HIQA inspection of Ballydowd Special Care Unit
Commenting on the findings of HIQA’s inspection of Ballydowd Special Care Unit*, Fred McBride, Chief Operations Officer, Tusla – Child and Family Agency said: “Tusla accepts that on occasion when faced with intense and sustained pressure from challenging and violent behaviour, the processes underpinning the use of single separation were not adequate. Tusla regrets this and is currently taking steps to strengthen its decision making procedures and facilities.”
“When considering the use of single separation, the key challenge for Tusla is balancing the dignity and rights of the young person concerned with our legislative duty of care toward that young person and that of other young people in the unit, as well as our staff who work in increasingly difficult circumstances.
“All young people in single separation have access to toilet and washing facilities. However, the reports references instances where this was not possible. Access was restricted when a risk assessment determined they were unsafe due to indications of self-harm. On another occasion a viewing panel had to remain closed due to an unacceptable health and safety risk to staff and other young people.
“Tusla is currently in the process of developing a specially designed single occupancy facility at Ballydowd which will be better equipped to deal with extreme challenging behaviour and which will in turn reduce the need for single separation.
“In relation to processes, an improved governance system has been rolled out across all centres which includes a ‘real time’ decision notification and approval system, managed by a Service Director. A new national information system is also in testing which will facilitate the identification of demand and risk in real time and management responses to same.
“Supported by the new National Information System, the Agency is currently commissioning research on managing challenging behavour to explore and better understand a noted upsurge in challenging behaviour, specifically violent and high-risk behaviour that is presenting amongst young people in Tusla’s care. This research will also examine the models of care the Agency might need to employ to meet that challenge. On foot of the findings, Tusla will work collaboratively to develop an effective and appropriate interagency response with colleagues in An Garda Síochána, HSE Mental Health and other services to ensure the needs of young people who present with challenging behaviour can be met now and into the future.
“Tusla is expanding special care from 17 to 30 beds over over a two year period, 2015-2017. This will build upon the existing special care model and enhance capacity in order to meet increasingly complex needs and behaviours. This includes using some of the additional capacity to help young people step down from special care in a more managed way and to ensure that their stay in special care is as short as possible.”
*Special care is an exceptional intervention requiring a legal order from the High Court restricting the liberty of a young person. Evidence must demonstrate that the behaviour of the young person is such that it poses a real substantial risk of harm to his or her life, health, safety, development or welfare unless placed in special care.
Within Special care, single separation is used as a measure of last resort, where a risk assessment indicates that a young person needs to be in safe locked space, or safe room, as they pose a risk to themselves and others.
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Aoife Greene 087 6348373