Ms Caroline Walker-Strong:

I thank the committee for the opportunity to speak today on behalf of the Irish Association of Social Workers, IASW. The IASW has more than 1,800 members and represents social workers working in all areas of social work across the country. Social work is the lead profession in adult safeguarding in Ireland and our expertise was recognised as such in the Law Reform Commission's regulatory framework for adult safeguarding. I am here to highlight our key recommendations regarding adult safeguarding in Ireland, drawing on the professional expertise of front-line professionals and the evidence base from recent inquiries, reviews and high-profile cases. I would like to introduce my colleagues and members of the IASW: Dr. Sarah Donnelly, associate professor at the school of social policy, social work and social justice in UCD; and Mr. Liam Keogh, social worker in disability services.

The IASW acknowledges the Department of Health’s ongoing consultation with us. In particular, we fully support the landmark report of the Law Reform Commission on adult safeguarding. We also welcome the introduction of a chief social worker position in the HSE and support the development of that role, with its specific focus on adult safeguarding.

Regarding decongregation and rights-focused care services, prevention is better than cure and that is particularly true in adult safeguarding. We caution that neither regulation nor safeguarding is a magic wand. It is our position that adults are safest when they live full, rich lives with autonomy and choice in their own communities, with care delivered through accountable, public services. Ireland has accelerated the sale of both home care and residential care in recent years to the private sector. Dr. Nicholas O'Neill, a postdoctoral researcher in DCU, has set out international evidence showing the association between the private sector care model and poorer outcomes for residents. This should serve as a wake-up call to Ireland.

Despite commitments made during Covid by our Government to downsize and decongregate large nursing homes, we continue to see planning approval for large-scale privately run nursing homes, often built on the outskirts of towns. Older people enter nursing homes and rarely return to participate in community life. They are never again seen in their local restaurants, at their GAA club, or at the local library. Why? In other jurisdictions, the connections between residents and their local communities are nurtured. Their rights within their new homes are better understood and residents form part of the interview panels for recruiting staff, or teach on staff induction programmes, and have resident councils. In Ireland, it was disappointing but unsurprising to note that following the recent "RTÉ Investigates" programme, many people and voices were featured in print and broadcast media, yet nobody interviewed a single nursing home resident to ask their views. Residents and people receiving care are the true experts, yet they are often silenced and invisible. This is why the known sexual abuse of people with disabilities was tolerated by the system in the Brandon case, and why the women with dementia who tried to tell staff that they had been sexually assaulted were ignored in the Emily case. Residents are too often seen solely as recipients of care, rather than adults with rights. We recognise individual homes are providing good care, but life is about much more than receiving good care. We have to ask ourselves this: who among us would like to age into our current care model?

In the UK, the Care Act 2014 enshrines the rights of people who need care and support. We need a similar social care Act in Ireland which recognises and responds to the rights of people with care needs. Too often, social workers identify risks to adults, but cannot implement a safety plan as the person may have no right to access social care resources, like a bed, transport or home care support. This can result in their premature and otherwise avoidable entry to long-term care.

I must stress that the IASW agrees with the Law Reform Commission that the current system for adult safeguarding is not fit for purpose. It is fragmented, inconsistently applied, and leaves too many adults at risk of serious and often preventable harm. In other words, with the right legislation, better social policies, structures and services, social workers could work with adults at risk of abuse far more effectively. This will increase their sense of safety and well-being to live the life we all want to live as adults, a life free from abuse.

We repeat our calls for the introduction of a comprehensive regulatory framework for adult safeguarding as proposed by the Law Reform Commission. This body has provided crystal-clear evidence of an informed roadmap for the Government. We need no further deliberations or consultation; action is now urgently required. It is vital that this regulatory framework includes, as the LRC recommends, the introduction of mandatory reporting. We have a two-tier system in Ireland, where employees are mandated to report child protection concerns, but not adult protection concerns. This sends an unintentional but clear message from the State to wider society that the abuse and neglect of adults is less serious. We saw this in practice in the Brandon case, when staff observed the repeated sexual assault of people with disabilities and did not report, when staff listened to women with dementia who tried to disclose sexual abuse and did not act and again, when the abuse and neglect of residents in "RTÉ Investigates" was unreported by staff. The IASW supports mandatory reporting which will ensure staff report abuse and neglect of adults at risk of harm in particular circumstances. This includes when abuse and neglect occurs in a care setting. We need a system that fully utilises best clinical knowledge and experience and applies appropriate and proportionate responses to reporting. The IASW calls for mandatory reporting in specific circumstances and we are happy to clarify this further in this session.

The IASW supports the Law Reform Commission's calls for effective interagency cooperation, which is practically non-existent in front-line services at present and this is hampering HIQA, safeguarding and protection social workers, gardaí and other professional groups from sharing information and working collaboratively in cases involving the abuse and neglect of adults. It is fair to say there is consensus across the safeguarding sector that the establishment of an independent safeguarding authority with oversight of safeguarding activity in all organisations is essential.

It is on the public record that in the Brandon case, the Emily case and the Grace case, professional expert social work advice was ignored by HSE management. We need a new system that ensures that staff with genuine safeguarding concerns, working within the HSE and other organisations, have a clear pathway to expert, independent safeguarding oversight. This will deliver more transparent and robust safeguarding intervention. We can never again have a case, like the Emily case and the Grace case, where expert social work guidance is ignored and overruled by less qualified HSE managers.

We call for improved engagements between regulation and safeguarding. HIQA plays a key and vital role as a systems regulator. It is not designed to handle individual safeguarding investigations. These require specialised, clinical expertise, particularly from trained, registered social workers. This is often poorly understood by Government. We call on HIQA to publish transparent information each year on the number of referrals it makes to adult safeguarding and protection teams and to the Garda. We call for a memorandum of understanding between HIQA, the HSE and the Garda with regard to the identification and reporting of abuse and neglect of adults. We fully support proposed HIQA regulation of safeguarding and protection teams, and recommend HIQA is resourced for any training it may require to carry out this vital work We also echo the call for an urgent review of regional inconsistencies in social work safeguarding practice. People in one part of the country should not receive a different standard of support and protection from those in another.

We call for a reform of safeguarding review processes. We are concerned about inconsistent quality and transparency of safeguarding reviews carried out across agencies, many of which are run by private unregulated operators. Many reports remain unavailable to the victims. We support the expansion of the national independent review panel, NIRP, which is a safeguarding review body staffed by qualified safeguarding experts. NIRP should carry out fully published reviews in all organisations, including section 38 and 39 organisations. We cannot overstate the trauma experienced by victims and families when poor quality reviews are conducted and then not published.

We call for the regulation of advocacy services. While independent advocacy is a vital part of adult safeguarding, social workers are increasingly concerned by the number of unregulated advocates with no recognised qualification engaging in adult safeguarding work. There is currently no agreed training or qualification for advocates despite the highly skilled and sensitive work with which they are tasked. While advocacy is vital, it must be safe and professional. When advocates intervene in complex safeguarding scenarios without adequate training, it could lead to poor outcomes.

We are calling for the formal regulation and accreditation of independent advocates; defined training and scope of practice, particularly in safeguarding contexts; and a temporary pause on the expansion of advocacy services until these safeguards are in place. Finally, we call for effective evaluation of how safeguarding works in Ireland, as was most recently highlighted in "RTÉ Investigates". Victims and families often share their frustrations in attempting to access quality safeguarding services. We need to research these experiences and understand how to implement meaningful, helpful measures of safeguarding activity to ensure quality services are delivered.

Gaps in adult safeguarding protections are not just policy issues; it is a moral imperative. Every day that reform is delayed, adults are left vulnerable to neglect, abuse and systemic failure. Ireland has the chance now to build a safeguarding system that is rights-based, responsive and, above all, effective. We urge the committee to take decisive action to support the calls we have outlined today. The IASW stands ready to support this important reform. I thank the members for inviting us to the committee today. We are happy to answer members' questions.