Paudge Connolly (Cavan-Monaghan, Independent)
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Question 289: To ask the Minister for Health and Children her plans to bring the standard of care in the majority of high support units for young people with emotional and behavioural problems to the required level, in view of the 2005 Annual Report of the Social Services Inspectorate; and if she will make a statement on the matter. [36219/06]

Paudge Connolly (Cavan-Monaghan, Independent)
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Question 290: To ask the Minister for Health and Children her views on the 2005 Annual Report of the Social Services Inspectorate which identified widespread inequities in the treatment of children in care; the action she proposes to take to correct this; and if she will make a statement on the matter. [36220/06]

Paudge Connolly (Cavan-Monaghan, Independent)
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Question 291: To ask the Minister for Health and Children the criteria used in the determination of care placements of children in residential centres and in foster care, in view of the 2005 Annual Report of the Social Services Inspectorate; her plans to eliminate the inequities in the care experience highlighted by the inspectorate; and if she will make a statement on the matter. [36221/06]

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I propose to take Questions Nos. 289 to 291, inclusive, together.

I welcome the publication of the 5th Annual Report of the Social Services Inspectorate (SSI) which is comprehensive and provides an important overview of the services provided to children in residential care.

The emphasis of the Child Care Act, 1991 is on supporting children and families in their own communities having regard to the principle that it is generally in the best interests of the child to be brought up in his or her own family. However, children are taken into the care of the Health Service Executive or placed voluntarily in care due to a range of family circumstances and the Health Service Executive has a statutory responsibility to provide appropriate services for these children. Children are placed in foster care or relative care, or in residential care, by the Health Service Executive, in accordance with the Child Care Regulations, 1995, which set out the requirements to be complied with by the HSE when placing children in care.

Foster care is the main form of alternative care for children who cannot, for a number of reasons, be looked after in their own home. My Department and the Health Service Executive have placed considerable emphasis on the further development and strengthening of the foster care service for children in need of alternative care. However, foster care placements may not always meet the specific needs of individual children and it may therefore be necessary to place these children in residential care.

Children's residential centres include community based centres which are small centres based in local communities, high support units which are open units offering more intensive levels of care for children with assessed difficulties and special care units which are secure residential facilities for young people aged between 12 and 17 years who are detained under court order for their own safety and welfare. The criteria used in the determination of care placements is a matter for the Health Service Executive, whose staff work directly with the children and their families. I have asked the Health Service Executive to respond directly to the Deputy in relation to this matter.

Having completed a full round of inspections of approximately 90 statutory children's residential centres in 2004, the SSI were able to focus inspection resources in 2005 on selected areas with a view to improving outcomes for services that were identified as experiencing specific challenges. This helps to explain why this report has more critical findings than perhaps other reports have had. The SSI focused on two themed inspections. The emergence of the Health Service Executive (HSE) as a national body facilitated a national themed inspection of the management of behaviour in high support units (HSU's). A cluster inspection of children's residential centres in the former South Western Area Health Board (SWAHB) was also conducted after a number of previous inspections had given rise to concerns about the quality of care provided in this former health board area. The SSI also conducted its annual inspection of the two Special Care Units, focusing on the standards that had been the subject of concern in previous inspections.

The focus of the inspections of the HSU's was on their capacity to manage the behaviour of the young people safely and well. A total of 56 children were accommodated in the units at the time of inspection. The inspections identified the factors which contribute to young people's behaviours being well managed. These include good management, a clear statement of purpose and function, an agreed model of care that is understood by the care staff team, a good standard of primary care and last but not least, respect for the rights of the young people. While many of the units were providing a good standard of care, inspectors identified a number of areas where improvements were required and made a number of recommendations in this regard. The SSI will be monitoring the implementation of these recommendations.

The cluster inspection of children's residential centres in the former SWAHB was conducted between September 2005 and January 2006. As the report states, a cluster inspection facilitates the identification of common issues that may be best addressed at a regional or national level. Between them, the thirteen centres inspected accommodated 43 children at the time of inspection. Arising from the inspections, recommendations were made in relation to the services' review process, the purpose and function of centres, policies and procedures, management and staffing, monitoring, care practices, children's rights, care planning, planning for aftercare, and accommodation. The report acknowledges that the former SWAHB had the second largest concentration of children's residential centres in the country and did not have the management resources of areas with fewer centres or better community resources. It is inequities such as this that the HSE, with its national remit can address. Indeed the report acknowledges the significant progress made by this region since the inspection in addressing the deficiencies highlighted.

I am pleased to say that in relation to the two special care units in the country, the SSI conducted their annual inspection in 2005 and found that both were meeting the standards. In fact the report states that the children in both units spoke highly of the care they received and the relationships between the staff and children were described as warm and respectful.

Whilst there have been clear improvements over the last few years areas of concern still remain and I in no way want to minimise the seriousness of these issues. However, it is only when we openly acknowledge the problems that exist that we can begin to work to find solutions to these problems. Many of the more serious difficulties clearly stemmed from inequities in the services and as I have already stated the move away from regional health boards to the establishment of the HSE with its national remit for services is key to addressing such inequities. It must also be remembered that the Report deals with inspections that were conducted last year and the SSI have already been back to the centres on follow up visits. Some of the centres have since been closed by the HSE and recommendations have been implemented by the HSE in relation to others. The SSI will continue to monitor the implementation of the recommendations and I am confident that with the ongoing cooperation of the HSE the services provided for the children in these centres can be brought into line with the required standards.