Oireachtas Joint and Select Committees

Tuesday, 10 May 2022

Joint Committee On Children, Equality, Disability, Integration And Youth

Foster Care Issues and the Loss of Positive Care Services: Engagement with Tusla

Photo of Kathleen FunchionKathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I welcome representatives of Tusla to our engagement on the challenges facing foster carers, general foster care issues and the loss of services provided by Positive Care.

We are joined from Tusla by Mr. Bernard Gloster, chief executive; Ms Kate Duggan, national director of services and integration; Mr. Pat Smyth, national director of finance and corporate services; Dr. Anthony O'Leary, director of quality and regulation; Mr. Ger Brophy, chief social worker; and Ms Niamh Doody, business manager. They are all welcome to the meeting. It is great to have them here in person. The last few times Mr. Gloster has been before the committee it has been in virtual meetings due to Covid-19. It is great to have him back in person.

We are encouraging people to wear masks apart from when they are speaking. I ask for people to be respectful of others' physical space. I also advise anyone who is joining us online through Microsoft Teams that the chat function is only to be used if there is a need to tell us about any technical issues or urgent matters that may arise. It should not be used to make general comments or statements during the meeting.

Witnesses who are participating from the committee room are reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in such a way as to make him, her or it identifiable, or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity. Therefore, if their statements are potentially defamatory in relation to an identifiable person or entity, they will be directed to discontinue their remarks. It is imperative they comply with any such direction.

I remind members of the constitutional requirement that members must be physically present within the confines of the Leinster House complex in order to participate in public meetings. I will not permit members to participate where they are not adhering to this constitutional requirement. Therefore, any member who attempts to participate from outside the precincts will be asked to leave the meeting. In this regard, I ask members partaking via Microsoft Teams that prior to making a contribution to the meeting, they confirm they are on the grounds of the Leinster House campus.

I note that in his opening statement, Mr. Gloster has advised he would like to briefly update the committee on a few key activities of the agency. I have no issue with him briefing members. However, I advise our members when putting questions to the witnesses that they keep to the agenda items under consideration. If members are of the opinion we need to examine some of the other activities performed by Tusla, we can arrange a follow-up meeting. I invite Mr. Gloster to deliver his opening statement.

Mr. Bernard Gloster:

I thank the Chair and members of the committee for the invitation to appear before them. I am joined by my colleagues, who have already been introduced by the Chair.

Prior to addressing the two specific matters raised in the committee's invitation, I would like to briefly update the committee on a few key activities for the agency, although by no means all of them.

The agency will shortly publish the annual report in respect of 2021. In a year that saw the continued impact of the pandemic and the added major challenge of the cyberattack, the agency continued to provide increasing levels of services and responsiveness across a range of statutory functions. There were 73,069 referrals to our child protection and welfare service alone, which was a 5% increase on the figures for 2020. That is but one of several indicators of not only the demand for our services but also the complexity of the lives of many children and families. Our full activity report for 2021 will be available shortly and will, of course, be briefed to the committee.

The agency is well advanced in its three-pillar change programme regarding its practice, culture and structure. While there is no doubt there are many complex issues, historical and contemporaneous, to be responded to, there are also clear signs of steady and continuous improvements on several issues against the backdrop of the heightened concern of 2018 and 2019. The agency has had, since February, a new national management structure and six new regions, modelled broadly on the Sláintecare analysis. Each new region with its own chief officer will by the summer be established with significant devolved authority and responsibility to be achieved incrementally at local level. This will substantially improve the governance of the agency creating the right conditions within which many issues can be tackled.

Following discussion in 2020 and at the start of 2021, a sub-committee of the board of Tusla commissioned the executive to produce a plan for residential childcare. This area of care is not only extremely complex with an increasing demand but it is also resource intensive and the board required a plan to set out the approach for the coming years. I will refer to this later as it is directly relevant to the committee's invitation today.

The agency has a long-standing role in respect of separated children seeking international protection and many of those young people are in our care or supported in an aftercare context. Children presenting at the ports from war-torn countries, such as Somalia and Afghanistan, as well as those arriving through structured international programmes, are now an integral part of our work. The situation in Ukraine has seen an exponential growth in demand for these services and by 4 May, we had received 128 referrals resulting in 70 care admissions, with 50 remaining in care, from Ukraine alone. The agency also has dedicated resources linking all Tusla protection and support services available in each local authority area to the local inter-agency responses. We are working closely with our line Department and the Department of An Taoiseach to make the best possible contribution to the State response in what is a traumatic time for so many Ukrainian children and families. I am aware there has been reportage of an issue unfolding in respect of a large number of people arriving at Dublin Airport today. I will not be in a position to comment until I receive more information on that issue. I only heard about it as I was coming into the committee room.

The agency continued to function as an essential service throughout the phases of Covid-19. While there were many challenges working in this environment and maintaining a workforce, I record my thanks to all the staff of Tusla and our funded partners for ensuring the safety and support of so many over an unprecedented and demanding two years. The agency now has in place a proactive blended working policy and many new ways of working adopted during the restrictions on movement, although not all of them, have been adapted and used for future responses to need.

The agency is making solid progress on permanently securing its own ICT infrastructure and I anticipate by the autumn that we will be 90% independent and have our own security system of the latest standards in place. We are also this year developing a complete new replacement for the national childcare information system, NCIS, and this will make us unique internationally in having such an up-to-date national case management system for child protection and other critical services. As previously reported, there was data theft during the cyberattack which we are currently assessing and I anticipate that in the next few weeks we will communicate publicly our plans for appropriately and privately notifying individual people whose sensitive data were compromised.

Early years registration has been a concern of this committee for a number of years.The end of 2022 will see the next three-year cycle of registration for the majority of some 4,000 providers of these services. Our regulation service will this year, with the support of the Minister and the Department, ensure a slimmer and more user-friendly process which will be publicised in June, six months ahead of the registration date, giving providers the maximum time to achieve their continued approval.

The committee will be aware of the agency position on adoption legislation from the pre-legislative scrutiny stage in 2021. In anticipation of the final stages to commencement of the legislation, we have advanced planning and significant additional resources in recruitment to respond to this new context.

Turning to the matters raised in the committee's invitation to today's meeting, I want to make the following opening remarks. I will speak first to challenges facing foster carers and general foster care issues. The committee will be aware from my previous appearances of the significant role played by foster care in the overall response to children who, for a variety of reasons, cannot live at their own home for a period or indeed for all of childhood. Ireland is an international leader with a prevalence of alternative care placements being at more than 90% for foster care. It is equally the case that maintaining this has proved difficult in recent times. Tusla had 4,039 foster carers on the approved panel at the end of 2021, down from 4,324 in 2018. The proportion of this in the private sector offering is 542, having grown only by 39 in the same period, and this is very satisfactory from a dependency perspective.

An indication of the in-year growth and loss rate of foster carers overall is in the context of 281 new approvals in 2021 and 208 cessations, leaving a net increase of just over 70. Tusla has targeted an improvement plan for foster care for the next three to five years which will be concluded in June. We have just completed the plan for residential care and in the autumn, we will conclude the third part, which is aftercare. Significant direct engagement has taken place with foster carers to listen to their experiences, issues and suggestions. Responding to many challenges, the next phase of improvement will focus on changes that will lead to continued improvement of foster care for children by also improving the support mechanisms for foster carers.

The agency is concerned that if we cannot maintain the high level of foster care as a model in the overall alternative care system, the outcomes for children will deteriorate and the attractiveness of fostering as an option will not keep pace with demand. Foster carers have reported satisfaction with our assessment process, the training provided and the role of the link worker. However, they have also described some of the key challenges they face, including turnover of social workers, difficulty accessing therapeutic services for children in their care, poor communication, delays in permanency planning, and failure to increase allowances in line with inflation. The Minister specifically raised foster carer improvements with the agency at a recent engagement and is anxious to support those improvements. I look forward to finalising and advancing these plans in the coming months.

I will move to the loss of services provided by Positive Care. Tusla has engaged in an updated procurement process since 2021 that is aimed at further ensuring the quality and appropriateness of private provision, both in residential and foster care. The purpose of the exercise is much more focused on quality, staffing and other compliances of service providers than it is on a competitive pricing process. I am aware of recent narrative, particularly since February of this year, on one private provider, Positive Care Ireland, PCI, which was unsuccessful in the third attempt at a rolling process. Tusla does not control either the external narrative or the commercial decisions of private companies, and some of the commentary has been concerning and created, more than once, a level of instability for children in the care of the provider and its many fine staff. The latest position advised to us by the company as of 5 May is its intention regarding the potential sale of its business and that it is at an advanced stage of same. However, should this materialise or not, it is and remains the position of Tusla that the least disruption possible to the children and to those caring for them is our sole objective.

I assure the committee that I am satisfied that all the processes that have been and continue to be utilised are appropriate and necessary. I further want to make it clear to the committee that there is no prejudiced view towards this individual provider being in or remaining in the market. The company is fully aware of the exact requirements it needs to fulfil to comply with a new contract from the current procurement process. It is a matter for it or any new commercial arrangement it makes to ensure it fulfils those requirements. I am more than satisfied that what has been required of it is neither unreasonable nor different from any other provider in the procurement process. In the final analysis of any such situation, and as I have previously advised another committee of the Oireachtas, there is a role for private provision across many parts of health and social care. However, if a service fails or ceases, the State ultimately must step in to do whatever is necessary to minimise the impact. This is not unique to children’s residential care. It is our hope the services currently provided by PCI will continue regardless of the provider, but always and only within the prescribed rules of such a sensitive service.

This scenario is one that arises in the wider debate about private provision in residential child care. I have previously indicated the concern of the agency that our level of dependency, rather than the existence of private provision, is a problem. At present we operate at a public to private ratio of approximately 40:60, that is to say, 40% public and 60% private. As I mentioned earlier in my statement, the board of Tusla requested a plan for the coming years and has recently approved a plan for residential care. In the plan, we aim to address the dependency to an achievable rather than an aspirational level, and we have targeted a 50:50 split in three years with desired reversal of the 40:60 split in five years. This will be achieved through increasing public provision as distinct from any intentional erosion of existing private provision, which has an important role. This is an important clarification considering some of the narrative that there is a correlation between this plan and decisions by the agency regarding PCI. I assure the committee this is not the case.

It is a fact that demand for residential care is likely to increase, regardless of any successes achieved in foster care. Therefore, to respond to this demand, increased public provision alongside existing levels of private provision will achieve the rebalance. The decisions of private enterprise to exit or enter the market are secondary to this. To demonstrate the detail of this plan, I am attaching for the committee a copy of the approved plan which we are working towards. It is my intention after this committee meeting to publish the plan on the Tusla website as chapter 1 of our alternative care improvement, noting, as mentioned earlier, that chapter 2 will be about foster care, and then chapter 3 will focus on aftercare where there are also many challenges to be addressed. All planned changes are based on the Tusla principle of the past two years, namely, continuous improvement.

I thank the Chair for the opportunity to make this opening statement and I am happy, as are my colleagues, to address any questions from members.

Photo of Kathleen FunchionKathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I remind members that this meeting is to discuss foster care and the private provider exiting the market. We want to start getting into the issue of foster care and children in care as a committee, so questions should be under those topics.

Photo of Patrick CostelloPatrick Costello (Dublin South Central, Green Party)
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I have a lot to say, so if I am to leave time for answers, I had better take a deep breath and speak quickly. Fostering is the backbone of our child protection system. We are lucky to have such high numbers of foster carers for children in care, as Mr. Gloster has pointed out. I have met excellent foster carers in my time, both in Tusla placements and in private placements. However, the system is struggling overall and I say that from personal experience of being that fostering link worker trying to find a placement and struggling to get it. We have seen in the childcare law reporting project a child who should have come into care but did not do so because there was no foster placement. The child had to come in later on an emergency basis because the safety plan put in place to manage what was at home was not good enough. There have been other cases and I know there are various legal actions in some of these cases that we will not necessarily talk about.

The system is struggling and we are barely above a replacement rate for foster carers when it comes to the national growth and loss number Mr. Gloster talked about. I am curious about the regional disparities. Are there some regions that are losing foster carers overall? There is a significant risk that there will be a collapse in foster caring because it is the backbone, it provides excellent care and we have seen, through the childcare law reporting project and others, what happens when it goes wrong.

I am concerned by the growth of private foster care. Before I get into it I want to differentiate between the individual carers, many of whom are excellent and whom I could not fault in any way, and the companies that have come into the marketplace. Even to use the word "marketplace" around children in care sticks in my throat a little. Private foster carers cost more - about three times as much as public ones. There is evidence from other jurisdictions to suggest private foster care company placements produce worse outcomes for young people. Let us look at out-of-area placements, young people who are placed a distance away from their local social work office. This involves greater levels of trauma, displacement, educational dropout and all these sorts of things. In the one area of Dublin and mid-Leinster, the percentage of private foster placements outside of the area is 84%, whereas in Tusla it is 18%. In Dublin north-east, 90% of private foster placements are out of the area compared with 20% of public placements. In the south east, 66% of private foster care placements are out of the area compared with 2% in Tusla. In the south west, 25% of private placements are out of the area versus 2.5% in public placements. In the west and north west, 14% of private placements are out of the area versus 3.5% of public placements. I seem to have forgotten the number for the midlands. That ends up not only having an impact on the child but also costing time for any social workers who have to visit this placement and child. Time is the most significant and precious resource the agency has and it is the most difficult one to hold.

There is a growth in foster care provision. There is private foster care provision that costs more in money and time. Both of those weaken the agency's ability to recruit and support its foster carers. This is the behaviour of a parasite weakening its host. All the while, these agencies are still making healthy profits at the end of it, and that steady growth in private foster care really concerns me.

That is especially so in view of the fact that foster care is the backbone of the child protection system.

We are here to talk about solutions. One thing I look at is kinship and relative care. It varies from region to region but about 20% to 30% are relative carers. In the Six Counties, it is the other way around. The vast majority of placements are with relatives. What are they doing differently? I appreciate that relative care brings complexity and is not simple, but what are they doing to tap into this resource and recruit carers that we are not doing?

I ask about in-house therapeutic supports for children in care and foster carers. The survey about foster carers has been mentioned and it refers to the difficulty accessing therapeutic supports. We know that from dealing with unmet needs on the committee, which we do a lot, but for children in care it is more complex, given the levels of trauma and the adverse childhood experiences that led them to be in care. In Dublin North-Central, excellent in-house therapeutic supports are provided. It is a flexible service, and it is mentioned in the programme for Government that it is an ambition to roll this out. This enables us to meet the needs the foster carers are crying out for. Many carers I have met said they would be slow to recommend fostering to their friends or anyone who asked. That is a terrible pity because as well as being the best placement for young people, they are our best recruiters.

Will the witnesses speak to the concern about the growth of private foster care? What is going on with kinship care and can we do it better? Will they speak on in-house therapeutic supports?

Mr. Bernard Gloster:

I am sure Deputy Costello will forgive me as I try to work my way through to find the questions. Many of his observations were suggestive of solutions and I do not disagree with the thrust of those observations. There are two or three points that I think are critical. First, I agree and have supported the view since I came to the agency that having 20% of our approved carers as relatives something we should continue to build on. It is difficult because it depends on the individual family and child circumstances but there is no slack on our side on that. We have focused on the link worker prioritised to relatives, particularly relatives who are unapproved in the early phase of a placement, to ensure the additional safeguarding and support systems are there.

I will let Ms Duggan address therapeutics but it is not only the time factor of the distance of out-of-area placements that is a concern. We are increasingly seeing concern in relation to foster care and private residential care that a child on a care placement, albeit important for their safety and well-being, is increasingly distanced from their network and community. That is a particular challenge on the private residential side and, for foster care, in the greater Dublin area.

We will have to make many improvements for foster carers in a short time. I have spoken with the Minister about that and he is committed to it. He is waiting for the final piece from us in terms of the plan. We had to try to deal with the residential first. I do not think anybody would dispute that. From the feedback we have got from foster carers, one of our biggest challenges is consistency in supporting Tulsa foster carers. No matter how good the rule set is, the interpretation of supporting them in Donegal will be different to Dingle but we are seeing increased consistency. This year, for the first time, we have made a decision about in-house therapeutics that I think the Deputy will find encouraging. It is not enough yet because we have to do it in step. I will ask Ms Duggan to talk about that.

I agree with the Deputy on the percentage of foster carers being the limit to which we should go because the dependency is small. I take on board his general concern. Family life and patterns have changed, as have many other things. I have no difficulty saying we have an out-of-hours social work team and even for very small children who might be considered easy to care for in an emergency, we increasingly find that, for Dublin emergency admissions, we have to go further and further. That concerns me and we will have to find a way to address that. As I said earlier, that probably rests in our ability to support foster carers in practical ways.

Ms Kate Duggan:

I share the Deputy's support of the therapeutic hub in Dublin North-Central. I, with my therapy background, support the need for Tusla to develop its own ìn-house therapeutic services. We have committed as part of our 2022 business plan to the establishment of therapeutic services. We are looking at having in place by the end of the year six therapeutic teams within Tusla. As the CEO stated, we need to do this incrementally in order that every new child coming into care will receive a trauma-informed multidisciplinary assessment which will inform their care plan. Our plan is to, incrementally over the next three years, replicate that in all 17 areas as they stand today. That will be overseen by a regional therapeutic co-ordinator who will be responsible not only for directing that service and the quality thereof, but also for more tightly governing how we commission private therapeutic services and how we engage with our community and voluntary partners around the provision of therapeutic services to children in care.

Mr. Bernard Gloster:

It will be the first time the agency will directly employ speech and language therapists and occupational therapists, along with the limited number of psychologists we have. The Deputy spoke about Dublin North-Central, and there is a variation in Waterford. There are variations in therapeutic definitions and we will not look to absolutely standardise that because there are different good examples around the country. We will look for basic standards to be met but have long since decided on the need to move on and have our own ìn-house therapeutic input. We have committed 15 posts to that this year alone and they are going into the recruitment process now.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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The standard response I get back to a parliamentary question is that Tusla is committed to ensuring all children and young people who can no longer live with their parents or guardians at a particular time are provided with a safe alternative care placing. I presume that includes foster care. Can the pressure on foster carers lead to the practice of placing children in hotel-like accommodation?

Mr. Bernard Gloster:

Yes. The Deputy has previously indicated concern to me. It would be of no benefit to the committee if I was not on the level with it. Pressure on care placements, both foster care and residential, leads to placement disruption and breakdown. That does not reflect on the people providing the care but on the context from which children come to us to present for care, including the level of trauma they have experienced and the level of influence in their lives. I will be careful not to engage in stereotyping because we have many children in care with good things going for them. However, many of them are now coming from a context where there are serious influences in the context of to addiction, crime and insidious forms of abuse. When they become safe, it inevitably leads to various expressions of that, which challenges their carers. Foster carers are telling us they need more support and, rather than saying we will give this or that for the sake of looking like we gave a support, we are focused in the coming weeks of ascertaining what is the best level of support we can give them and producing a plan to deliver it.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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There was no question on people involved in foster care. Like Deputy Costello, I take my hat off to them.

Fostering is a unique and humanistic approach to looking after people and needs to be welcomed.

Going back to the children who may be placed in bespoke residential settings, including hotels, are they children with more complex needs?

Mr. Bernard Gloster:

Yes.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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What supports do they get while they are in those bespoke residential settings?

Mr. Bernard Gloster:

I do not wish to overstate the term "bespoke" or to make it sound like something we consider adequate. We have some bespoke settings which are very much adequate and heavily resourced and, in fact, would cost more to run than private residential centres, so they are appropriate. We had roughly 127 people the last time I counted - the number varies between 120 and 150 - in bespoke arrangements. While many of those arrangements will prove to be quite good, we are now moving on to focus on those of the big private providers, having done the procurement. Within that there is a group of young people who require staff to be with them. Because we cannot ground them or connect them safely to any suitable care placement for any prolonged period, they often end up moving between a variety of settings, including hotels, over a period of months. As far as I am aware, Tusla never places a child in something like a hotel without appropriate staffing, oversight and supervision, but that does not make the arrangement appropriate.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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Absolutely. Is there an average length of time a child might find himself or herself in such a situation, or is it a question of how long is a piece of string?

Mr. Bernard Gloster:

I will ask the chief social worker to speak to that and to give an example of it, but it is a very variable set of circumstances. Does Mr. Brophy wish to come in on that?

Mr. Ger Brophy:

I thank the Deputy for the question. This varies greatly. We are concentrating on matching much more now, particularly with HIQA. We are conscious of a child's need in developing that. Some days, if we cannot find a matching placement, the child may be placed in a bespoke placement in the short term and we will match him or her in the longer term. Such children may not have significant needs. Some children, though, have very complex needs, as has been said, and for a variety of reasons our residential care providers will not be able to provide placements that match their needs so we provide bespoke placements for them. In many cases children aged 16 to 18 will age out and will be able to move on to more independent placements, so that is relatively short-term. Some of those children might be under the supervision of the High Court or other courts. A placement is provided but, generally speaking, it does not go beyond that. We make every effort to move them on to some of our own placements or standard residential placements. It may be a one-to-one placement as opposed to a placement that involves living with other young people, but we move them into those placements as soon as we possibly can. Generally, such situations do not go on long-term.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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For clarification and for the benefit of people who might be watching these proceedings, bespoke settings include apartments and holiday, chalet and hotel accommodation.

Mr. Ger Brophy:

Yes.

Mr. Bernard Gloster:

Essentially, they are non-conventional placements. I know that this is not where the Deputy is going, but in the context of having spoken earlier about private care, to be clear, in none of these arrangements is money an issue. That is just not the question. The question is the appropriateness of the placement versus the best possible option we can provide on a given day, given where the child finds himself or herself and where we find ourselves.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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I welcome that directly employing occupational therapists and speech and language therapists was mentioned a few minutes ago. That is a really positive move forward-----

Mr. Bernard Gloster:

I apologise to Deputy Costello. I know he is gone. I referred to 15 posts. The number for this year is actually 31.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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We have just increased the number by 100%. Brilliant stuff.

Mr. Bernard Gloster:

I will give the Deputy that.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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It was mentioned that one of the key challenges foster carers face is the difficulty in accessing therapeutic services for children. Does that include child and adolescent mental health services, CAMHS? There is a reason I ask that.

Mr. Bernard Gloster:

To be fair to my colleagues in the HSE and CAMHS and the many demands they face, they can speak to that themselves, but yes, of course, that does include CAMHS. There is little doubt about the increasing synergies now for children who require State intervention in their lives. That is not unique to Tusla or the HSE; it involves all of us together. There is no question but that CAMHS is a feature of that.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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In response to a parliamentary question I tabled, I was told that some children accessing CAMHS in south Kerry were also offered supports through Tusla. Parents have told me that social workers in Tusla often sit in on the consultations between the psychiatrist and the child. I have spoken to parents whose children were mistreated. I met those families in Tralee. They feel they were mistreated or the parents feel that their children were misdiagnosed. They told me they feel not only that CAMHS failed their children but also that Tusla let them down with this process. Were there any conversations between the HSE and Tusla about south Kerry and the Maskey report?

Ms Kate Duggan:

There has of course been direct contact between our regional chief officer for the south and the chief officer for the HSE. A number of children have been involved in that case. Certainly, where it has been appropriate, social workers from Tusla have accompanied those children who were in care on some of those visits.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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What role does Tusla carry out in that regard? I am unsure of that. When Tusla social workers go to meet psychiatrists, are they there to represent or to advocate for the child or to support the parent? What is their role?

Mr. Bernard Gloster:

To be fair to parents and families, I would not blame them for the confusion. CAMHS have their own social workers, but sometimes when people hear the term "social worker" they automatically assume he or she is a Tusla worker. There are a number of children who would have been known to or in the care of Tusla and who were also patients of CAMHS and, as part of the investigation and review, were being considered. The normal role of a Tusla social worker in such a context is to ensure that the CAMHS professionals have the social work assessment and social care profile of the child, as Tusla knows it, to assist in the CAMHS assessment.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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Without identifying any individual, of the 246 children mentioned in the Maskey report, were any under the care of Tusla?

Ms Kate Duggan:

Approximately 20 were.

Mr. Bernard Gloster:

Yes.

Ms Kate Duggan:

I can get the Deputy the exact figure if he needs it but it is around 20.

Mr. Bernard Gloster:

It is approximately 20. As the Deputy will know, in the Maskey report there is categorisation of potential harms, so they are in different-----

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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Absolutely.

Mr. Bernard Gloster:

Yes, there were children under the care of Tusla.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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I thank all the witnesses for coming before the committee. I think we all appreciate the incredible work that foster families offer to young people. It is an invaluable service that is often, I think, underappreciated. It happens quietly in communities all over Ireland, and it is important to acknowledge the work of those families and the difference they make in the lives of individuals as well as in reaching families themselves. As this is a public meeting, it is really important to highlight that. When I was a child I had a teenage foster sister. It was one of the best things that ever happened to our family.

In Mr. Gloster's opening statement he indicated concerns about the growth in the loss of foster carers overall, and Tusla's engagement with current foster families indicated some of the challenges in that regard. Will the witnesses elaborate on the challenges of delays in permanency planning and the failure to increase allowances in line with inflation? What are the difficulties around permanency planning and their impact? Should the committee seek for allowances to increase in line with inflation?

Mr. Gloster spoke about some of the practical ways to support foster families. What are they? He also highlighted difficulty in accessing therapeutic services for children. That is an intersectional issue because the waiting lists for assessments of need and therapies are absolutely disgraceful. He spoke a little about occupational therapy and speech and language therapy, but without the assessment of needs it is not possible to get those therapies. Will the witnesses give us an insight into how that is impacting the fostering system?

Finally, will the witnesses discuss the specific challenges around recruiting and retaining foster carers for children and adolescents and older children?

Mr. Bernard Gloster:

I will take the Deputy's contribution in a couple of bite-sized parts.

As for the allowance, I will ask our director of finance and corporate services, Mr. Smyth, to talk about the rate that is paid and when it was last changed or introduced. The rate is set by the Department in a regulation context. Tusla does not set the rate; it pays it. The Minister has asked me that question. To be upfront, it is our intention, in the context of our foster care improvement plan, to put forward an amendment to the foster care allowance that is provided to try to reflect more globally the modern-day demands involved in supporting a child in foster care. Maybe Mr. Smyth could clarify the rates.

Mr. Pat Smyth:

I can confirm that the rates were set in 2009. I think most foster carers would be aware of the period involved. There are two rates: one for under-12s of €325 a week and one for 13- to 18-year-olds of €352 a week.

There are some additional supports that can be brought in exceptional cases but they are the standard rates and they have not increased since then.

Mr. Bernard Gloster:

On the therapeutic side, I might ask Ms Duggan to explain this. The assessment of need is part of it, but therapeutic services come in two streams in the health service, namely, primary care, which is not associated with disability or assessment of need, and disability assessment of need. Ms Duggan, who was previously one of those therapists, might explain that better.

Ms Kate Duggan:

The assessment of need process is set out in legislation regarding the child's right to an assessment of his or her need and we understand there are delays in that process. An assessment of need is almost like an identification of need. The model we are putting forward is not an assessment of need under a legislative basis but rather where we meet a young child, with the foster or birth parents if required, necessary or appropriate, to assess where that child stands developmentally. From that, we look at designing a care plan and appropriate therapeutic supports to ensure that when the child is in care, all his or her needs are being met. It is not just physical and safety needs but also developmental needs, whether through motor skills or speech and language skills or psychological supports the child may require.

Mr. Bernard Gloster:

The other main part of the question related to the issues foster carers are raising with us, and I appreciate my opening statement did not expand on all the detail of that. I have met a group of foster parents who left me in doubt as to their view. Many of them correspond with me individually and we try to respond on an individual basis, but we have to try to change the system rather than just individualise the response. This year, Ms Duggan directly invited every foster carer in Ireland to come and talk to her in regional sessions. She might paraphrase what they have been telling us we would could do better.

Ms Kate Duggan:

As part of informing this plan the CEO referenced for foster care that we are finalising, we engaged not only with foster carers but also with various stakeholders such as academics and relevant departmental officials. Foster carers were very clear that they really believe in foster care as a placement option for children and can see the benefits of it. They were positive about our assessment process and the training provided, and where there was consistency with the social worker, they were very positive about their experience. The challenges very much related to the turnover of staff, an issue Mr. Gloster will speak to later in the context of recruitment and retention. Where there is a change in a young child's social worker, that causes disruption to both the child and the foster carer. There is also the lack of access to therapeutic supports we have just described. Moreover, if we are trying to promote and retain foster carers, the model of the different types of supports they need to sustain a placement is the key, especially if a child is having some significant difficulties. A further issue relates to the lack of a standardised approach to payments, which we have referenced.

Those engagements concluded in February and we immediately sent out some direction to the system, particularly regarding the payment of medical expenses associated with assessment, to ensure some clarity and consistency was brought to that. Foster carers also talked about not being adequately involved in care planning for the young people in their care and, again, that was inconsistent. In some areas it was more positive, while in others it was not. We are very committed to ensuring that will become a much more consistent approach to care planning such that foster carers will be seen as partners in care planning for the children.

We have talked about the fostering allowance. On permanency planning, it is very much foster carers' wish that where it is understood a child will be in care for a longer period, that be recognised early on and that we look to more permanency planning regarding a placement for the child. As will be seen in that plan, we are, as an agency, significantly looking to address our approach to permanency planning for all children and young people in our care.

Mr. Bernard Gloster:

I might add one other aspect to be of assistance to the Deputy. Foster carers individually have had experiences where they have felt we have not responded appropriately to the problem or the issue and that is where a complaint can arise. This is associated with the issue of safeguarding in foster care. We hear reports periodically from the sentencing courts where things have gone wrong. I might ask the chief social worker to address what we do about safeguarding in foster care. Conversely, foster carers sometimes experience that as not being supportive but, in fact, it is an essential part of it.

Mr. Ger Brophy:

We endeavour to support the carers in the first instance and to have an advocate with the carers, and our link worker is part of that process. We screen all those concerns through the intake, just as we would any concern that comes in. We try to take an independent and objective approach to the matter. Where concerns are founded and an investigation begins, they will form part of the new child abuse substantiation procedure we are introducing in June and have been part of an independent process up to now. That will be a new approach. The details will be clearly stated and there will be clear information for the carers as they go into the process. There will also be clear information for the children and it will be an independent investigation. It is important that while we are independent, we will support the carers as part of that, and we try to take that balanced approach.

Obviously, when we look at the complaints, they can be unfounded or founded. Where they are founded, we take the appropriate steps to, first, safeguard the child and if the child has to be removed, we do that quickly where we find there is a need, and in the longer term, we support the family to move on. Often, it can be upsetting for the foster family to be under considerable inspection and that can present difficulties for the family to continue fostering. We are conscious of achieving a balance in that for carers and, as my colleagues said, appreciating the significant work families do. A foster home is not a workplace. It is a place where children grow and live and parents parent their children. It is not a work environment and we very much appreciate that.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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My final point related to the specific difficulty in recruiting foster families for older children and adolescents. Do our guests have any insight into that?

Mr. Bernard Gloster:

We recognise it is a challenge. As I said in response to Deputy Costello, family life, working life and the construct of the family changes and keeps changing, and people live busier and different lives. The cohort of separated children seeking international protection, such as those coming from Ukraine, is not as challenging to recruit for because there is a group of people who have a specific interest in that work. It comes down to the matching of the child. It is not that foster carers have a prejudiced view against teenagers but rather it comes down to the matching of the child with foster carers. Some, although not all, of the teenagers who present as needing our care might present too great a challenge, and foster carers may opt not to proceed with a placement in that context. We are not giving up on that, however, and we want to find specific ways in the coming weeks that will support foster carers to do that, but I do not want to give any false expectation about the issue. It is a big challenge.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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What are the specific ways we could support foster families in those instances?

Mr. Bernard Gloster:

There is the issue of the practicality of caring for a teenager, depending on how disrupted his or her life might have been and whether he or she is coming into care for the first time or coming from another placement. The foster care allowance helps the carer support the child, and access to therapeutic supports for that young person must be presented in a way in which he or she will be able to engage. There might be the best therapeutic supports in the world, but if a 15- or 16-year old whose life is fairly chaotic and who has had some dreadfully traumatic experiences cannot interact with them, they will not meet the need that exists.

Ms Kate Duggan:

One of the opportunities members will see in the plan we are developing relates to shared care. Often, foster carers may need more access to respite to be able to sustain a placement. It is about looking at what foster carers have told us would help them with the placements they have at the moment. Foster carers who foster teenagers or older children have identified the need for some additional respite. The shared-care approach is something that, as well as the therapeutic supports, we see as supporting that.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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Is it the case that two foster families receive respite at once? Is that how shared care works?

Ms Kate Duggan:

Yes. As the Deputy will see in the plan, shared care can be provided within a foster carer's network of supports. There could be almost a second foster family within that network who support the foster carer. I would be delighted to meet the Deputy or any other members to discuss in greater detail the plan we are developing, once we have written it, and to talk through the implementation we are going to carry out.

Photo of Jennifer Murnane O'ConnorJennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I also thank Tusla for coming here today. There are cases in my area that I am concerned about but that is for another day. Two thirds of the recommendations have been implemented. What about the other third? It is important that we know the scale of that. Foster carers provide an invaluable contribution to the State. They are the people on the front line yet after years of service to the State they are not entitled to a full State pension. They are told they do not have enough contributions. Is that something Tusla finds puts foster carers off? That is something we need to address. Deputy Cairns asked about the fostering allowance. There has not been an increase since 2009. Does Tusla support an increase?

The next issue is one I am working on. What steps are being taken for foster carers to advocate on or question decisions made by Tusla? What supports are there for them to be the voice of the child if the child cannot speak for themselves?

Are many foster carers walking away from the service? I see huge barriers in accessing supports for families, particularly for family members. A family I know very well is fostering the child of a member of the family. It was so hard fighting for payments and access to counselling for the child and there was even an issue around the communication coming back. I worked with the family for some months and I felt there really was no encouragement for a family member to do this. They were the nicest family you would ever come across. I was struck by the barriers. They came to me and I was trying to work with them to help them and support them. We got it sorted but I had to get past many barriers myself. What if a family feels they have no one to go to or they need advice? It is something that we need to address so that no matter who fosters a child, they fully believe that the supports are there for them. I understand that Tusla is doing its best and I am certainly not here to give out about the system, as such. Everyone is working understaffed and there is a huge issue with staff. However, we need to examine this so that families in that situation feel that the supports are there.

Mr. Bernard Gloster:

I am not sure which report the Deputy is talking about where there are two thirds implemented. It is probably one of the improvement pieces.

Photo of Jennifer Murnane O'ConnorJennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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It is. Sorry.

Mr. Bernard Gloster:

No, that is okay. The simple answer on the rate of foster care allowance, which is there to enable people to create that home setting for children, is that I agree. To be fair to the Minister and his officials, we want to give an informed view as to what we think that is and what it should be rather than just making it up for the sake of it. That recommendation will be with the Department and the Minister in the coming weeks. That will be subject to regulatory decision and the Department of Public Expenditure and Reform and so on.

The pensions question is very interesting. Whether the foster care allowance could be subject to a PRSI deduction that would in turn lead to the potential of a contributory State pension has been raised with me. I have no particular prejudiced view of that but equally when the foster care allowance was introduced, it was hard fought that it would be defined as not-income so that it would not affect people's entitlements to jobseekers' payments, assessment for SUSI grants for their own children and so on. You could go one way and it would cause an unintended consequence. I do not have a prejudiced view about foster carers being supported after 30 or 40 years or fostering.

Leaving aside the advocating for services that are not there or that cost money, I think the Deputy made a point around a foster carer who fundamentally feels that they are at odds with Tusla around the care plan for the child and the decisions around them. We are into the whole nature versus nurture debate and all of that. The policy position in the State is, of course, that children should if possible be cared for within their own family and community, and care is the last option. I will ask Mr. Brophy to mention how we try to balance that. To be honest, we have foster carers who fundamentally disagree with us at times on decisions about children. Ultimately we are always trying to balance what the consequences for the child will be if we go in one direction or another. It is quite a sensitive issue.

Mr. Ger Brophy:

I appreciate the Deputy raising the concern and the focus on foster care overall. That is immensely helpful to us. We want to get the message out there all the time that we would really like people to volunteer to foster. We want people to have that positive experience. I am sorry that the Deputy was working with a family where that had not happened.

Photo of Jennifer Murnane O'ConnorJennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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They are sorted now. Thank you.

Mr. Ger Brophy:

That is great. I know as a team leader, principal and social worker over the years that differences of opinion can occur. Tusla's role is to advocate for that child. You have a dedicated social worker although I know we have problems with unallocated children. That may happen and cause one of the blocks in these situations. You advocate for the child's rights. That can be difficult in a family because you have the natural family and parents who may want a particular way or style for the child to be brought up. The length of time a child is in care, or the engagement with the natural parents, can be one thing. There may also be a difference of opinion. Parents in the natural family may have a very established pattern of dealing with children and it may take a while for that pattern to change or it may take time for Tusla to adapt and see how the particular foster parents parent best. There is a process. We try to achieve that balance. It is a very personal thing. We talk a lot in child protection and welfare about creating a network. Basically we are doing that in foster care all the time. These carers are becoming that network. You are involving the school and if there are therapies involved we also try to involve those too. Increasingly, as well as the emphasis on providing therapeutic hubs we are providing all sorts of support to foster carers. It could be equine therapy or other support. It may be short term or long term but we try and provide it as it is needed.

Mr. Bernard Gloster:

I want to return to advocacy because it is so important. Advocacy, from our perspective, has to be supported for everyone in the relationship. For children in care we have three forms of advocacy. There is the child's social worker who is an advocate. People often forget that and think that the Tusla social worker is the big bad person but actually they advocate for the child. Many children increasingly have a guardian ad litem and their care is subject to supervision of the courts. We also fund a national NGO, Empowering People in Care, which increasingly provides advocacy to children in care. We would like to see more on that. That is on the child.

We fund direct supports to foster carers through the Irish Foster Care Association. Not everyone is a member of that. People come in and out of associations like any other club or so on. We are well over 90% in this case. Separate to the child social worker, foster carers have a direct link social worker. That is a social worker who specialises in fostering and foster parents. The third part of the advocacy is a group which sometimes gets forgotten in the debate or the narrative, namely the parents of the children in care themselves. There are small support systems in different parts of the country for parents of children in care but they are very sporadic. Over the last six months I commissioned the Children's Rights Alliance, independently of Tusla - although we will fund it - to commission a support service for parents of children in care which will grow nationally over the next three years. We have committed to investing very significant resources in that. By then, trying to take the combination of all that advocacy, you hope that ultimately you get the best outcome for the child and the carers.

Photo of Jennifer Murnane O'ConnorJennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank Mr. Gloster.

Photo of Alan DillonAlan Dillon (Mayo, Fine Gael)
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I welcome our guests and thank them for their briefing note and opening statement. I want to acknowledge foster carers and the crucial role they play along with others. Tusla foster carers provide a safe, secure and stable environment for the most vulnerable children.

I would like to go back and forth on the initial recommendations going to the Minister on increasing allowances, which I welcome. I also want to touch on the perceived two-tier system in the model involving Tusla and the private agencies. Perhaps we could run through the different rates and allowances currently being provided and get thoughts on those. Mr. Smyth stated that for children under 12, the Tusla rate is 325, and that for those aged 12 and over, it is €352. The agency is at a set rate of €450. Is that correct or what is the current rate now for private agencies?

Mr. Pat Smyth:

We referred earlier to when the rate was originally set in the context of it not being a taxable amount. For anybody, €325 and €352 are the standard rates for us. Any other rates are not approved rates in that context. We pay just over €1,000 to private foster care companies for the services and the comparative all-in cost for us for those services is in or around €800. The private company gets back €200 per week more than we believe it would cost us with the rate added in. The Deputy's question was specific to the rate and €325 and €352 are the standard set rates.

Photo of Alan DillonAlan Dillon (Mayo, Fine Gael)
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I am looking for the equivalent in terms of the rate for those under 12 at €325.

Mr. Bernard Gloster:

Yes. Private foster care bodies are obliged to pay the same to their carers. Those rates at €325 and €352. That is out of the money we give them. The rest of what we give them is tided up in their costs of providing social work and support services, foster carer training and other elements. There is a perception, and I have no doubt that there are some examples of other supports being provided or paid outside the rates of €325 and €352. Ultimately, they might equate to what might be seen to be and in some cases the experience would be a two-tier system. Only in recent weeks the companies have been written to again to remind them of their obligations in that regard. Essentially, while the experience of a foster carer in a private company might feel and be different to the experience of a foster carer in a Tusla area, the rate that the foster carer receives in the foster care allowance should be the exact same. The regulations do not allow for it to differ.

Photo of Alan DillonAlan Dillon (Mayo, Fine Gael)
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Mr. Gloster must feel from his engagement with members that there is certainly a difficulty in understanding the additional amounts, whether they are placement fees or for Christmas presents.

Mr. Bernard Gloster:

Yes.

Photo of Alan DillonAlan Dillon (Mayo, Fine Gael)
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I suppose I am trying to get an understanding of the standardisation. What are we doing to ensure we do not have a two-tier system? We have increased the number of private operators by 39 this year and 12% of the current foster care offerings are private. The difficulty for many foster carers is the fact that the allowance is meant to belong to the child, which is not disputed, and foster carers are unpaid volunteers. Mr. Brophy said earlier that the role of Tusla is to advocate on behalf of a child's rights. Why do we have more money being allocated to the private sector and not Tusla operators?

Mr. Bernard Gloster:

It is not an unfair question. It is the question of what we are doing immediately to try to regularise or standardise - whatever phrase we use - the process. Ms Duggan might address that in speaking about what she has done with the private companies in recent weeks. I will come back on the wider piece.

Ms Kate Duggan:

It is important to say that Mr. Smyth has set out the standard allowance but there are also enhanced allowances. Where Tusla can provide an enhanced allowance to a foster carer-----

Photo of Alan DillonAlan Dillon (Mayo, Fine Gael)
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Will Ms Duggan provide an example?

Ms Kate Duggan:

For example, it may be demonstrated or assessed by a social worker in consultation with a foster carer that a child has particular extra medical needs requiring additional payment. Perhaps the child might need additional therapeutic supports not available to them in the public system. In such a case, we would support a foster carer to pay to access those privately. Orthodontic treatment is an example. The enhanced payment has been set at a maximum of twice the weekly rate. The maximum to be paid for a child under 12 is €650. It is important to say those enhanced payments must be for an identified medical or educational need. They must be assessed by the social worker as required and they must be approved.

I will speak to the chief executive officer's earlier point. We recognise and have heard over the past couple of months that there are some inconsistencies across our areas with the approval of those enhanced payments. The Deputy will see in the forthcoming plan very set guidelines around the standardisation of those enhanced payments. Where a child or young person is in foster care, there may be a requirement for modification to a house, either to support a child with a disability or medical needs or where a foster family is willing to take a child in placement, Tusla will also support modification of building works required for a house.

Photo of Alan DillonAlan Dillon (Mayo, Fine Gael)
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Respite is one example that has been raised. What is Tusla's position in offering respite for foster carers?

Ms Kate Duggan:

There are two elements. There had been a discrepancy or issue with the payment of the fostering allowance while a child was on respite. That has been resolved. The fostering allowance is maintained and paid even when the child is on respite. That had been an issue flagged with us and we brought consistency to that in 2021.

Photo of Alan DillonAlan Dillon (Mayo, Fine Gael)
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Is that currently included in every child care plan?

Ms Kate Duggan:

Is that when a child needs respite?

Photo of Alan DillonAlan Dillon (Mayo, Fine Gael)
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Is it included automatically?

Ms Kate Duggan:

It would be determined by the care path. There are many children in foster care today who do not need access to respite. It is part of the care plan. Do we have adequate respite? No, and it is something we must look at. It is back to the point around shared care placement and increasing not just the number of respite places we have available but our model of respite. That is all being addressed in the plan we are developing.

Photo of Alan DillonAlan Dillon (Mayo, Fine Gael)
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Again, it is automatically included in private agency plans.

Mr. Bernard Gloster:

To be complete, we have children who come into respite care. They live at home with families and we pay respite carers to look after them. We then have children in care who go for respite. If they are children with a disability, they go to a HSE respite service. We now continue the foster care allowance for foster carers while they are in the respite service. When I came here, that was raised with me by many foster carers and the ombudsman and application was sporadic. That has been resolved.

We have children in care who do not have a disability but either the child or the foster carers might need respite, or a break. Do we have enough of that? I would not think so. Where we have it and where we can work it into the care plan, we support the foster carer as well as the respite carer to do that. There were debates about that before.

I will come back to the Deputy's fundamental point about what we are doing to standardise. This will involve a question on which we have not yet landed on a final decision. If we set out the rules by which foster carers are supported, whether public or private, and we pay for one, two, three, four or five, it would be great but I can guarantee that within a day of those being published a need would emerge to push the system to go outside those rules. The minute we go outside those rules, there is inconsistency. The question will be how much discretion we can give our local teams versus how much rigidity we bring to the rules. The more discretion we have, the more inconsistency there will be. That is the challenge for us but we can make a fundamental improvement.

I am very confident that any absence of standardisation in the apparent or experienced difference of foster carers between public and private can be eradicated or reduced. The child in care with a private foster carer or a Tusla foster carer always has a Tusla social worker. The experience is on a supported level.

I am certainly keen for us to take out any possibility of that being different.

Photo of Kathleen FunchionKathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank Deputy Dillon. I have questions, some of which have been covered. I was going to raise the issue of the pension today. I know it is more of a social welfare issue. It also applies to carers. Once people are in receipt of an allowance payment, they fall outside this. Maybe there should be an option for people to opt in or out. I have come across it in a different context. People who may have been caring for a number of years, contract an illness and then do not qualify for the invalidity pension because they have been caring. I know that is not foster care but it is a similar scenario. It might encourage people if they knew that they could opt into something. Will the witnesses speak on relative care and how we might encourage that?

While my other question might seem basic, who can actually become a foster parent? My experience is that people think they are not qualified or cannot do it, or they might think they have to have a traditional two-parent family with 2.5 children, when as far as I am aware, many people who are parenting alone are also foster parents, as are people who are working outside the home. Many people think foster parents have to be available at home all the time. Will the witnesses clarify that, while we have the chance, to encourage people to come forward to foster? I am conscious that this is a public meeting. If people are watching who want to get involved, Tusla could use this opportunity to tell them how to go about it.

Mr. Bernard Gloster:

I ask Mr. Brophy to address who can or cannot become a foster carer. We spent our last three annual campaigns trying to emphasise that diversity is really important for us.

Mr. Ger Brophy:

Anybody can be a foster carer. People do not have to be single, married or have a partner. We try to match needs, as I referred to earlier. We would try to ensure there is at least one carer at home if the child is very young. Many children need placements and they have a variety of needs. They are aged between zero and 18. We mentioned education supports earlier. Education is important for those children and for carers, so that there is a place for them during the day. Anyone can do it. We welcome couples who are married, who are not married or who are in same-sex relationships. We have had real success with providing diverse placements. We are also trying to encourage more members of the Traveller community and Roma community to take up placements. We have a special project to involve them. We are open to that diversity and want to encourage it. I am delighted to have the opportunity today to invite people to come forward and to ring their local office or our fostering helpline to have a conversation with us. We work hard to get back to people as quickly as we can to respond to those inquiries. I am delighted to have the opportunity to say that.

Mr. Bernard Gloster:

Our portal is fostering.ie. Relative carers are a connection to where fostering originated in the Brehon law period. It arose from the concept of a village raising a child. Relative carers make up about 20% of our approved carers. I hope that research or a study can be done on what the outcomes look like. It is important. People have a perception of an adversarial relationship between Tusla and a family. In our modern-day approach to practice, there are about 5,800 people in our care, with about 16,000 open cases of children at home in our child protection system. Social workers visit those children, engage with those families and work well to support the parents to keep the children safe. We have a good national approach to practice, using safety plans. In safety plans, we bring relatives in to be part of the ongoing support system of the child. We hope that, should that child require a carer for a period, we will rely on the relative. It is important that we emphasise that. It is not an adversarial thing with the State going to take a child off a family and the family being cut out of the child's life. In our experience, most children in care eventually determine the level of contact and engagement they want. Relatives have a significant part to play in that.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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Can somebody who is not a parent foster? Do people have to have parented that age group?

Mr. Ger Brophy:

No. Single people are more than welcome to foster.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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With no children.

Mr. Ger Brophy:

Absolutely. They have much to offer and are very successful.

Photo of Kathleen FunchionKathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I have a question about the withdrawal of Positive Care. Do the witnesses know how many children were affected by that? Are plans in place for those children?

Mr. Bernard Gloster:

To be clear and to be fair to the people working in, owning and running Positive Care, there have not been new placements with it since the start of the current procurement process but it is still operating under a previous contract. Twenty-nine young people are still in its care. It still exists and is not gone. There is an indication that there will be a transition. We will work with it. This is a problem with dependency on private care. If it ceases or is disrupted in any way, the State has no choice but to do certain things. It is the same in nursing homes for older people. It is not unique to children. I ask Dr. O'Leary to speak on the 29 and our regulation and oversight of private residential care providers, though not specifically Positive Care Ireland, to ensure that we keep children safe, because we have an important role in it.

Dr. Anthony O'Leary:

We are the regulator for the private residential care sector. We approve companies to provide services. We have a role of inspecting and monitoring them to ensure that they deliver on that standard of care.

Mr. Bernard Gloster:

I have had to say in other committees in the past that I do not agree that we should be the regulator for private residential care, because we also provide it. It is one of the greatest possible contradictions of governance. To be fair to the relevant Departments, they are trying to resolve it. We are the provider of public residential care, the funder of all residential care, the overseer of the placement of children in all residential care, the commissioner of private residential care, and the regulator and inspection and registration service for private services. It is a fundamental contradiction and it is problematic. That said, our inspection and monitoring team does the job very well and ensures the safety of children in those contexts.

Ms Kate Duggan:

The Chair referred to Positive Care Ireland. It notified us of the closure of seven centres, which would have impacted nine young people. We are engaging with it so that if those seven centres close, we will look after and care for those nine young people.

Photo of Alan DillonAlan Dillon (Mayo, Fine Gael)
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I have a question for Mr. Gloster about the Tusla operation. He talked about many different areas in his opening statement. Things are becoming more and more complex, with many more legislation and governance issues. What challenges does Tusla have with recruitment, notwithstanding current operations?

Mr. Bernard Gloster:

When I saw Deputy Costello coming back in, I thought he was going to raise that. There is good news and not-so-good news. The good news is that we have increased the resource profile to be able to staff Tusla in recent years. Tusla has never had as large a workforce employed as in the three-year period including Mr. Pat Smyth's tenure as interim CEO for a year, before I came, and in my own time. There were many years in which the agency could not fill jobs at all. That said, we reached full employment at the end of 2020. We got significant additional resources thanks to the Minister. We struggled with recruitment due to the pandemic and the cyberattack.

We also struggle in our retention of staff regardless of the pandemic or the cyberattack and I do not want to be hiding behind those. Roughly speaking, we have approximately 4,800 employees and with whole-time equivalents that might number 5,000 people. We are trying to have approximately 5,150 people by the end of this year. It is a big ask. Within that we are down approximately 150 social workers. Essentially, we would not have been down that number but in quarter 3 of 2021 we took one of our biggest retention hits not because there was anything particularly wrong with Tusla other than that, as I have said, this work is extremely complex. I do not think the social work profession would dispute the fact it is probably the most complex area of social work. It is not for everybody. We took a big hit last year in the third quarter because of something that is a good development but which is challenging. All the health and social care sectors have now grown to multidisciplinary teams. In the health service, for example, there are doctors, physiotherapists, speech therapists, occupational therapists and now every team has a social worker, including child and mental health service, CAMHS, teams and mental health teams. There is a limited base.

Approximately 238 students will graduate this year in Ireland as social workers. For the past two years, with the support of the Minister and the board, I have taken the decision to offer them all jobs before they graduate. My fellow employers in the health service and other places would say what is there for them but people make choices. Out of 238 who will graduate this year, 181 applied for posts with Tusla, 140 have been panelled and we have commenced offers. As I said, we are down 150 social workers and the members can note the pattern there. We will lose people this year as well, which will be a challenge. The answer to having staff into the future, apart from growing additional social work places, is to have a diversity of the workforce at the front line, more social care workers and more therapeutic staff working in social work-led teams. That is a longer-term bigger policy change. For now we are doing everything we can to grow the number of social workers in order to recruit them. We have got good at recruiting. We need to find ways to get better at retaining staff. We must also accept there will be a level of retention challenge in this type of work. I could not but say, and I know that Deputy Costello will know this better than I do, we have the most committed and dedicated people working for us in every staff grade, be it clerical staff supporting social workers on the front line, social care staff or social work staff. It is the most rewarding but the most demanding and challenging work and it is not the easiest. We are in a good place compared to where we were but we are under pressure.

Photo of Kathleen FunchionKathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank Mr. Gloster for that.

Photo of Patrick CostelloPatrick Costello (Dublin South Central, Green Party)
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To follow up on the employment aspect, Tusla's aim is to have 5,150 staff. Two points strike me from what Mr. Gloster said. The first relates to the retention issue. Many people who get into social work do so longing to work directly with children. If there are multidisciplinary teams and if it is a social work-led team, the social worker becomes, and this is already a complaint of some staff, a case manager and does not do the direct work. When I have spoken to some social workers about the in-house therapeutic supports, they argue if there were more social workers they could do that work. There is a danger that reducing that direct work with children in order to address the retention crisis will feed a retention crisis. My second question is on what is the figure of 5,150 based. We know the number of children in care. We have a tool to measure the pressure and from that we can gauge how many social workers we need. There is demographic information and from that we can estimate the likely number of children who will come into care and anticipate the demand. Based on measuring the pressure, we will know the number of social workers that will be needed. Has Tusla done that type of workforce planning exercise? I have one or two follow-up questions on fostering, which I will come back to later.

Mr. Bernard Gloster:

The Deputy has covered a good deal in that. First, regarding social workers having time to work with children directly, the Deputy is 100% correct on that point. Social workers say that to me all the time. Young social workers, in particular, who come to work for us get very frustrated about that. Some of them record up to 60% of time is spent either on administrative work or on other matters. Two elements drive that. The first is the regulatory compliance levels the agency now has to meet. In saying that, I am not saying regulation is a bad thing. We all know where it came from. It is a very important part of the feature of safe personal social services given our history but there is no doubt our laborious methodologies make that worse than it is. As I referenced in my opening statement, this year we will introduce the new replacement national childcare information system, NCCIS. We estimate that will reduce computer screen time for a social worker managing a case by approximately 20%. I could stand to be corrected on that. It is social workers who have been involved in designing that and I hope that in time, that will contribute. There is also a second element, which the Deputy will probably know about, which has made a difference. Social workers have told us this. In the past two years we have assigned 45 or 50 extra clerical staff to directly supporting teams. This year we will assign more. Because we cannot get all the social workers we want we have asked social workers what would help with that and it is more administrative support. However, the Deputy and I both know the administrative support can only do so much. The social worker will still be pulled on.

On the 5,150 figure, I would dearly love to say to the Deputy it is a direct target linked to a direct assessed level of need and response to need. It is not. It is an incremental growth from what we know is well below what we need. We still need to do more of that. Regarding starting to introduce some evidence-base to that, Ms Duggan will speak briefly on the resource allocation model we now use for that.

Ms Kate Duggan:

That is something we have introduced in the past 18 months. It has been very much, as the Deputy said, looking at the demographics of the number of children by age profile and it also involves taking account of the number of social workers, the number of commissioned services within an area and the socioeconomic profile of the area. We also need, in consultation with Dr. Anthony O'Leary and Mr. Pat Smyth, to define further a resource allocation model. We have an immature version of it at the moment that is bringing transparency to how we are allocating. We are dealing with legacy issues where posts evolved over time. We are trying to bring a consistency to the number of social workers we would have per child population in the context of the socioeconomic factors that are at play. That is something we are committed to developing and refining over time. However, as Mr. Gloster said, the supply of social workers coming through the educational system is another focus we have. He has had engagements with the Deputy of Further and Higher Education-----

Mr. Bernard Gloster:

To indicate how far off meeting the need that exists we are, I will ask Mr. Brophy to summarise the international comparator for social worker per child. I am sure Deputy Costello will be well versed on it already. Mr. Brophy might make reference to that because it is stark.

Mr. Ger Brophy:

Roughly speaking, we have approximately a quarter of the social workers per head of population that there are in the North. The North has a particularly trauma informed need and requires a trauma informed practice for a portion of its general population. We have approximately half of what they have in the UK. If we take that as a general population, and these are figures produced by the Department of Children and Youth Affairs, now the Department of Children, Equality, Disability, Integration and Youth, and beyond that we do not have exact figures. That is our general position. We know there is huge need.

It would be remiss of me today not to take the opportunity to say that as a social worker of more than 20 years standing, I have enjoyed every day I have been in it. I get what Deputy Costello said about the taking away from direct practice. Having been a team leader for 12 years in Athy, the days I enjoyed most were the ones where I was involved in a child in care review and I got to engage with that child in care. There is so much engagement to be done. We want to put our social workers in that place where they meet those children but we still need to rely on speech and language therapists, CAMHS, physiotherapists and all the other professions who work with us to inform that child’s care plan. I enjoyed those days and I enjoy it just as much now. I would say to anybody who is interested in helping other people to come and join Tusla, apply to be a social worker, a social care worker, or a family support worker. We have many positions for people who have other qualifications or who are married and have experience. There are many opportunities to help. We want to engage those people and get them into our workforce.

Ms Kate Duggan:

I would like to raise the issue of practice reform. We talked a good deal about the reform of alternative care services in terms of foster care and residential care.

We have talked about the development of our therapeutic services. The third strand of that for us is around developing integrated response pathways which are very much our commitment to ensure that we are moving away from a system of thresholds and a child or young person not meeting a threshold for a child protection response and instead of getting no response, that they get a different response. It is that different response that may not require a social work response. It is a response that requires perhaps somebody who has experience in working in and engaging with families with addiction issues where the person has experience of working, maybe, with young people between 16 and 18 years of age. It may be a youth worker who is able to support those children to remain at home and to support those families to parent and look after those children safely. When we talk about the social work-led teams, it is, of course, the social work teams but it is the other teams we need within areas to respond to those children and families that need a response from Tusla, and not only a child protection response.

Mr. Bernard Gloster:

This year we are trailing the introduction of five teams that would be in the low-harm but high-need category and that is that response that Ms Duggan is talking about. To be fair, because we are trying to commence it this year, I do not want to overstate it either. Let us see.

Ms Kate Duggan:

What is important is that it is that evidential base. We have gone out and we have looked at that profile of children and young people who have not met a threshold and who are not receiving a service at present, looking at what their needs are and what is the best skill mix to put in place to respond to those needs.

Mr. Bernard Gloster:

The biggest reflection of where we need to go, not only as Tusla but as a society, is in the 73,000 children referred to us last year. Fifty-two per cent of them were non-abuse suspected cases. They were welfare cases. That means somebody was sufficiently worried about those children to say the State needed to be aware that they needed some support. It does not matter whether it is Tusla, CAMHS or the local NGO, but that is indicative of how far we have to go.

Photo of Patrick CostelloPatrick Costello (Dublin South Central, Green Party)
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That gets us into a conversation about Meitheal and the prevention, partnership and family support, PPFS, programme, which is definitely a conversation for another hearing.

Photo of Kathleen FunchionKathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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That is for another day anyway.

Photo of Patrick CostelloPatrick Costello (Dublin South Central, Green Party)
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It would be good to have these guys back to explore that because it dovetails with a lot of community development and that missing piece. As they say, it is important that when most people hear child protection their minds go to abuse, and particularly sexual abuse, whereas the vast majority of children are in care for neglect and there are much deeper societal issues in terms of addiction, poverty and mental health that we must address beyond Tusla's remit. Anyway, I will stop with my soapbox.

Photo of Kathleen FunchionKathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank the Deputy. That concludes that section. I thank all our guests from Tusla. It was really good. I was glad there was time for a discussion as well and we are not as limited. Obviously, because we are the children's committee and we seem to be the everything committee as lots falls to us, we will have Tusla back before us in relation to other issues. On behalf of the committee, I thank them for coming in today.

I must get agreement to publish the opening statements to the Oireachtas website. Is that agreed? Agreed.

We will go into private session to consider our last agenda item.

The joint committee went into private session at 4.45 p.m. and adjourned at 4.57 p.m. until 3 p.m. on Tuesday, 17 May 2022.