Tuesday, July 16, 2024

HIQA’s Report Highlights Issues in Special Care Unit

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The Health Information and Quality Authority (HIQA) has published a detailed report on Coovagh House Special Care Unit, shedding light on several critical issues within the facility. HIQA conducts inspections based on the Health Act 2007 (Care and Welfare of Children in Special Care Units) Regulations 2017 and the National Standards for Special Care Units. These standards apply to all special care units in Ireland, which are secure residential facilities for children aged 11 to 17. Courts place children in these units when their behavior poses significant risks to their life, health, safety, development, or welfare, deeming the placement essential for their care and protection.

HIQA conducted an unannounced inspection of Coovagh House Special Care Unit after receiving reports indicating escalating risks within the service. These reports included incidents of physical restraint that did not comply with the Child and Family Agency’s (Tusla’s) approved behavior management methods and the introduction of close protection personnel within the unit. The inspection assessed compliance with eight critical regulations, including positive behavior support, protection, governance and management, and risk management. The findings revealed that the registered provider was substantially compliant with three regulations but non-compliant with five, indicating significant areas for improvement.

Individual Care Programs Noted

During the inspection, it was noted that an individual program of care was in place for each child residing in the center. The records reviewed by inspectors were found to be appropriately detailed, up to date, and reflective of the children’s individual needs and circumstances. Additionally, children had access to the Assessment Consultation Therapy Service (ACTS), which provided tailored support to meet their specific care needs. Interviews with the children revealed their satisfaction with the care and support provided, highlighting positive aspects amidst the broader concerns.

There was a clearly defined management structure within the unit, outlining lines of authority and accountability. However, this structure was not being operated in accordance with the regulations, standards, or Tusla’s policies. The management systems in place were deemed inadequate, failing to ensure that the service was safe, consistent, and effectively monitored. The management of several serious incidents involving the use of close protection personnel did not align with the unit’s interim policy and procedure, raising significant concerns about the implementation of proper protocols.

Special Care

Inconsistent Safeguarding and Escalation Process

Child protection and safeguarding risks were not consistently identified during management reviews of serious incidents. The response to identified risks did not adequately consider safeguarding issues related to the use of unapproved behavior management techniques. These shortcomings underscored the necessity for a robust management approach to effectively address and mitigate risks, ensuring the safety and welfare of the children in care.

Due to the identification of significant risks, the service entered an escalation process following the inspection. Assurances were sought to ensure that adequate and sustained arrangements were implemented to improve and maintain compliance with the regulations. In response, the registered provider submitted a comprehensive compliance plan to address the deficits and risks identified during the inspection. This plan outlined specific measures to enhance the overall management and operational framework of the unit, aiming to align practices with the established standards and regulations.


Resource: Health Information and Quality Authority, June 28, 2024

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