Mr. Pat Bergin:

Remand and committal cases are separated. This means that young people on remand are accommodated in units 1 and 2, which are in the old buildings in Trinity House, while committal children are maintained in the other part of the campus. We have more or less separated them. From time to time we may mix in individual circumstances because children might know each other or because there are historical factors but in the main the children are separated. With regard to the GP service, we have one GP who comes on site on Monday, Wednesday and Friday from 9 a.m. until 1 p.m. That GP does some routine work and also looks at admissions and discharges, thus providing a medical service to any child on the campus at that stage. The GP may link in with other GPs to look for or to pass on information. They also work with the nurses on this. Our nurses are not available 24 hours a day. We have looked to develop access to a medical service on campus from 8 a.m. until 9 p.m., seven days a week. If medical services are required in the meantime, we fall back on D-Doc, seek access to hospital services or whatever may be required. It would not be appropriate for us to have nursing on site 24 hours a day: this would just not be practicable. We originally looked and had posts for four nurses. There are significant challenges, however, in getting four nurses so we currently have three full-time nurses along with a social care worker who can dispense medication, has advanced first aid training and is also involved with further medical bits and pieces. This is so as to ensure that we have a robust service in place.

The Deputy also asked for clarification over the morale of staff and I hope that morale is a lot better now than it was this time last year.

I am starting a round of town hall meetings with staff to get some feedback and to communicate. Generally, my sense is that morale has improved. There is still a long way to go but we are going in the right direction. The engagement between staff, the young people and the management has improved substantially. That is my general sense and hopefully I will not be corrected on that.

On the psychological services, I shall give the committee a sense of the services. Today is Wednesday and this morning the full assessment consultation therapy service, ACTS, meeting started at 9.30 a.m. to review cases for all children on the campus. At that meeting there is the ACTS team, the psychiatric services through Professor Harry Kennedy, our care staff and one of my deputy directors. We review cases with regard to new admissions, who has arrived and what is the plan. Assessments are then undertaken. Professor Harry Kennedy's ACTS team will go on site to the units and engage directly with the young people. If there is particular piece of work or advice they can give to care staff to continue some of the sessions outside the clinical sessions this is part and parcel of the approach.

Single separation is not acceptable. Terminology, structure and sentences are important. I do not know the case that HIQA referenced. I do not know if it related to other cases that have been referenced in other forums that relate to last September. The issue of single separation may be about someone in their bedroom. The issue of no light may mean being out in the yard or being taken out of the unit. The scenarios that would arise may have to do with fear and around removing someone; they may be a threat to staff or they may not be engaging. The ongoing conversation that staff have with a young person may not have got the young person to the point where they can do A, B or C to return and the young person may not be willing to meet certain expectations. This could be for a number of different reasons. A young person may still have drugs on them and we cannot get the drugs off them. They can hide drugs in many different places and they can continue to take drugs. Until we are assured that there is some level of engagement, the scenario is that this young person would be maintained in a particular environment until it is safe to move them.

This is probably one of our biggest challenges around risk. It is one thing to engage with a young person who is reasonable and who can hear what we are saying. If, however, we have a young person who is on a substance - and we do not know what it is - then it can be very difficult to get them to co-operate and engage. If they were out of their bedroom, out in the corridor or the yard, and they refused to engage we would then have a situation where we may have to restrain them. If we restrain a person who is on drugs we then have an issue over whether we could actually contribute to other physical concerns. It is a judgment. We have put in place a measure where there is a check undertaken every day for which lads are on single separation. This is done by the deputy director and it looks at who is in single separation, what is the plan, how long have they been out, what is the next step. It is now a daily audit rather than at the end of the week or the month. We get the figures on that basis and this is how we manage and measure to ensure young people are not maintained in single separation for long periods of time. We also look at alternative approaches. Is there somebody else who can engage with that young person? Is there a solicitor or family coming to visit and what can we do to actually move the goalposts?

We have a girl with us until tomorrow. Girls come every so often for a week or two while they are remanded by the courts. We have not had any girl on committal for a long time. They are usually on remand for a week or two. We get notice of two hours to let us know a court has decided that this young person who is a girl is to be remanded. Girls have a unit on their own. Our most recent girl was in the school with the lads and attending one of the classes with two or three boys. The teachers managed that and it was appropriate. That is the nature of the service we provide. In one sense it is positive that we do not have lots of girls there but the law says that if a young girl is remanded we must take her and mind her appropriately. I am aware of concerns expressed previously about this but I am very focused that the CEHOP framework - care, education, health, offending behaviour and preparing for release - looks at individual young people's needs whether it is a boy or a girl and whether it is a vulnerable young person or not. The plan we have in place has to be around that particular young person rather than the gender issue. I would look at the needs of the girl who is coming in. The campus has had some complicated situations with young people of various genders and the plan has to be based around their needs rather than a gender issue.