Joe Costello (Dublin Central, Labour)
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I thank the Ceann Comhairle for selecting this matter and welcome the Minister of State, Deputy Lynch, to the House.

I raise this matter as the provision of support services to people at risk is becoming an increasingly important issue in my constituency and, I am sure, in many other constituencies throughout the country. I agree that the Minister and the HSE have a duty of care to provide for young people at risk. However, it is equally important to balance those duties of care to the young people at risk with an obligation to the communities where the services are being located.

I represent the constituency of Dublin Central which probably has the highest concentration of residential social and support services in the country. The recent experience at the Stepping Stone premises on Botanic Avenue shows the need for the proper management and regulation of such premises. Stepping Stone opened a residential care centre for troubled adolescents at the premises on Botanic Avenue in January 2011. From the outset, there were serious issues of anti-social behaviour on the part of the youths living in Stepping Stone and an inadequate response from management. There were threats to people and damage to property locally.

It is important to note that there was no consultation with the local community on the proposed use of the premises. Moreover, there was no consultation with the Garda Síochána on the matter. They had not even been informed of Stepping Stone's intention to locate there. Reports of anti-social behaviour from youths living in the premises started soon after Stepping Stone moved in and it was only then that the Garda Síochana became aware of the nature of activity being carried on. The situation came to a head last week when a serious criminal incident occurred. Fortunately, the Garda was able to deal with the matter effectively. Nevertheless, a quiet residential community was seriously disrupted.

The HSE has contracts with a large number of organisations such as Stepping Stone to run residential care units on its behalf. It is not clear how much these organisations are paid as they are private operators but there is no doubt they are more than adequately remunerated for their work at the taxpayers' expense. The HSE should have complete oversight in regard to the provision of such facilities. It should be the conduit of information with all of the relevant agencies in an area where such services are being located. The HSE should also ensure that there are clear procedures in place for liaising with the relevant agencies. For example, the local Garda Síochána should be the first agency to be consulted but in cases such as this it is the last to be consulted. Moreover, there is a need for strict guidelines regarding the management and operation of such facilities, which clearly were not in force in the case of Stepping Stone.

The HSE should put protocols in place to ensure that the senior management personnel liaise, consult and work with the local communities in which they are operating. Clear procedures for responding to issues as they arise and before they develop into a crisis must be established. Where the systems fail, the HSE and, ultimately, the Minister should be accountable. Furthermore, on a broader scale, the HSE should develop procedures in regard to the number of centres and support services to be located in any one residential area.

Dublin City Council has acknowledged that a concentration of voluntary and statutory organisations is not in the interests of the people being served by these organisations and is not good for the local community where they are located. Accordingly, DCC has adopted policies in its current City Development Plan stating the need to avoid a proliferation of institutions and support services in any one area. The HSE should adopt a similar policy to ensure that there is not a concentration of its outreach facilities in any one area. At present there is no register of facilities and services provided or funded by the HSE. The Minister should instruct the HSE to compile a register and map outlining the location of such facilities to facilitate future planning.

To date the HSE has failed to put in place adequate quality control and monitoring of the procedures and management of facilities managed by outside agencies. It is time that the Minister ensured that the HSE took responsibility for the operation of the centres and facilities it funds.

Kathleen Lynch (Cork North Central, Labour)
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I thank Deputy Costello for bringing this issue to our attention. I agree that one is lining oneself up for trouble where one does not consult or get the support of a community for the location of a facility like this. This should also be done through consultation with other agencies charged with keeping public order. The business of putting facilities in place without telling anyone, thus allowing people to find out about them by dent of an occurrence in their area is completely wrong.

I welcome the opportunity to reply to this Adjournment matter. The Health Service Executive is required under the Child Care Act 1991 to promote the welfare of children who are not receiving adequate care and protection. There are a number of procedures which the HSE can use when dealing with children who are at risk or who are in need of care. If a child is in need of care and protection and is unlikely to receive it at home then the HSE must apply to the courts to take the child into care. The HSE is obliged to care for these children for as long as their welfare requires it. All of these children have unique circumstances and experiences that need to be taken into account when HSE managers, social workers and other staff are planning and providing services.

Standards for children in residential care are governed by the National Standards for Residential Care. The HSE centres are currently subject to inspection by the Health Information and Quality Authority, HIQA, and the non-statutory centres are currently registered and inspected by the HSE. The centre referred to by Deputy Costello is a non-statutory centre which was registered by the HSE to commence operation on 10 September 2010 pending a full inspection as per the registration and inspection service protocol. The centre was registered for a maximum capacity of two young people aged 12 to 17 on admission. The written and agreed purpose and function of the centre was to offer short term placements to young people. The service was to offer a high level of support to young people in a community based setting.

The first full on-site inspection of the centre by the HSE took place on 14 and 15 March 2011. There were two young people living in the centre at the time of the inspection. In general, the inspectors found that the centre was not in substantial compliance with a number of operational practices and there were issues with leadership and management of the centre. It was also identified that there was no consistent model of care being utilised in the centre. The inspectors have been in regular contact with the centre since the inspection and have been informed by the registered proprietors that it is their intention to request the suspension of the registration of the centre. A meeting has been organised with the registered proprietors to formalise the suspension of the registration. There is currently one young person in the centre and a move on plan has been identified for this young person in a planned manner.

I again thank the Deputy for bringing this matter to our attention. I will take on board his suggestion in regard to a register of non-statutory centres, which is probably where the problem arises. I also agree that the register should be available to all local authorities in regard to planning matters. The manner in which the centre concerned was put into operation is not the model we should be following.