HSE Child Protection and Welfare Service in Carlow/Kilkenny - hiqa.ie

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Inspection of the HSE Child Protection and Welfare Service in Carlow/Kilkenny Local Health Area in theHSE South RegionHealth Information and Quality Authorityreviews which identified the need to develop new protection plans including theinitiation of care proceedings to maintain children’s safety. The formal review processof child protection plans as outlined in the Children First (2011) was at an early stageof implementation in the LHA. It was not possible to determine if the review processfocused on the risks and safety of children. However, the review case conferenceswhich the inspectors attended provided evidence that the risks and safety to childrenwere considered.During the reviews, the case conference chair set time frames for interventions to becarried out and identified persons responsible for them. At one review, the meetingdecided that some direct work with a parent was to take place and time frames andpersons responsible were agreed. In another review, supports were put in place forchildren to attend counselling and after-school projects. Inspectors observed theattendees considering and agreeing the need to secure supervision orders under theChild Care Act 1991 at the child protection case conference review.There was no evidence of a robust system or agreed criteria to close cases based onthe outcome for children. Inspectors observed a CPNMT meeting, and also reviewedminutes of previous meetings, where new notifications were considered. Inspectorsidentified that there was no agreement reached as to when cases open to the CPNSwere to be reviewed.Standard 2:8 – Child protection and welfare interventions achieve the bestoutcomes for the childThis standard was met in partSome parents believed that their children’s lives had improved following involvementwith the service. Inspectors met with two families who outlined the involvement ofthe social work department and challenges they experienced. The parents informedinspectors that the intervention of the social workers had improved the lives of theirchildren. One set of parents described how they had not been able to care safely fortheir children. They said that some of the children were placed in the care of the HSEand others placed with relatives. They highlighted the process they went through toaddress their own needs and how the children were reunited with them. Anotherfamily described their ongoing challenges in addressing mental health issues and therole of the social worker in supporting the family to stay together safely whileaddressing the issues.On the other hand, parents also told inspectors of difficulties they experienced withthe social work department and they believed that their children’s lives had notalways improved following involvement with the service. They said that on occasionsthey could not tell social workers about their own problems and difficulties as theywere worried that this would be seen as a threat to the safety of their children. Theytold inspectors of specific concerns they had that access meetings with their childrenwould be cancelled.28
Inspection of the HSE Child Protection and Welfare Service in Carlow/Kilkenny Local Health Area in theHSE South RegionHealth Information and Quality AuthoritySome children interviewed said that they had achieved good outcomes followingchild protection and welfare interventions. They said that they saw the role of thesocial worker as important in their lives. Inspectors were told by one child thatwithout the involvement of the social worker s/he would not have been able toattend secondary school and prepare for third-level education.Inspectors found the LHA were unable to provide information about trends or thepattern of the outcomes resulting from interventions. The community and voluntarygroup services in the LHA provided positive examples of supports in place forchildren and families. However, there was no systematic review to assess theeffectiveness of these or any other interventions for children and families. As aconsequence, the inspectors found no clear evidence base for decision making inorder to attain best outcomes for children.There was no robust system in place to consistently consider and respond, asappropriate, to changes in the level of risk to children or where there was a lack ofprogress with interventions. Inspectors observed core meetings where increasinglevels of risk to the child were considered by the multidisciplinary group and plansamended. Inspectors also saw some evidence in case files viewed where decisionswere reviewed by social workers and team leaders which resulted in changes to thefamily support or child welfare plans. However, this was not in line with Children First(2011) as there was no evidence of inter-agency involvement when consideringchanges to these plans. Some representative of community and voluntary groupstold inspectors that they would often hear retrospectively that cases with which theywere involved had been closed by the social work department.Standard 2:9 – Inter-agency and inter-professional cooperation supportsand promotes the protection and welfare of childrenThis standard was met in partThere were some procedures for inter-agency and or inter-professional cooperation.Children First (2011) was cited by social workers to inspectors as the guidingprocedure for agencies and professionals in their engagement with the social workdepartment which promoted the best interest of children. Inspectors found there wasa process in place for ongoing engagement between the area manager, the actingprincipal social worker and An Garda Síochána to discuss children missing from careand instances where there were risks to children. There were formal meetings heldquarterly between An Garda Síochána and the LHA to discuss these issues.Social workers and social work team leaders told inspectors that there were goodinter-agency and inter-professional partnerships, but inspectors found that clearprocedures needed to be established to support good effective working relationships.Local general practitioners, school principals and medical consultants played asignificant role in the ongoing screening and assessments by social workers of29
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