Robert Troy (Longford-Westmeath, Fianna Fail)
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34. To ask the Minister for Children and Youth Affairs the actions he is taking in response to the most recent Health Information and Quality Authority inspection report which highlights the lack of suitable placements to meet the needs of some young persons in care due to the closure of high-support units, which has meant that many young persons with complex needs are currently in mainstream and adult residential care; and if he will make a statement on the matter. [42685/15]

James Reilly (Dublin North, Fine Gael)
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I welcome the fact that, over the past two years, the Health Information & Quality Authority (HIQA) has looked at Tusla's children's residential centres work with children whose behaviour is very challenging. HIQA's findings are mixed, by and large showing a committed staff dealing with young people, some of whom have serious emotional and behavioural difficulties. The age profile of children in residential centres has risen over the last number of years, and now approximately half the young people resident are aged 16 and 17 years. Some of these young people will have come into care recently, while others will have experienced the breakdown of other care placements, including foster care. In some instances the young person's behaviour will have triggered the breakdown, in other instances it may be a response to repeated disrupted relationships and poor self esteem. I want to emphasise that unlike Special Care, children are not detained in residential centres, nor were they detained in High Support Centres either.

The majority of children's residential centres are, de facto, providing high support care. Across the country there are 160 centres, including private and community based caring for 337 children. There are, at a minimum, two staff on duty and, when needed, this number is increased. This shows an average of 2 young people per centre, although of course the number of children in a centre will range from 1 to approximately 4. 98% of children in residential care have an allocated social worker (329). Young people placed in community based centres who have serious emotional and behavioural problems, and who are being considered for special care, are linked with the Assessment, Consultation and Therapy Service (ACTS) multidisciplinary therapeutic team. Further specialist supports are also routinely made available as needed and many centres have specialist skill-sets, therapeutic modalities, or links with same, in their local communities to meet the varying need of the young people in their care. Tusla managers and staff are fully aware of the emotional and mental health needs of children in care. While the term High Support is not currently used, high support care is provided, through Tusla placements and also, privately commissioned residential and foster placements, with access to specialist psychological and psychotherapeutic play opportunities.

I believe the Deputy's question refers to the inspection report published by HIQA on the 5th of November 2015, where a focused inspection was carried out on a children’s residential centre in the Dublin Mid-Leinster region. This unannounced, themed inspection, focused solely on how the needs of children who display challenging behaviour are met. The HIQA inspection report found that of the seven standards inspected in the centre, only one was fully met, five required some aspect of improvement and significant risk was identified in one standard. This latter standard outlined the risk to the safety of the young people due to their behaviour when outside the centre.

Inspectors found that staff worked in partnership with the social work department, parents and other professionals to try to manage these risks; however their interventions did not have the desired effect, at the time of the inspection, to stop dangerous behaviour by the young people. The report outlines how the staff and management of the centre demonstrated a real commitment to the young people in their care, despite their challenging behaviour. However, HIQA determined that the risk taking behaviour of the young people was such that other interventions should have been put in place.

I am fully aware of the serious challenge faced by the Department and Tusla in working with this group of young people. Reports from the National Review Panel provide sufficient evidence of the tragic outcome for some young people who take risks with their own lives and safety. In order to improve outcomes, Tusla has established a working group to reviewing strategy for alternative care, and two of my officials are members of the group. Separately, senior managers in Tusla and officials in my Department are in discussions about how best to meet the needs of some of these young people to secure their safety and future.