Excessive delays in a significant number of cases posed a risk to the delivery of a safe service to at-risk children in the child and family agency’s Cork area, the State’s healthcare watchdog has said.
In its inspection report of Tusla’s Cork service area, the Health Information and Quality Authority (Hiqa) found “poor” governance and management of cases awaiting allocation, with some preliminary inquiries taking up to two years to complete.
This resulted in “excessive delays in a significant number of cases”, Hiqa said.
Governance arrangements and structures were “ineffective” at providing assurance to the area manager and Tusla national office that the service delivered was safe, effective and timely.
The leadership, management and governance of the duty, intake and initial assessment service lacked clear direction and, while there was evidence of service improvement, further “significant improvements” were required.
There was a “lack of robust systems of oversight” in the service area, and risk management systems did not identify all significant risks to the service. Systems in place to review the quality of the service were “underdeveloped”, Hiqa said.
Of the seven standards assessed by Hiqa in Tusla’s Cork service area, two were found to be majorly non-compliant and five were moderately non-compliant.
Staff shortages
There was a “chronic shortage of staff” in some areas of the service, which managers said made it more difficult to make improvements. Staff were struggling with “unmanageable caseloads” and measures to address this were not effective, Hiqa said.
Despite the risks identified by the healthcare watchdog, inspectors did find some areas of good practice.
“Immediate action was taken to protect children and subsequent work by social workers with children and families had a positive outcome for the children in terms of their protection,” Hiqa said.
Safety plans reviewed by inspectors were also of good quality, the report said.
In response to the report published on Thursday, a statement from Tusla said the inspection of its child protection and welfare services in Cork showed there were “improvements needed” in the operation of its services to make sure they were consistently operating at a high standard.
“Following liaison with Hiqa, in order to address the areas highlighted for improvement we submitted service improvement plans, and a compliance plan, which were accepted by Hiqa and are now complete,” Tusla said.
Clare Murphy, Tusla south region service director, said that while there were "positives to take away from the experiences of the children and families we work with" and the dedication of staff throughout the pandemic, it was "clear that progress in the area has not been quick enough".
The service “was not meeting the high standards expected,” Ms Murphy said.
“We have had regular liaison with Hiqa and have set out clear and timely remedies, many of which have been completed since the inspection in April. Two main aspects of remedying the situation are the establishment of an area governance group with oversight of the development and implementation of the areas service improvement initiative, and the recruitment of two additional team leaders.”