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 Authoritycommunication technology.Overall, the management team was not learning from issues arising at a nationallevel. Minutes of other staff and management team meetings were reviewed and ononly one occasion did the minutes reflect discussion about national recommendationsor findings from the regulatory body’s reports in other regions. Minutes showed thatthe area manager had requested the management team to review the Report of theIndependent Child Death Review Group (Shannon and Gibbons, 2012). There was noevidence of changes in service delivery as a result of their review of this report.There was no evidence to show that an effective process was in place to assimilatenew policies into practice and it was not clear how this was to be done.Standard 3:2 – Children receive a child protection and welfare service,which has effective leadership, governance, and managementarrangements with clear lines of accountabilityThis standard was not met.Leadership and governance arrangements were found not to have been sufficientlyrobust. Systems were not in place to ensure that all children received help andprotection when they required it. When children required statutory intervention,inspectors found that the response was not always sufficient to address the risks andneeds identified. Not all children and young people had been sufficiently wellprotected when they had needed help and support. Inspectors found thatweaknesses were present in the delivery of front-line safeguarding services, but alsoin other parts of the service. As a consequence, these shortfalls in practice gave riseto concerns about the leadership and management within the LHA, particularly asthese practice issues had not been identified prior to the inspection taking place.These failures in managerial oversight meant that poor practice was neitheridentified nor challenged and led to children potentially experiencing ongoing risk ofserious harm.The LHA was undergoing significant changes to its management structure. Somesenior managers demonstrated an understanding of their roles and responsibilitiesand how they contributed to the overall delivery of service. However, the lines ofauthority and accountability at individual, team and department level were not clear.Inspectors found, through interviews and the review of team and managementmeeting minutes, that staff were uncertain about their role and level of responsibilityand problem areas that should have been managed at a local level were escalated tothe senior management team on a regular basis for a solution. Minutes of meetingsdid not reflect clear actions, the person responsible for carrying out those actionsand agreed timelines for completion. Inspectors found that certain areas of workwere of poor quality and these issues had not been addressed by the relevantmanagers. Some systems were not sufficiently embedded in the work of the LHA andthis was acknowledged by managers.34
Inspection of the HSE Child Protection and Welfare Service in Carlow/Kilkenny Local Health Area in theHSE South RegionHealth Information and Quality AuthorityThe LHA provided the Authority with a document which outlined the purpose of thechildren and family service, including the service’s basis in legislation. However, it didnot describe how the service protected children and promoted their welfare or theservice’s objectives, its models of service delivery and the aligned resourcesnecessary to protect children and promote their welfare.Nationally, the 2012 service plan identified a number of priorities for children andfamily services including:• promoting the major culture change required in planning and deliveringservices to children and their families• implementing consistent child protection procedures in line with the revisedChildren First national guidelines (2011).• continuing the reforms necessary to provide a comprehensive range of highquality services for children in care• improving effective multidisciplinary shared practice and efficient communityengagement.The area manager advised inspectors that the primary focus for the local operationalplan was to support the implementation of the comprehensive national changeprogramme which had consolidated all the reform initiatives arising from recentreviews into a coordinated change programme. The LHA had committed to a numberof priorities for 2012 including:• implementing child protection procedures in line with the revised Children Firstnational guidelines (2011)• implementing phase 2 of the standardised business processes.At the time of the inspection neither of these had been fully implemented. It wasunclear how the service was monitored and evaluated against strategic objectives orwho was held to account for them.Performance management and quality assurance processes were inadequate. Therewas a significant amount of information available to front line managers and socialworkers, but it had not been used systematically to drive improvement and gain acomprehensive understanding of the demand for services. The dataset submitted aspart of the inspection process identified risks in relation to a number of stages of thechild protection and welfare reporting process. This information was already availablein the LHA but had not been used to bring about improvements in the service,especially at the intake phase of the process.Auditing of social work practice took place infrequently. Audits were not completed toan adequate standard and there was a lack of findings, analysis and actions agreedto ensure that case work was of a good standard. The audits did not inform serviceimprovement or aid social workers’ development and practice. The LHA had beenincluded in an audit of 40 case files at a regional level. The audit looked at a number35
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