Oireachtas Joint and Select Committees

Wednesday, 21 June 2017

Joint Oireachtas Committee on Children and Youth Affairs

Foster Care Services: Discussion (Resumed)

9:00 am

Mr. Fred McBride:

By way of introduction and context, I thought it would be useful to give an indication of the volume of business that Tusla - the Child and Family Agency - deals with. In 2016, Tusla received over 47,000 referrals. Only 43% of these proceeded to initial assessment following preliminary inquiries. This highlights that a large amount of social work activity is occurring in screening and initially assessing cases that do not always require ongoing social work intervention. However, many of these cases may require access to lower-level family support services. The latter are sometimes led by our own services in Tusla and sometimes by other relevant agencies and supported by Tusla. A key objective for Tusla is to ensure children and families receive the right service at the right time and in the right measure and that we maintain statutory social work input only for those children who require that level of intervention. Later, I will discuss Tusla’s recently developed child protection and welfare strategy that will underpin this work and also our plans to introduce risk-sophisticated practice in the way we intervene in people’s lives.

Regarding the provision of foster care services, there were in total 6,300 children and young people in care at the end of the first quarter of 2017. Of these, 92% were in foster care with both general and relative carers. This means that each of those 5,819 children and young persons who, for one reason or another, cannot live at home is being cared for in a family setting, often by their own extended family and within their own community setting, with all of the associated benefits of educational continuity, access to their friends and regular social activities and so on. Ireland's performance in this area compares extremely favourably with that of jurisdictions such as England, for example, where only 75% of children in care are in family settings. The figure for Northern Ireland is 80%.

As the committee will be aware, Tusla was established in 2014 following a recommendation made by the task force. It was established on the back of some 29 inquiries and reviews and 551 recommendations contained therein. We always endeavour to be open and transparent if we make mistakes, and we do make mistakes. We are not dealing with an exact science. A number of cases have recently been the subject of media attention - a matter to which I will return later - but there is evidence that children are now safer as a result of the establishment of Tusla. I will set out some of the evidence for that.

We have established a child protection notification system, this is known in some jurisdictions as a child protection register, which contains information about children who may be at risk. This means that members of An Garda Síochána, emergency hospital staff and out-of-hours GPs who have concerns about children presenting to them have access to information on vulnerable children and families. They will have information about what category they are registered in - whether it is neglect or abuse - and they will also have information regarding whether the child was previously on the notifications system.

Since the establishment of Tusla, we have reduced the number of unallocated cases by almost 30% and those in the category of high priority have reduced by 70%. All of those children and young persons who have had their cases managed and who have now been allocated a social worker or referred on to appropriate services are safer. These reductions are in the context of a significant increase in the number of referrals. Between March 2016 and March 2017, there was an increase in the number of referrals of approximately 35%. That fluctuates throughout the year. The average increase of referrals during the year to March 2017 was in the region of 10%, but there was a very significant increase in the first quarter.

Last year we introduced and amended our special care processes and ensured enhanced governance of the special care services, including an ongoing reduction in the number of children approved and awaiting special care intervention. When I first came here, typically a dozen people were waiting for special care and the High Court was becoming very frustrated with that situation. As of today, there are no children waiting for special care in Ireland. Those who require special care beds get them when they need them. We have extended coverage of our emergency out-of-hours service and we believe this will enhance the safety of those children and young persons presenting outside core office hours.

During 2016 there was an increase of approximately 51% in the number of early years services inspected by Tusla. These services were inspected by Tusla to ensure compliance with early years services regulations and to enhance safety of children who attend them.

Close to 4,000 children accessed and were supported by our educational welfare service. We hope they have been assured better outcomes as a result of our interventions. Over 24,214 children and nearly 17,000 families received family support services in 2016. This work is part of Tusla’s prevention, partnership and family support work. Hopefully, it prevents children having to enter the care system and provides the supports required to maintain them safely in their own homes, schools and communities.

I will comment on the national approach to practice. I do not deny that gaining consistency of approach across the country has been a challenge. One of the things we are trying to do as part of what has been the most comprehensive reform of child protection and early intervention ever taken in Ireland is the launch of the State's first child protection and welfare strategy. I will not go into all the details but the signs of safety approach to practice is intended to be in place by the fourth quarter of this year. It is an innovative, strengths-based, safety-organised approach to child protection casework grounded in partnership and collaboration with children, families and their wider networks of support. It is quite a significant change from what was perhaps a rather paternalistic way in which the State would provide services and interventions to families as though it always had the answers. This approach is very much based on helping families to come up with their own solutions in conjunction with professionals support. It is very much about giving power, control and choice, wherever that can be given to families in order to maintain their dignity when we have to intervene in private family life. All the qualitative and quantitative evaluation and research and the administrative data from jurisdictions around the world that have implemented this signs of safety approach consistently indicate the following outcomes: families feel more empowered and are able to understand and address the concerns of child protection authorities to keep children safe; the number of children removed from families reduces relative to the numbers who are helped to build safety around the children at home; and, importantly, practitioners report greater job satisfaction due to the clarity of the approach, the usefulness of the tools and the impact for the children and families and professionals spending more time in direct, face-to-face work with children and families, which is what they were trained to do.

As I mentioned earlier, it is about risk-sophisticated practice. Tusla operates in an environment of uncertainty. It is often uncertain about what has happened to the child and the impact this has had on the child. It is also uncertain what will happen when we intervene to try to protect them. We also operate in an environment of risk and risk management and when things go wrong are unforeseen or could not have been prevented or predicted, of course an emotional response is provoked among the public. We understand that and have to take account of that. As part of our reform programme, we hope to work with our key partners to develop risk-sophisticated practice and help to define the agency’s and the State's risk appetite. Through this work we hope our Departmental colleagues, our politicians, our partner agencies and our regulators to engage with us to ensure a collective understanding of what an intelligent response to risk management looks like.

We have no problem in being held accountable but we need to move away from the any notion that risk management means risk eradication. There will always be children at risk.

We need to change the rather unrealistic expectation that all children will be safe all of the time. We need to move away from a blame culture that resulted in defensive practices where people start to hide behind processes and procedures for fear of making a mistake. That does not lead to intelligent interventions and protection of children. It also creates recruitment and retention difficulties as well. While my staff and I accept accountability, we should be judged by reasonable standards and not blamed because hindsight has a distorting effect and makes it seem obvious later that a child was in danger. Furthermore, if we collaborate in risk sophistication with those who make referrals to our service then perhaps we can start to address the more than 27,000 referrals received each year that are screened out of our service, all of which need time and the associated capacity and resources to be checked and screened.

In terms of foster care in Ireland, as many as 92% of all children in care live within a family setting and compares favourably with other jurisdictions. I acknowledge at the outset my respect and admiration to foster carers who open their homes, families and lives. Some of them dedicate their entire adult lives to caring other people's children. As in other jurisdictions, foster carers are the backbone of our child protection and child in care system.

The provision of foster care is part of a continuum of services provided to children and young persons. Tusla strives to adhere to the national standards for foster care that were developed in 2003. Given that it is now 2017, I contend that the standards require to be updated at this juncture. There are particular challenges in delivering foster care, some of which have been highlighted during HIQA inspections. I shall outline two particular challenges. First, allegations that are made against foster carers, which are quite tricky situations to deal with. The other challenge that HIQA highlighted was the assessment of relative carers.

On the first challenge, Tusla is developing a clear national policy to deal with allegations against carers in order to have a consistent approach across the country. We are also developing a shortened assessment for relative carers. We do not believe necessarily that relative carers need to go through the full assessment process that general carers must undergo because relative carers are looking after their blood relative. We think a differential approach is required in terms of the assessment of relative carers and we are beginning to put that in place.

Keeping children in their local communities is a challenge. Sometimes moving a child to a relative means he or she must be moved to another community. Such a move sometimes results in discontinuity in education and social networks and so on. These are difficult judgments to make but we try to do so in the best interest of the children.

In respect of private foster care, the committee asked a number of other questions that we have answered. Suffice to say that foster care provided by private agencies is governed by the same range of legislation, standards and regulations as statutory care. In Ireland, 6% or 384 children in foster care are placed with private providers. There are a range of factors that give rise to private placements, only one of which is the availability of foster carers. When placing a child or young person in a private placement, consideration is given to the level of support required by the child. It is often the case that in complex cases, additional levels of therapeutic support are required that are not always available directly from the State. Furthermore, private providers often have the capacity to provide 24-hour helpline support to their carers, respite services and additional therapeutic services. It is worth noting that 10% of the 384 placements in private care are separated children seeking asylum, while another proportion of them are young people over 18 years of age who Tusla continues to support and there are some children with a disability who require specialist care.

Earlier I mentioned services out-of-hours. Since November 2015, we have established an emergency out-of-hours service. I wish to clarify that there have been dedicated out-of-hours teams in the greater Dublin area and Cork for a number of years but the rest of the country was not covered. Since November 2015 Tusla has provided an on-call service that covers the rest of the country. It is available to An Garda Síochána in order to provide specialist guidance, advice and information should the Garda request when it seeks to invoke section 12 of the Child Care Act, which is an emergency intervention.

Inter-agency collaboration is the cornerstone of Tusla's child protection work. It includes collaboration with doctors, teachers, public health nurses, An Garda Síochána, mental health services, disability services and so on. I would like members of the committee to note that I am personally on record as calling for a duty to co-operate clause in terms of a review of the 1991 legislation. I want agencies to be duty bound to co-operate with one another. I mean not just referring matters to Tusla but to stay involved and be part of the support plan for children and families. A duty to co-operate clause is not uncommon in other jurisdictions.

With respect to liaising with An Garda Síochána specifically, at a local level there is regular liaising between Tusla staff and the force in terms of discussing individual cases. At a national level there are quarterly liaison meetings between Tusla officials and senior gardaí. As a result of this work, a joint working protocol on arrangements during office hours and out of hours is being finalised in line with the new Children First guidance. Ultimately, we plan to have joint child protection teams across Tusla and the Garda and again, such teams are evident in other jurisdictions. We are currently assigning senior managers to work closely with the Garda to help develop proposals in this regard.

Tusla works with other State agencies and our partners in the voluntary sector to keep older teenagers out of residential care. Many of them are in private residential care where the outcomes are not always good. We try to provide intensive flexible support into the evenings and weekends in order to keep them connected with their homes, schools and communities.

Members have asked questions about recruitment and retention so I shall briefly comment on both aspects. For the first quarter of 2017 we have begun to recruit social workers at a much faster rate than we are losing them. I shall give some specific data and numbers, if requested. The retention of staff remains a challenge. Tusla must compete for social workers with the Health Service Executive, the private sector, hospitals, and the probation, community and voluntary sectors because, unfortunately, there are only so many graduates per year.

As someone who has managed services in all of the care groups, I can state that child protection social work is by far and away one of the most challenging roles for a social worker. We are examining creative ways to recruit graduates from our own universities, as well as from other jurisdictions. We are also in discussions with the Department of Children and Youth Affairs to scope creative ways of recruiting and retaining social workers, including examining terms and conditions and the rolling out of senior practitioner status to keep experienced workers in front-line practice.

Media coverage is particularly challenging for Tusla. For confidentiality reasons Tusla cannot go into details about individual cases and sometimes that gives rise to stories in the media that lack context. Tusla needs to stop simply saying that it does not comment on individual cases because I think it is not particularly helpful to the media, the public or politicians. We cannot comment on the detail of individual cases but I think, much more, we will have to get into giving general messages about the circumstances in which children find themselves and the decisions we make about these circumstances without necessarily going into details about an individual case.

As I have said already, Tusla has been criticised for leaving children in a placement or at home and sometimes we have criticised for removing them from home. It is extremely important to realise that there are no risk free decisions.

Removing a child from home or a foster placement can inevitably cause significant trauma and loss. Therefore, the need to protect children needs to be carefully balanced with the loss they may experience by removal. There was a particular case where two foster children were in the same placement, one allegedly harming the other. It is not a reasonable proposition at all to protect one child by damaging another. We have a responsibility to both children and their needs and best interests need to be balanced. There are extremely complex and difficult judgment calls around these kinds of issues.

There has also been some commentary in respect of children returning home following their removal by the Garda under section 12, which provides for emergency interventions. It is important to understand that a range of factors contributes to a decision about whether a child can be safely returned home. A significant proportion of these children, approximately 60%, are in the 15 to 18 years age bracket and often present with complex behaviours, including addiction and mental health issues. It is not always safe for these young people to be placed in a foster home or even a residential home. Sometimes, immediate medical treatment is required. However, returning a child or young person home, once the crisis has been dealt with, can be an extremely positive outcome. We want children to return home where it is safe for them to do so. As an interim exercise, the chief operations officer conducted between January and May 2017 an audit of section 12 cases where Tusla had become involved in the follow up. We can report that in the particular county in question, there were 14 occasions where An Garda Síochána invoked section 12. In all of those cases, we provided very robust social work support and follow up, even where the children were returned home. We do not just return children home or see that they have returned and forget about it. We follow that up with intensive support.

I have alluded to the Shannon report once or twice throughout my statement. I confirm that the report was commissioned by An Garda Síochána for An Garda Síochána and that no member of Tusla staff was interviewed as part of its production. However, I also confirm that the findings of the report, when completed, were discussed with Tusla. Tusla has requested An Garda Síochána to provide identifying details, if possible, for all of the cases where section 12 was invoked in order that we can follow up and make a judgment as to whether the way we followed up in those cases was appropriate and satisfactory. We have offered to do that.

I thank the committee for inviting myself and my colleagues to appear in front of it today. Hopefully, it has provided some clarity and context to the work that we do, specifically around foster care and associated issues. We are, of course, happy to answer any questions.