

While I thank Mr. Bergin for his statement, it is very typical of statements where it is about how wonderful it is that things have improved. I have some concerns. The child is not central to this statement. Mr. Bergin spoke about how he is improving things for staff. He spoke about putting different structures in place. Mr. Bergin briefly mentioned restrictive practices usually when children are brought in at the beginning. Two really serious concerns are not addressed in the opening statement. It is all very well to put structures into the organisation, but if the child is not central to everything, then none of this is worthwhile.

Mr. Bergin referred to the nature of the children and that they have challenging behaviours and also about how the lack of resources may be impeding any major progress. The reality is that Oberstown is for children with challenging behaviours. The system should have been created around that. The two basic things I want to discuss have nothing to do with resources. First, I presume restrictive practice means single separation and restraints. Is that correct?

Mr. Pat Bergin

That is correct. It also refers to use of handcuffs.

Use of handcuffs - I am instantly offended on hearing that. I was going to ask Mr. Bergin to list the types of restraints that are used in practice. According to the Oberstown records, when restraints have been used, the type used has not been recorded. I find that worrying. Is it a deliberate act that the records do not show that or was it a mistake?

Mr. Bergin said that the practice of single separation is really for children on admission in the first place. As we know, single separation has taken place with children who are detained there. The records show that not only did some children spend long periods of time alone, but also it did not show that this was used as a last resort. We have no idea if this was a quickie solution or if everything had taken place to ensure that the proper procedures were followed. I will throw all these questions in and I appreciate Mr. Bergin listening.

Mr. Pat Bergin

That is okay.

The second part is about the health of the child. I was deeply concerned to see that not all the Oberstown staff had been trained in Children First. I ask for an update on that.

The first-aid training the staff received did not include basic elements such as the management of burns, broken bones, scalding or wounds that are bleeding. These are everyday hazards that occur with children in this environment; they get broken bones, cuts and other wounds. I again seek an update. Has that improvement in training been implemented?

The next item is very close to my heart. Research shows that children who are incarcerated usually engage in self-harming behaviours. I would like Mr. Bergin to answer this question before the others. What do the Oberstown staff do with children who self-harm?

Those are the three basic concerns I have. This is not scrutinising or condemning the witnesses. We can only improve if people make us aware of the areas in which we need to improve. This is a wonderful opportunity for Mr. Bergin and his organisation to make valuable improvements in Oberstown. He should not see this as me lashing out at him. It is something that really concerns me.

Mr. Pat Bergin

I will start with the last point the Senator raised regarding self-harm. We have young people who inflict harm on themselves for many reasons. Some when they come to the campus have a history of self-harming. As we would be aware of that, it allows us to put measures in place very quickly.

What are the measures?

Mr. Pat Bergin

We have clinicians and psychologists on site. We have access to the Tusla ACTS team, who are on site to support staff. They review the information on young people and design particular programmes or approaches. There is constant monitoring and evaluation of that young person. There is access to the GP on site; we have a doctor on site three days a week.

Self-harm in a child, when it happens, usually happens in private. When it is discovered, what happens? Is that child removed to another room where there is no-----

Mr. Pat Bergin

Children are usually maintained in their bedrooms because that is an area that is familiar to them and they have their stuff with them. We have designed bedrooms where the possibility of self-harm is reduced. Ligature points are removed. We look at linen, clothes and such matters. From time to time young people may use their own clothes to wrap around their neck to try to choke themselves. Some young people will try to bang their heads against the wall. There is a range of different behaviours. We engage with those young people and spend time with them. We are minding them during the period of crisis they are having. In one sense there is no point in taking them away; that is not what they require.

Are they restrained during that time?

Mr. Pat Bergin

No.

The use of restraint is based on whether there is a harm to somebody else. It is not used if they are harming themselves, unless they are using an implement to cut themselves and that may be taken off them. Somebody may break a piece of cutlery or a cup and the intention is to try to remove that safely. The risk is assessed according to whether they are just threatening themselves or inflicting pain on themselves. If they are inflicting pain on themselves, consideration is given to the level of pain or damage. Sometimes young people scratch themselves and then they say they have cut themselves and they look for attention. There is a range of behaviours. Each young person will behave differently. Our staff are constantly monitoring young people. For young people in particular, we have five-minute observations, ten-minute observations and half an hour observations depending on the associated level of risk. There is a general default position in Oberstown, which is that there is a possibility that any child there will inflict harm on themselves.

Mr. Pat Bergin

That is the position we take. Right throughout the night, we have night staff monitoring children. At 10 p.m., there is a review of everyone in the unit. Two staff are on for the night looking after eight young people. They get a hand-over from the day staff on how, for example, Tommy got on during the night and what are the issues. There could be a five-minute observation of that young person right up until they go to sleep and then after that it could be every ten or 15 minutes but that will be determined by individual issues. Some young people ask that we do not come in to check on them after they fall asleep because it wakes them up and that creates further distress for them. Some young people have a very complicated history of self-harm. We usually get the information very quickly when they arrive because they have been involved in other services. The assessment, consultation and therapy service, ACTS, team links in with outside services and the GP is aware of it. Particular plans are put in place. We may have particular key workers who are aligned to a young person so as to have one or two staff engage with them. One does not want a large number of different adults engaging with a young person over a week. We tailor the approach.

I am very sorry to interrupt Mr. Bergin but there is a vote in the Dáil. I regret to inform Senator Freeman that we must suspend the meeting.

Is it all right if Mr. Bergin responds to the rest of the members here?

Absolutely, yes.

They will follow up in case Deputies have missed out.

We will suspend the committee to allow members to attend the vote in the Dáil and we will resume when the vote has concluded.

Professor Ursula Kilkelly

Should we stay here or remove ourselves as well?

The witnesses can stay.

Sitting suspended at 11.15 a.m. and resumed at 11.35 a.m.

I thank Mr. Bergin and Professor Kilkelly for their patience. They may continue their responses to Senator Freeman's questions.

Mr. Pat Bergin

The Senator raised a number of points about self-harm and restrictive practices, and I would like to talk through those issues because it is important to offer a better insight into them. It may help the committee if I describe particular scenarios and what happens with young people in Oberstown.

If we have a young person - for example, a 16 year old - who is in crisis, not managing well or demonstrating behaviour that is a concern, that behaviour will be evident in a number of different ways. The young person may refuse to go to the kitchen, refuse to return from school, turn furniture upside down or be threatening to staff. That might be the scenario. The default position of all staff in Oberstown is to engage verbally with that young person. What normally happens is that other young people are moved away from the environment in which the incident occurs, after which staff can start to engage. One considers the staff team and who has the best relationship with this young person. The staff member and the young person start talking at length. More often than not, the scenarios last 40 minutes on the corridor and two or three staff members try to get an understanding with this young person of what is going on, what his or her way out is and how he or she will manage. They will relate this back to scenarios that occurred the previous day or the day before that.

Young people on the campus have what we call individual crisis management plans. We develop these with young people. If they face crises, we try to establish what things work and do not work for them. Everyone is different. Some young people will say they want to ring home. We will tell them they can do so when they have calmed down, and that will help them. Other young people will say they want to be away from Mary or Tommy or Billy. Each individual crisis management plan is known to the staff and they will draw on that plan. However, if a young person in this situation continues to become more volatile, staff will make an assessment. They will evaluate the risk. The risks can vary. The risk could be that an incident has been ongoing for an hour, by which time it is half nine at night, the young person is creating a challenge on a corridor and no other young people can go to bed because that person is there. The decision is then made that we need to move that young person on. The young person is made aware of the possibilities, which may involve what we call a physical intervention. The physical intervention can be to walk him or her out of the corridor or to go into a full restraint.

All the staff are trained in what we call management of actual or potential aggression, MAPA, as part of our behaviour management programme. This looks at how to physically hold someone in as safe a way as possible, for both the young person and any other young people there. Staff are trained in this and the physical restraint involves two or three staff members. It is neither an option that staff like nor an option in which people want to participate for many different reasons. Staff are very mindful that once they get into a physical intervention with a young person, there is a possibility they will damage the relationship with that young person and that someone will get hurt, either the young person or the staff member.

A restraint may involve two or three staff members, or perhaps more, holding a young person on the corridor or the floor until he or she calms down. There are very clear approaches going back years in this regard. If one physically restrains someone, one keeps a hold of him or her there until he or she calms down, and in calming down one then regains control. One then agrees a plan with that young person. The plan may be to go to the young person's bedroom or the sitting room. The young person may be asked what he or she wants or what is the issue. A key focus of the physical intervention is to ensure that while that young person cannot manage, he or she is being helped to manage. All the training we have done over the years is around not only maintaining the relationship, but also ensuring that people are safe. This is another key focus of the approach. We do not want people hurt or in pain.

The top part of the body is held on the floor, the legs are maintained in one position and one person talks. It is a very scientific approach. Only one person speaks at a time in case the young person gets confused. There is one voice and one direction and that is about moving on. If the young person is allowed to calm down then the situation can be moved along. The number of physical restraints has substantially decreased in Oberstown because people are spending far more time talking. That took a shift in culture. Rather than going in and physically moving the child and putting him into a room, we are now spending time in the corridor or in the yard engaging with them. That has become part of the norm.

There was a reference earlier to self-harm. The same approach is applied on that issue. One spends time - as long as it takes - with the young person who is self-harming. However, if it gets to a point where there is a serious risk that the young person is going to damage himself or herself, there must be physical intervention because one has a responsibility to keep that young person safe. We have many options for that eventuality. There are psychiatric services on site. We have spent a long time working with the HSE and the assessment consultation therapy service, ACTS, team to ensure we have mental health services on site. There is access to a GP. We have a medical team. We have nurses on site from 8 a.m. to 10 p.m. We have a medical suite. All of these services are available and are accessed as required. If something occurs after 10 p.m., we call CareDoc or the medical emergency services. We do whatever is required.

The other restrictive practice relates to handcuffs, and it was referenced earlier. Handcuffs are not routinely used on the campus. There are exceptional circumstances where a staff member would use handcuffs to manage behaviour. However, all young people - 99% of them - arrive on the campus in handcuffs. They leave with gardaí every day in handcuffs. That is the nature of young people being in detention. We have been attempting to introduce a policy where young people are not handcuffed when they are leaving the campus with a member of staff. That is based on a risk assessment. If we were to take a young person off campus today and were he to run away, the first question that would be asked is why was he not secured. The young person would have become a risk and might offend out in the community.

The three points to which reference was made earlier are covered by the term "restrictive practice". I will speak about single separation in a moment. We want to highlight that it is something that is very significant. To restrict the movement of a young person and to take away his or her control is not routine. We are attempting to highlight with all of our staff that this is outside of the norm and it is working. There needs to be accountability when these restrictive practices are used.

There was a reference to records earlier. Staff know how to restrain. The focus then is to record it. While what they have done is important and appropriate and has resulted in the safety of the young person, unless it is recorded, we do not know what has happened. That has been a shift in culture and it is improving significantly. Linked with that is the concept of single separation. Single separation is used across the campus in many different forms. There was reference to young people coming in on admissions. If that happens they may be separated for a length of time, depending on the concerns around their behaviour. This morning, like every morning, we check how many lads are on single separation. There are 42 children on the campus this morning, two of whom are on what we call structured programmes. Due to behaviour that has taken place over the last few days there is a clear structure in place outside of the norm for those two. One young person is in single separation and has been for a number of days. Staff have been going in and engaging with him, trying to establish a plan and to move this young person on. He has very complex needs. Every day we evaluate what is the approach, what is the individual crisis management plan, what is the staff relationship and how it can be moved on. We have policies and procedures but we are focused on the practice and making sure it reflects what is best practice and that the young person is at the centre of it.

The care, education, health, offending behaviour and preparing for release, CEHOP, framework, which was developed by me over the past few years, is based on the focus of young people. Everything we do focuses on the care, education, health, well-being and offending behaviour of the young people and how we can prepare them for leaving. The centre of all that we do is the young person and to support that, our placement planning is key. We look at the young person's needs and decide how we can put a plan in place that is specific to that young person. The plans are not generic or all in one, because the young people who come to Oberstown all have different experiences and challenges. From that perspective, I make the point that everything that we do on the campus places the young person at the centre.

Is Mr. Bergin satisfied he has answered all the questions Senator Freeman asked?

Mr. Pat Bergin

There was a reference to child protection and training. The HIQA report identifies that 86% of staff are now trained, which is a significant improvement for us compared with what had been there. All staff have now received training in child protection. Because of the change brought about by Children First, we need to update that again for 2018. We have a social worker on site. We have access to the social worker for all staff and young people. While the training is important and necessary, the culture should be one of openness and willingness to understand child protection issues, how to report them and how to follow them through. There have been significant improvements in the area of training. My concern is that we may overtrain the staff. While much needs to be done in respect of behavioural management, child protection and restorative practice, it should be spread over a period, rather than doing it all over six months, in which case our staff would be overtrained.

Senator Freeman asked an interesting question about triage and about burns, cuts and so on.

Mr. Pat Bergin

I made the point that when I started on campus, around four years ago, we had a nurse. Now we have three nurses on site to cover throughout the day. The idea is there will be proper medical provision on site. We have a comprehensive GP system on site. All of our staff are trained in basic first aid. The question that arose concerned an enhanced first aid model. My concern is that we have over 160 staff and if everybody was to be trained to that level, it would take a long time. If there is a scald injury or a broken bone there needs to be an immediate response. The focus should be on making sure the service is available to the young person rather than on everyone being trained. I have structured that by making sure the appropriate medical ability is on site. We have recently added a social care worker to our medical team to ensure that medication management over weekends is at the highest possible standard. We are continuously reviewing how we can do that.

Senator Noone is scheduled to speak next but I understand she has been unavoidably delayed at the health committee. Members can indicate to me if they wish to come in, but before that I have a question. During my recent visit to Oberstown I was very impressed with the school, and in particular the available curriculum, which is tailor-made for individuals with more practical subjects. The only question arising from that which I did not ask during my visit concerns access to that school, in terms of a programme for all detainees, whether they are there on a temporary or more permanent basis. This was subject to correspondence by a third party following my visit. Can Mr. Bergin outline the sort of programmes, the educational requirements and the access pathways that are available in Oberstown, please?

Mr. Pat Bergin

To set the scene, the provision of education is on site through the Department of Education and Skills and is delivered locally by the ETB. Outside of the staff complement, there are approximately 28 teachers who provide education. The school has been designed and built to accommodate up to 80 young people and the ratio of young people to teachers is approximately 3:1. The school is based around the primary school year and runs until the end of June even though second-level classes and subjects are taught.

With regard to the campus, it is expected that all the young people attend school and they want to and are eager to attend school. Generally, the young people would divide the subjects into two categories. They would talk about the practical subjects such as metalwork and woodwork, which they all want to attend. Then there are the more academic subjects such as English and Irish. The school has a regime, which is that they do both. That is the deal between the young people and the principal and teachers, and it works well.

The school day kicks off around 9.45 a.m. and finishes at 3.20 p.m. The class times are longer now. They used to be 40 minutes. However, due to the challenge of moving young people between classes, they are now one hour long. The school structures that by reference to the subjects and the mix of young people and their inclination. If memory serves me correctly, in 2017 ten young people sat junior certificate exams. In 2016, 17 young people sat junior certificate exams. In 2016, 83 or 84 young people did QQI education modules and I believe that so far 53 young people have done them in 2017. These modules are components of junior certificate exams which they will be in a position to use when they move on to other educational facilities. If they go to school out in the community, they will be able to build up the capacity and say they have done certain exams or got certain accreditation.

Art, reading and writing is important to many of the young people and making stuff for their families is important to them. They want to spend as much time as they can in school. We are currently considering what the exact educational programme should be and the board has instigated a process to examine whether we need to have a better understanding of the educational needs of these young people rather than saying this is the model for young people to fit into.

There are two schools: one in the remand unit, which young people there attend, and one in the main campus, which the committal lads attend. That helps because it means people are getting more time in school. Dividing them, we can get people into school quickly and teachers can focus on the individual subjects. Young people on remand will engage with some subjects. Classroom numbers are even smaller again because of the way it is designed. Therefore, there might be two young people in a classroom with a teacher. In the main campus, it is usually three. The lads are quite anxious to and want to attend. When we consider the posters and all that is going on, we see that the lads are quite proud of what they do in the school. The principal and the vice-principal tailor a lot of what they do to individual young people's needs. They then work with us by identifying schools and options for young people who are moving on. When young people come in, they contact the schools the young people had attended. In our recent statistics, when we reviewed the figure in the first quarter of 2017, 45% or 46% of young people had not been attending school prior to their coming to us. There had been a big drop out. Therefore, to have young people come back into the school situation was quite a benefit and important for them.

I meet young people regularly and many speak about their options when they move on. More often than not, they want to do an apprenticeship, get a Safe Pass to work on a building site or go onto Youthreach. They want to continue what they started. That is the challenge and the school helps to support us in terms of ensuring those options are available.

I thank Mr. Bergin for his presentation. I want to focus on the major areas of non-compliance found in the HIQA report. I have several questions. The discussion on control and restraint, as it was called in the past, is reminiscent of lots of discussions of psychiatric institutions and other jails and what is now accredited. Mr. Bergin referred to the management of actual or potential aggression, MAPA, model. The management of difficult behaviour is difficult. The HIQA report states that the MAPA model of managing behaviour did not fully meet the needs of children or staff but it also states that not all staff adhere to the behaviour management policies. Is MAPA sufficient in meeting the needs of children and staff? Is it the only show in town? Are staff not implementing MAPA? It is quite traumatic for the individual and the staff to have to hold someone down and stay with them. We know from the fatalities that have been caused due to obstruction of airways and interference with cardiac functions that many front-line staff have come across this and we need to reform it. However, there is a contradiction in the two statements in the report in that it is not meeting needs yet the staff are not adhering to it. Will Mr. Bergin comment on the training model and whether he believes it is the right one?

There is an insurance issue for staff if they do not use the MAPA model and are seen to be outside it. As a practitioner, my insurance cover was compromised if I did not use the prescribed accredited method. In situations of extreme violence, trauma or emotion, not everything can be followed to the tee. This needs to be understood.

On children being at the centre of their own care, are they involved from the outset? Do they understand and agree to a treatment model? Is this by way of signature? This way there would be ownership on the part of the child, as much as it can possibly be understood. They will not adhere to it all the time but it gives them a strength of ownership in following a treatment model and an understanding that it is best for them and not necessarily just there to continually punish.

The other quite concerning area of major non-compliance is the administration of medication. There are three nursing staff. Is it just the nursing staff who administer and dispense medication and sign off on the prescriptions or is it the general workers in the facility also? The report notes incidents of treatment being delayed when this was recommended by nursing staff. Will the witness comment on that statement? I know there has been something akin to a Mexican stand-off in our prisons when nursing staff have told prison officers that someone needs treatment. There is a sort of Mexican stand-off as to who has the authority. That is another issue.

The report stated that the measures in place to ensure a robust chain of custody for medicines requiring additional controls were not adequate. This refers to the Misuse of Drugs Act and the Dangerous Drugs Act, which have specific provisions on how drugs are stored, ordered, counted and how one double-signs and makes sure the chain of events can be followed. Drugs are to be returned to the pharmacy or, if there is one, the pharmacy facility on-site. Drugs are always accounted for and two professional people are responsible and account for them.

Mr. Bergin has said that he had addressed the matter with written assurance to the inspectors. Can we have an explanation and copy of that?

Mentally ill people are increasingly incarcerated in prisons because of the closure of our big institutions and the lack of beds. The same applies to children. We know of the closure of Linn Dara and of other facilities for children that are not functional or at full capacity. I gather there are 47 beds in the entire country. Can the Oberstown representatives comment on whether child mental well-being or mental ill-health is becoming part of the criminal justice system? Is Oberstown getting more people who would be more appropriately housed in secure child units?

Mr. Pat Bergin

I will work my way through those questions and begin by making some points on the management of actual or potential aggression approach. I describe MAPA as a tool in the box of approaches that our staff can use. Overall, we have a behaviour management approach. Under the behaviour management approach on admissions we talk about how we gather information on young people. We talk about young people understanding the routines and what is expected of them. We look at the key worker allocated to the young person and the engagement the key worker will have. We talk about what the expectation will be and contact with family etc. A range of elements form our behaviour management approach.

Let us consider the scenario where the young person is not managing well. We try to talk it through before a young person gets into a situation where there is a difficulty to ensure the person understands the rules and what is expected. We talk of an individual crisis management plan. In that way we are ahead of the posse in respect of being able to work through the possible challenges with the young person. That is not always possible, but it is the focus.

We say 80% of the MAPA approach is around de-escalation. We talks about looking at triggers, managing the environment and using minimum force and maximum care. We consider who the triggers might be. It might be me and I may need to move away and let someone else deal with the situation. In that sense 80% of MAPA is around that engagement. The remaining 20% of MAPA is around physical intervention.

Reference was made to how a staff member can be trained and can put his hand in a particular place and do this and that and so on. Then, more often than not, some errors arise and the young person is not going to stand in a particular position. That means it will not happen the way it should. It is like any training. We set out what we normally want people to do and we advise people to stick to that as best they can. However, situations will arise when people will deviate from that, but they need to bring it back. One relevant example is the question of moving young people when we restrain them. The MAPA approach and all physical interventions talk about not moving people from such a situation. Young people should not be picked up because of the physical impairment that may result. Let us suppose someone deals with a situation, picks up a young person and carries him from A to B. Then, there is a question of that staff member creating a level of risk. The restraint applied in that case may not be exactly how MAPA is expected. The staff member is safe in doing that and has not gone beyond some of the key principles that exist for any physical intervention.

Previously, there was a therapeutic crisis. Reference was made to the Crisis Prevention Institute and the range available. They all hold the same principles, that is to say, engage, provide options, use the relationship and risk-assess. If a staff member is going to physically intervene, then he should ensure that it is safe to do so, that the right people accompany him and that they are working together. The idea is that there is no broad scenario in which a person is caught up as a consequence of which people get hurt.

I will have to speed you up a little, Mr. Bergin.

Mr. Pat Bergin

We have been working with staff around previous practices to ensure good practice and that re-training has taken place. Two staff work continually with staff around MAPA and behaviour management. Our review of behaviour management is ongoing and many of these factors are considered. We hope to have a more comprehensive approach in 2018. The principles are in place. The key point is to ensure people do not get hurt.

Some specific points were raised on medication and major non-compliance. The inspectors found keys in the medical safe. That amounted to major non-compliance because of the potential risk. The assurance was given that we would be checking regularly. Staff would go to the safe and take out medication and they were not putting the key away.

Was that staff or nursing staff?

Mr. Pat Bergin

No, it was care staff. Back in March not every hour of the day was covered. There was a period when care staff were dispensing medication. We found keys in the safe. That was one issue.

Another issue involved a young person who was allergic to bee stings. Some of the staff did not feel competent to use the EpiPen so they were trained up. That was the second major non-compliance highlighted from a medical perspective. I am confident that our nursing staff are rigorous in respect of prescribed medication and record management. I have no concern on that point. It was a question of the practice of the medicine cabinet and the training around the EpiPen. They were the two key issues or specifics.

Reference was made to the delay. We have challenges whereby a young person could be acting out and causing a challenge for themselves. There may be a requirement for that person to go to hospital at midnight. The question was how to balance the safety when taking the young person off campus and ensuring that he has access to treatment. It has been clearly put out that if a person needs treatment, then the person needs to have access to treatment, but we can also bring treatment on-site, whether through Caredoc or the emergency medical services. If someone requires treatment out-of-hours, the director or deputy director will be contacted to ensure the young person has access to the medical services required.

The concern previously was that people were making judgments. Some may have decided to wait until the morning and go to hospital at that stage. The difficulty of the unknown arising is an issue. We have put in place measures to ensure that if someone needs medical attention, he or she will get it. Access to that medical attention may take several forms depending on the issues, for example, when it involves a bang. I was involved in a scenario when a person thought he had broken his arm. He was willing and happy to go but we put more staff on to ensure that when the person went off campus the behaviour could be managed.

My question centres on the supports available to staff. In many institutional settings the pressures of the job can be a factor in people not adhering to guidelines or the rules in place. It applies in particular in this setting. It is a very difficult job. Sometimes staff might find themselves in an impossible situation. Is counselling available for staff? Are supports available? Is there somewhere they can go to highlight difficulties or discuss how the guidelines are not working? How can we assist in making things more workable?

Mr. Pat Bergin

We developed a campus support service for staff one and a half years ago. We now have an organisational psychologist on site who provides direct support to staff. She has developed infrastructural support mechanisms for staff. I made reference in my statement to the critical incident management system, which is a peer-support structure. A total of 23 staff were trained up on CISM. They provide ongoing peer support to staff during times of crisis. The programme has been put in for an award and is the first of its kind. The benefits have been noticed.

We use the employee assistance programme for supports. There may be issues for staff that are external to the campus, but they come to the fore within the campus because of the job. Our on-site organisational psychologist will provide direct support for staff. She meets them and uses signposts from different directions. We try to use peer support and undertake debriefings. We have put in place a range of measures. After incidents, we look at debriefing staff to elicit the learning outcomes and how things can be better. A comprehensive programme has been undertaken in the past ten or 12 months around any incident that has occurred.

That is where staff would have some input. We have also been trying to develop a system of one manager for one staff team so that if a team works well together it will share, pull together and address issues together. This is how this matter is best addressed. This has been a key focus for us and over the past few months it has very much helped us to deal with some of the challenges we have faced as a staff team. We continue to engage with staff on an ongoing basis and there is now quite a positive and open relationship between staff, staff representatives and ourselves when it comes to solving problems and moving things forward.

That is very positive. It can be very easy sometimes to throw the staff under the bus without assessing why the situations in question arose in the first place.

Professor Ursula Kilkelly

Our new strategic plan has a clear focus on these issues. First of all, we absolutely recognise that young people are the priority. We have to support staff, however, in order to make an environment safe and in order to operate to best practice. There is a very clear commitment on our part to ensure that the priority is on young people but that a range of steps, measures and supports are necessary to make this a reality. In creating an environment that allows for best practice we have to focus on what we can deliver and not just what we aspire towards.

I thank the witnesses for their presentation. I will not go back over questions that have already been asked; my own questions are mainly for Professor Kilkelly. How often does the review group meet? How many people are on it? Are the 120 recommendations listed in the findings now in the public domain?

Professor Ursula Kilkelly

Yes.

They are in the public domain. Okay. Deputy Chambers has raised this, but I would also like to ask more about the morale of the staff. How many of the staff are agency workers and how many are core staff based in the building? Are there always nurses on duty on the campus, seven days a week and 24 hours a day? Both the witnesses themselves and HIQA have stated that one of the key findings in the report is the care of the children that present to the facility. This is complex, be it from the point of view of mental health or education. Are there any girls currently on the campus? Have there been any girls since the witnesses last addressed this committee? The witnesses talk about remand as opposed to detention. Something that struck me when I visited Oberstown was that the mixture between children on remand and children in detention was very unsettling when some were leaving. Has the unit now been set up differently? Could the witnesses explain how this has worked in a positive sense? It was very unsettling that children were coming and going all the time.

The issue of GP cover has been raised. Is this a matter of the GP coming in on a Tuesday or Wednesday morning for half an hour, for example, or is there broader access to a GP on campus? I would also like to know what psychological supports are available on campus. In the case where a child presents who poses a risk to his own life then the social care worker, even with the best will in the world, is not a trained psychologist nor is anyone on the management team. I would like to know what level of training is available to support such a child.

Something that worried me in the follow-up to the HIQA report, both in commentary on RTÉ and with regard to the interview, was the fact that it was reported that a child was held for up to nine days in single separation without access to air. I look forward to hearing the witnesses' commentary on this and I need to understand this because that, to me, is not humane. We talk about separation and the like, but what came out in the report was that separation did not seem to be the last resort, though I would like to think that it is. I can understand why separation takes place because of the need for adjusting and this is something that the witnesses have explained very well. I am particularly focusing here, then, on one particular aspect of the report.

Professor Ursula Kilkelly

I can start off here before handing back to the director to comment on some of the more operational issues. In March of this year the Minister set up the review implementation group, which I chair and which includes representation from the Oberstown management, staff and board; from the trade union; from the Department; and also an external specialist on child development. We have met nine times to date. The task of this group is really to bring together the recommendations of all of the reviews that have been undertaken on the campus over the past year. We are doing this with a view to carrying out a number of things - to record and track the implementation of all of those recommendations, which is very significant; but prior to that to also analyse, synthesise and make sense of what all of this is telling us. We have created a framework of five headings and 14 themes, and this framework was included in the summary of the review document that we published in August. We are currently continuing that work and we are on track to complete it by the end of the year when a report will be made to the Minister. This work will achieve two things. First, it will allow us in the future to look back and identify what happened to the recommendations of all of those reports; and second, and as part of that, it will allow us to see what progress was made and what was the record of implementation. It has, then, a double purpose. This is a very important collaborative process that draws in many different perspectives from the people around the table. It also fits in with the ongoing work of the board, including our planning and our constant examination of the extent to which all of these issues converge around the HIQA recommendations. We do not see all of these as separate, disjointed processes but rather we are looking to bring all of this together into a single body of work. By the end of our work we will produce a full action plan around the recommendations and this will of course be publicly available. All of the recommendations have already been published in one form or other and we communicated those at our external engagement group and our stakeholder engagement session in May of this year. Subsequently, of course, further analysis has been undertaken and all of that will be published by the end of the year.

I will let the director deal with the more operational matters but I am happy to come back in then to fill in any gaps or address any issues further.

Mr. Pat Bergin

Remand and committal cases are separated. This means that young people on remand are accommodated in units 1 and 2, which are in the old buildings in Trinity House, while committal children are maintained in the other part of the campus. We have more or less separated them. From time to time we may mix in individual circumstances because children might know each other or because there are historical factors but in the main the children are separated. With regard to the GP service, we have one GP who comes on site on Monday, Wednesday and Friday from 9 a.m. until 1 p.m. That GP does some routine work and also looks at admissions and discharges, thus providing a medical service to any child on the campus at that stage. The GP may link in with other GPs to look for or to pass on information. They also work with the nurses on this. Our nurses are not available 24 hours a day. We have looked to develop access to a medical service on campus from 8 a.m. until 9 p.m., seven days a week. If medical services are required in the meantime, we fall back on D-Doc, seek access to hospital services or whatever may be required. It would not be appropriate for us to have nursing on site 24 hours a day: this would just not be practicable. We originally looked and had posts for four nurses. There are significant challenges, however, in getting four nurses so we currently have three full-time nurses along with a social care worker who can dispense medication, has advanced first aid training and is also involved with further medical bits and pieces. This is to ensure that we have a robust service in place.

The Deputy also asked for clarification over the morale of staff and I hope that morale is a lot better now than it was this time last year.

I am starting a round of town hall meetings with staff to get some feedback and to communicate. Generally, my sense is that morale has improved. There is still a long way to go but we are going in the right direction. The engagement between staff, the young people and the management has improved substantially. That is my general sense and hopefully I will not be corrected on that.

On the psychological services, I shall give the committee a sense of the services. Today is Wednesday and this morning the full assessment consultation therapy service, ACTS, meeting started at 9.30 a.m. to review cases for all children on the campus. At that meeting there is the ACTS team, the psychiatric services through Professor Harry Kennedy, our care staff and one of my deputy directors. We review cases with regard to new admissions, who has arrived and what is the plan. Assessments are then undertaken. Professor Harry Kennedy's ACTS team will go on site to the units and engage directly with the young people. If there is particular piece of work or advice they can give to care staff to continue some of the sessions outside the clinical sessions this is part and parcel of the approach.

Single separation is not acceptable. Terminology, structure and sentences are important. I do not know the case that HIQA referenced. I do not know if it related to other cases that have been referenced in other forums that relate to last September. The issue of single separation may be about someone in their bedroom. The issue of no light may mean being out in the yard or being taken out of the unit. The scenarios that would arise may have to do with fear and around removing someone; they may be a threat to staff or they may not be engaging. The ongoing conversation that staff have with a young person may not have got the young person to the point where they can do A, B or C to return and the young person may not be willing to meet certain expectations. This could be for a number of different reasons. A young person may still have drugs on them and we cannot get the drugs off them. They can hide drugs in many different places and they can continue to take drugs. Until we are assured that there is some level of engagement, the scenario is that this young person would be maintained in a particular environment until it is safe to move them.

This is probably one of our biggest challenges around risk. It is one thing to engage with a young person who is reasonable and who can hear what we are saying. If, however, we have a young person who is on a substance - and we do not know what it is - then it can be very difficult to get them to co-operate and engage. If they were out of their bedroom, out in the corridor or the yard, and they refused to engage we would then have a situation where we may have to restrain them. If we restrain a person who is on drugs we then have an issue over whether we could actually contribute to other physical concerns. It is a judgment. We have put in place a measure where there is a check undertaken every day for which lads are on single separation. This is done by the deputy director and it looks at who is in single separation, what is the plan, how long have they been out, what is the next step. It is now a daily audit rather than at the end of the week or the month. We get the figures on that basis and this is how we manage and measure to ensure young people are not maintained in single separation for long periods of time. We also look at alternative approaches. Is there somebody else who can engage with that young person? Is there a solicitor or family coming to visit and what can we do to actually move the goalposts?

We have a girl with us until tomorrow. Girls come every so often for a week or two while they are remanded by the courts. We have not had any girl on committal for a long time. They are usually on remand for a week or two. We get notice of two hours to let us know a court has decided that this young person who is a girl is to be remanded. Girls have a unit on their own. Our most recent girl was in the school with the lads and attending one of the classes with two or three boys. The teachers managed that and it was appropriate. That is the nature of the service we provide. In one sense it is positive that we do not have lots of girls there but the law says that if a young girl is remanded we must take her and mind her appropriately. I am aware of concerns expressed previously about this but I am very focused that the CEHOP framework - care, education, health, offending behaviour and preparing for release - looks at individual young people's needs whether it is a boy or a girl and whether it is a vulnerable young person or not. The plan we have in place has to be around that particular young person rather than the gender issue. I would look at the needs of the girl who is coming in. The campus has had some complicated situations with young people of various genders and the plan has to be based around their needs rather than a gender issue.

I thank Mr. Bergin.

I thank Mr. Bergin very much for his presentation. I feel a bit shell-shocked. I find it alarming that when we talk of a child who was separated for nine days and who did not get fresh air, Mr. Bergin can say that he did not know of that case. When HIQA produced the report this should have been one of the first things addressed by the directors. People in charge should have found out the background to the case. The HIQA report stated that in four out of six days of a child's period in single isolation there is no evidence of authorised reviews. I find this quite alarming. Who is reviewing these children? Who reviewed that child who was in there for nine days? What has Mr. Bergin done to rectify this? Oberstown's own policy on separation states that it should only be used for as short a time as is necessary. Will Mr. Bergin define what is a short time, what is the process, when is it used and for how long?

The HIQA report referred to cultural needs. This point was raised by the staff. Inspectors had viewed some of the files of children who were from minority groups and while the ethnic origin of the young people was recorded, staff felt that their cultural needs were not being addressed. What has been done to rectify this? It is important.

I do not want to dwell on the matter, but I wish to return to the issue of restraints and handcuffs. I am upset that in his opening remarks Mr. Bergin said that as the young people arrive in these restraints then it is okay because they are used to it. This did not sit right with me. When are handcuffs used? Are they used when these young people are going out to school? Are they used when a person goes off on one in their cell? Can Mr. Bergin please be more specific so I and my colleagues can feel a bit better about it? I would appreciate it if he could go into it in a bit more detail.

Mr. Pat Bergin

I will start with the handcuff issue. They are not used on the campus. The children are not handcuffed when going to school. There is free movement around the campus as the young people move around with staff, so there are no handcuffs. I believe that in the last 12 months there have been four occasions when handcuffs have been approved for use by a deputy director or myself with regard to the movement of a young person. This was because of the level of risk they posed. I shall give an example rather than a specific incident. If a staff member is moving a young person from one side of the campus to the other and there is a concern that he or she is going to act out, then we have an agreement with them. My concern is that if a person is acting out we cannot really put handcuffs on them. The capacity to put handcuffs on a person while they are acting out does not sit well with me.

I did not mean to come across as disingenuous with the comment around children arriving to the campus in handcuffs. The point I was trying to allude to was that once they arrive, the majority of the young people are in handcuffs, the handcuffs are removed from them and they do not use handcuffs again. The challenge arises when we do need to use handcuffs when we take the young person off campus. Previously, all young people who went off campus had handcuffs. We have changed that practice based on the assessment of risk. If a young person is out on permitted absence - going out for the day with family and so on - and if he is due in court two weeks later I do not expect to see that young man going to court in handcuffs.

However, the challenge is the risks associated with that because if he runs away, I will be asked what I was doing to prevent him from running away. Handcuffs are rarely used on campus and only in exceptional circumstances.

There is a significant challenge on the campus regarding records. This is a historical issue and when I say we are nearly there, I mean there have been different practices around recording as people did not record or see the need to do so. We try to explain to people that the more they record, the better, because records provide us with insight, information and accountability. Record keeping is improving substantially.

On single separation, every morning one of my deputy directors visits each of the units and asks which young persons are in single separation, why they are there and what is being done. They then check the position and records are also checked. Rather than leaving this to managers in units and members of the staff team, we have brought this up a level. We have decided to change practice and improve awareness of what is being done. We challenge staff by asking why Tommy is still in his room and has not been moved on and what is the story with him. This is challenging for everybody because if Tommy is moved on and something goes wrong an hour later, we will have moved him too soon and before he was ready to be independent or make decisions. These are the risks and challenges we face daily. Everybody is different and the important issue for me is that we look at the individual rather than a routine piece.

The issue of cultural needs was raised. The number of young people on campus who come from a Traveller background is significant. Many of the young people who come in do not want to be identified as being from a Traveller background. When they get to the point of mobility and going off campus they are involved in projects outside the campus that are focused on their background. There is a challenge around bringing people into the campus and how one designs particular programmes. What we do in this regard is around placement planning. Any professional and any link that is known to the young person in question becomes part of his planning process. The young persons attends meetings to find out what they can do and deliver and, where he or she is moving home or into the community, what is the contact. The work of Youth Advocate Programmes Ireland, YAP, and Le Chéile involves identifying and matching particular supports in the community with young people on the campus. This considers ethnic background and links. We want to try to maintain this. We have looked at what mentors are best suited for families and children. This is an ongoing development.

Will Mr. Bergin elaborate on his policy on last resort? To his knowledge, what has been the longest period of single separation?

Mr. Pat Bergin

Part of the challenge I have is around how single separation is recorded. If a young person is separated from his peer group all day, that is determined to be a period of ten hours. The young person is on his own at night and starts again the following day. We have changed this so that the young person will not automatically go into single separation the following day. If he or she did not manage well the previous day and had a good night's sleep, it will not automatically mean he or she will be placed in single separation the following day. We have been breaking this down and reducing it. One could have a young person in single separation for eight or nine days. That has been the history and we are trying to change that by asking how we can get the young person to go out to the yard to exercise and to do so safely.

To put this in context, some young people will not want to mix with Tommy because he is not managing well. One is then in a scenario where Tommy, who is not managing well, needs to mix with the rest of the group. This has been a challenge. It has also been an interesting challenge for some young people who are managing well and decide they do not want to be tied up with a particular person. That is our problem and one we must overcome.

The HIQA report stated that an appropriate level of staffing was in place, which is to be commended. It also stated that an additional 23 staff would be required if the campus were to operate at full capacity. Is the facility constantly recruiting staff and what type of recruitment campaigns is it running?

Mr. Pat Bergin

For every unit, there are 15 residential care staff and we have an excess of staff to run the current number of units. We are starting the process of recruiting more care staff on the basis of our staff turnover, as people age or move on. For every residential unit we will open, we will have the relevant number of staff. We currently have a licence which means the numbers are capped at 48 boys and six girls. We have not yet reached that cap and when we do I can refuse. However, I want to be prepared for the possibility of an expansion. We hope to start another recruitment campaign before Christmas or in early January.

We are also in a promotional process for staff whereby we will create a team leader post to allow staff to have a level of engagement in decision making. We hope this will change the dynamics for staff in terms of how they contribute, do business and support managers. It will give them the possibility of acquiring more experience. We hope to roll this out in early January.

Professor Ursula Kilkelly

I will say a few words about the single separation issue. We are finally reaching the issues that really matter in Oberstown. We have clearly had a very difficult couple of years. This has been part of the change process and the amalgamation of the schools as well as the very tedious but also very important operational development.

Single separation has been on the board's agenda since I joined. Over the years, we have had no data, poor data and data that nobody could make sense of or understand. We are finally at the point where we can understand what is going on. We finally have proper, effective and timely visibility of the data and what is happening to young people in the context of single separation in particular. This has been greatly aided by two things. Deputy Lisa Chamber referred to the first of these, namely, the confidence, competence and ability of staff to work within this framework and, aided by a new revised policy on single separation, separating out the procedure from the policy. It is now very clear what procedure needs to be followed. As the director stated, earlier this year, a new enhanced approval mechanism was introduced which interrogates and questions the use of separation all the time in a challenging and different way. Coupled with this, an information technology system has been introduced which makes recording absolutely essential because it will send alerts and times. These electronic methods of recording will not only give us better data but will also give us much better visibility and governance around what is, for everybody, an unacceptable practice that cannot and should not ever be used outside of our policies and procedures.

That is where the priority is in bringing visibility to the issue and driving down the numbers in the safest and most effective way possible in line with the rights and interests of young people. What we do not want to see are other practices compensating for one that is now being accepted as restrictive. The board's position earlier this year was to make very clear that it considers these three different types of intervention serious and last resort interventions and wants to see and track a fall in the number of times they are used. This is to make clear to management, staff and everybody that this is our position, lest it is not clear. However, we have to work within the framework.

If I may, I will make one further point on communication, which has been an Achilles heel or weak point within the campus and externally. It is an issue we have invested in and worked hard on for the past year. We have a new communications and engagement plan that is about better communication with staff as part of the whole process of building morale and providing the support staff need.

Part of the new strategy involves documenting the participation of young people in decisions about them. It involves raising the profile of that issue, communicating externally and engaging with people in order to be accountable for what we do. That is just to put the matter in a broader context.

I was hoping that the witnesses would come before us today with a very clear, metric-driven response to each of the points which were raised in the HIQA report. These points are addressed in quite general terms in the witnesses' statement, but I was hoping that we would be able to go through the six standards with which there was moderate non-compliance, for instance, and that the witnesses would lay out a very clear timeline as to what actions were being taken to address that non-compliance and when they would be completed. I would also like the witnesses to address the two standards with which there was major non-compliance. I am hopeful that the witnesses can come back to us with a very clear, definitive action plan as to when those actions will be completed.

I will start with something which is a little bit outside of what has gone before. There was a major incident on the campus in August 2016. There was a fire. The dates of the announced inspections in the HIQA report range from 27 March to 30 March. In that report it is stated that there was moderate non-compliance in respect of standard 9 - premises, safety and security. For instance, "Staff were found to have inconsistent responses with regard to the procedure to be followed in the event of a fire." The report identifies that doors were of varying sizes and, in respect of national standards, "Appropriate annual inspection and testing certificates were not available to demonstrate that the emergency lighting system was in compliance with the appropriate standard." Notwithstanding the positivity of what the witnesses have presented to the committee regarding deconstruction of some of the cultural, staff and managerial practices and the fact that they are engaged in a process to try to rectify many of these issues, by any fair analysis there is a long way to go if there was a fire in August 2016 and in March 2017, a good number of months later, HIQA was still identifying deficiencies in respect of something as simple as fire safety. That is the first point the witnesses might address.

The second point relates to the recent High Court judgment against Oberstown in which the judge clearly stated that there was a limited breach - and I emphasise the word "limited" - of constitutional rights in respect of deprivation of physical exercise; loss of contact with families; lack of procedural safeguards relating to the imposition of separate and associated deprivations, particularly the formal written recording of decisions; and regarding imposition of the separation regime. As I understand it, and I would like the witnesses' perspective, this case was taken by four people. It related to a specific incident or incidents which took place in August 2016. Is Oberstown Children Detention Campus still breaching the constitutional rights of citizens - children and young adults - in respect of separation and associated deprivations, particularly in respect of the formal written recording of decisions? Is it still breaching these rights or has it rectified the matter in the intervening period? I am not a lawyer, but the HIQA report of March 2017 would clearly suggest that there was major non-compliance in respect of standard 2 and that "Some children spent long periods of time in single separation and the reasons for this were not always clearly recorded." I suggest that, notwithstanding the positivity in the witnesses' embracing of cultural and managerial change in a real and meaningful way, the witnesses still have not dealt with these issues satisfactorily. These are simple issues which can be dealt with without expenditure of major resources and within a short timeframe. When will the witnesses satisfy the committee, the Minister, and the users and staff of this service that this will be rectified?

I urge the witnesses to be cautious in their response.

For the record, in respect of the witnesses being cautious in their response, the High Court judgment is a matter of public record.

Professor Ursula Kilkelly

I will start on that matter. Obviously, as the Deputy has said, the case arose out of events subsequent to the fire and the other incident on campus in 2017. In the judgment handed down by Ms Justice Ní Raifeartaigh on Monday we saw a very careful consideration of all the circumstances which arose in the case taken by four young people. It is very important for the record that there is that kind of accountability and that these people were able to access and take those proceedings. That is very significant. This is clearly one measure of accountability. It will take us some time to go through the judgment and assess its implications as it is nearly 100 pages long. Certainly, our preliminary reading of the judgment, which has been limited as we have been dealing with other matters in recent days, suggests that the learning contained within it coheres with the HIQA report. The concerns are primarily that the usage of separation is, to a limited degree as the Deputy pointed out, a breach of rights in the very specific context of the judgment. The issue of recording is also important in the judgment and is repeatedly mentioned in the HIQA report. We have already addressed this to some extent in changing the practice around recording, we now record as much of the substantive issue as possible.

Is the witness saying the issue has been addressed?

Professor Ursula Kilkelly

We have outlined the specific steps we have taken to drill down into this issue. I have to disagree with the Deputy, it is not at all a simple issue. That is not to ignore the efforts we are making to ensure that absolute priority is given to recording.

The principle is simple.

Professor Ursula Kilkelly

I completely agree that the principle is simple. That was the essence of the statement which the board made in the last couple of months. It made that very clear. We will be going through the implications of the judgment in a very detailed way. I can absolutely guarantee that every lesson to be learnt from it will be learnt. If additional measures and steps need to be taken when we have considered the judgment in full, they will also be part of our process. On a preliminary reading, my sense is that the judgment is highlighting issues which we already know about and which contributed to the conclusions of the HIQA report, particularly around recording. Those conclusions have led to various steps which have been taken over the last six to nine months, on top of others.

Mr. Pat Bergin

I will just return to the first point the Deputy made about having a comprehensive plan in respect of the findings of the HIQA report. That plan exists and has been published. It is available to everybody. On the inspection, while the inspection was in March, the report was issued to us in June and we reverted to HIQA with an action plan in July.

It accepted the action plan and all the works we intended to undertake. It published the report in August. In the past four weeks, it sought a follow-up to the action plan and we have provided that. It wrote back to us on 7 November to seek clarification on one or two documents we had referenced. That information will be provided to HIQA in the next week or two. I expect that HIQA will come on site to inspect and monitor. That is part of the inspection element of the matter. The action plan will identify what has been completed and what the timelines are. I suppose this is specific to the points the Deputy is making. In each case, the action plan will map out what action is being undertaken and when it will be completed, if it has not already been completed. I will bring that to the Deputy's attention.

I thank Mr. Bergin.

Mr. Pat Bergin

I am not entirely sure whether the points made by the Deputy are that simple. If they were simple, I would be happy to move them on. These things are quite complicated in practice. There are many variables in day-to-day practice that have to be considered.

I am happy to help Mr. Bergin to understand where I am coming from.

Mr. Pat Bergin

Okay.

How many reviews of Oberstown have been carried out over the years? How many reviews have there been in the past five years, for example? I will accept an approximate figure.

Mr. Pat Bergin

I understand that the period of time on which all the reviews of Oberstown have concentrated has been the past year. They were instigated-----

I apologise for interrupting. I asked a very specific question. How many reviews have taken place?

Mr. Pat Bergin

There have been five reviews.

Okay. That has been over a period of a year. I would say that by any operational standard, if five reviews were carried out internally or externally it would set off some kind of signal or alarm to the effect that action needs to be taken in a short timeframe.

Mr. Pat Bergin

It is important to bear in mind that the five reviews cover specific elements. They are not all reviews of Oberstown per se; they are reviews of elements of Oberstown. For example, we had a health and safety review and a behaviour management review. It is important to stress that the reviews were targeted to enable the experts who know best to advise us on them. The Deputy also asked about issues relating to doors. There are doors arriving today. It has taken us a long time to get doors that meet the appropriate fire standards, etc. It has been complicated because of the nature of the campus. We need to make sure our doors are fire-compliant and fit for security purposes. These are ongoing issues. While it might seem simple to get a door for a room, it is not quite as simple when consideration is given to the complexities that are part and parcel of what we are doing. Progress is being made with all of these matters. Some of them have been closed off. Some of them are still in motion. My job is to make sure the facility is safe, its standards are high and everybody, including myself, is held to account in the context of what we are supposed to be doing.

I have a final question. Is the management structure flat or hierarchical? Are there any comparable management structures in the public sector? Does it mirror the structure in the Prison Service, the Civil Service or the public service? Is it the case that there is a director and a deputy director with a management team underneath them?

Mr. Pat Bergin

There is one director. I have four deputy directors - one on the residential side, one for care, one for risk and safety and one for general operations. I have a human resources manager who looks after recruitment and a logistics manager who looks after day-to-day administration.

Mr. Bergin did not answer Deputy Neville's question about the number of agency staff.

Mr. Pat Bergin

There are four agency staff members on campus.

What is the turnover of staff?

Mr. Pat Bergin

The turnover of residential care staff is quite small in percentage terms. They usually leave for reasons of early retirement. Some staff decide to finish up on the basis of age. Some staff are now leaving to take up other opportunities. The turnover would be low.

Okay. I would like to ask about the culture in Oberstown.

This needs to be the Deputy's final question.

Yes. I thank the Chairman for his forbearance. I am very grateful. Can an individual employee feel comfortable in addressing an issue that he or she might have directly to Mr. Bergin, or is there a line of command through which such a person has to go?

Mr. Pat Bergin

There is a line of command. There has to be a line of command because there are 265 staff working on the campus.

Mr. Pat Bergin

The care staff are normally in groups of 15. Each group has a manager who, in turn, has his or her own manager at deputy director level. The capacity for people to raise issues within that structure is key. Otherwise, I will have 265 staff ringing me and I cannot manage that. However, I operate on the basis of an open door principle. This applies to young people and staff. If someone wants to speak to me, he or she can do so.

That might seem obvious, but it is a very important point for us in terms of our understanding.

Mr. Pat Bergin

Absolutely.

Professor Ursula Kilkelly

The board is a very unusual body in so far as nominees from three Departments are represented on it, as are representatives of staff and the neighbouring community. In addition, five people are appointed to the board through the Public Appointments Service process. This is done with particular reference to expertise in governance, finance, risk and human resources matters. There is a focus on young people as part of that. While it is an unusual body, in some respects, it provides an interesting and diverse range of perspectives on issues. Robust discussions take place within the board and when management personnel are being held to account on various issues. During the great deal of work that has been done to date, it has been found that this structure is working really well. At this point, it is enabling us to focus on the matters that are at the heart of what we are doing. Our governance structure has made very good progress in that respect. It is paying dividends. Even though our board might be unusual in its composition, its diverse perspectives and voices are important because they facilitate communication with staff, the neighbouring community, the relevant Departments and other stakeholders. I think that is an important point.

I will allow Deputy Rabbitte to ask a final question.

My question, which arises from the HIQA report, touches on Oberstown's relationship with the OPW. Does Oberstown have the funding it needs to get the building to a standard that means it is functional and workable for management, staff and children? We have heard that the doors are now coming, over a year after the date on which they should have arrived. What kind of progress is being made by those in charge of Oberstown as they contend with the challenges associated with the building that was left to them?

Mr. Pat Bergin

We are getting there. The building presents its own challenges. People's behaviour raises challenges in the building. We have been in the process of outsourcing facility management. We have experts, but I am mindful that we do not have all the expertise on the campus to cover everything.

Mr. Pat Bergin

The idea is to get people who know what to do in to work for us. That has been a significant achievement. We are working with the OPW and the Department. The situation in Oberstown is unusual. We are trying to balance security and care.

Mr. Pat Bergin

That has been a challenge. We have ongoing conversations and engagement with the OPW and the Department. Those relationships are important to us. We believe we are reaching the point where the changes to the buildings and the remedial works should be completed fairly quickly.

All right. The one thing that struck me the day I visited was the sound in the units.

Mr. Pat Bergin

It has been sorted.

I was not aware of the sound issues. They must have been sorted by the time I visited.

Professor Ursula Kilkelly

Sound has been an issue.

Mr. Pat Bergin

The acoustics were quite interesting as a result of the design of the buildings.

I see. On behalf of the committee, I thank Professor Kilkelly and Mr. Bergin for their presentation, for their patience and for dealing with members' questions in such a comprehensive manner.

The joint committee adjourned at 12.50 p.m. until 9.30 a.m. on Wednesday, 22 November 2017.