Dáil Éireann Debate, Thursday - 4 July 2013
57. Deputy Jonathan O'Brien asked the Minister for Children and Youth Affairs the measures she will take to address the deficiencies in social work provision in Health Service Executive North Lee area; her plans to implement the recommendations arising from the Ombudsman for Children's Investigation of April 2013; and if she will make a statement on the matter. [32594/13]
View answerThe Ombudsman investigation arose from a complaint submitted by a social work staff member from the North Lee social work team which related to the level of referrals received by the duty team and the difficulties in responding to this, specifically referrals regarding child welfare and protection. A number of serious concerns were raised throughout the report and in its conclusions. The HSE was given an opportunity to respond to the Ombudsman’s report, and those responses are reflected throughout, including in the recommendations section. The HSE indicated they were firmly of the view that at no time either previously or currently has there been Immediate or Priority 1 cases left unattended to, and that at all times these cases are receiving a service and depending on their ranking will either receive a service within 24 hours or within 7 days. In relation to Priority 2 cases, HSE South advised that the necessary network checks are completed when there is capacity within the team to deal with same. At no time are these cases left unscreened as review has taken place by the Team Leader. In relation to screening of duty referrals the HSE advised the Ombudsman that all referrals received are recorded by a Social Worker, the intake record is completed and more clarifying information is sought if possible from the Garda, other HSE personnel/agencies or the referrer. Any case that warrants immediate attention is discussed immediately with the Team Leader or any on site manager. Overall, HSE National concluded that the area was aware and taking steps to address the issues raised. A decision was made to keep the area under review which occurs at senior management meetings with the National Director and Regional Managers. It should be noted that the level of social work service required will vary greatly, depending on the circumstances of each case, and this can put a high degree of pressure on the overall social work resource.
The Ombudsman made recommendations in respect of external audit, monitoring of referrals and review of unallocated cases, HSE procedure for management and assurance of child protection cases by file audit, clarification of child protection procedures, social work caseload, public accountability and recording of professional activity. HSE responses to these recommendations include:
- During the course of the Ombudsman investigation, the HIQA commenced its inspection of child protection services. The North Lee area fully co-operated with a targeted HIQA inspection, and a report of this inspection is awaited;
- A review of cases in North Lee is under way as recommended by the Ombudsman;
- Referral levels and resource capacity are to be reviewed on a monthly basis;
- A national audit of cases in social work services has commenced;
- Practice guidance has been clarified in the HSE’s Child Welfare and Protection Practice Handbook;
- The HSE is actively monitoring areas where there are growing caseloads and waiting lists in order that these areas can be supported;
- Progress continues to be made in respect of the National Childcare Information System going live next year.
More generally, reform of the social work service is an ongoing priority process within HSE Children and Families, and this will continue when the new Child and Family Agency is established. Work is under way to ensure that all areas work to a national policy on review of cases awaiting allocation. Where immediate actions are needed to safeguard a child the duty social work team provide the service. For instance where a child needs to come into care, or where an assessment is deemed a priority or a case conference is required, the duty social work team undertake this work. The HSE has rolled out the Standardised Business Process and is bedding it down across the 17 areas to make sure services are provided on the basis of a consistent assessment and categorisation of risk. The recently commenced inspection of child protection services by HIQA will assist in the identification of areas where improvement is required and in time will support safer systems for children at risk. It is important to note, as has been highlighted in other reports, the number of referrals in respect of welfare has increased substantially in recent years. What has also been highlighted is the challenge of understanding fully and responding to welfare concerns underneath which may lie more serious neglect issues. What is critical is the support of those reporting concerns to give as much information as is possible to ensure a 'complete' picture and to ensure that the persistence and ongoing nature of concerns is clear to the HSE. If this is highlighted quickly where necessary the child's case can be escalated to the appropriate level of priority. The new prioritisation system provides not only assignment to a priority category on intake of a referral, but a review of individual prioritisation by Principal Social Workers on an ongoing basis, as well as an overall assessment of numbers and levels of prioritisation across the area and across the country to ensure consistency of approach and to identify areas of high pressure. The Ombudsman for Children’s report is important, and once again a range of service delivery issues have been highlighted. Improvements to the social work services, and integration of these services with a range of other child and family services, continue to be a high priority for the CEO designate of the Child and Family Agency, Mr. Gordon Jeyes, and his senior management team.
