The Health Information and Quality Authority (HIQA) has today published an inspection report on the child protection and welfare service operated by the Child and Family Agency (Tusla) in the Midlands service area.

HIQA conducted a focused inspection of this child protection and welfare service between 25 and 27 November 2024. The inspection was undertaken to validate assurances received from Tusla about the integrity of its data on unallocated cases, and the management of these cases from point of referral to the allocation to a social worker and until a preliminary enquiry or initial assessment was completed. 

In July 2024, HIQA received information from the Regional Chief Officer that principal social workers and team leaders in the Midlands service area were allocated a significantly high numbers of cases. HIQA wrote to the Regional Chief Officer who responded with additional information which highlighted the disparity between the published number of unallocated cases and the actual number in the area. It also highlighted significant delays for some children referred to the service in having assessments completed or a service being provided to them and their families. 

Data provided by Tusla from October 2023 to July 2024 indicated that the unallocated cases in the Midlands child protection and welfare service did not rise above 16%. As a result, the Midlands service area was not included in HIQA’s 2024 provider programme which inspected service areas where at least 25% of children had not been allocated a social worker in child protection and welfare or foster care services. However, as highlighted above the data from the Midlands service area was found to be inaccurate. 

The inspection assessed the level of compliance with six of the National Standards for the Protection and Welfare of Children (2012), and found the service was substantially compliant with two standards and not compliant with four standards.

Overall, HIQA found that while there were structured management systems in place for the governance and oversight of unallocated cases, the volume of referrals to the service, the number of unallocated cases and the workload of staff meant that these systems were not effective. This meant that it was not possible to ensure that all children and families in need of a service received it within a reasonable time frame. While the service was fully staffed to its approved whole time equivalent staffing levels at the time of the inspection, there was a chronic shortfall in resources to meet the demands of the service. Many children and families were waiting prolonged periods for the completion of preliminary enquiries and initial assessments. This meant that the level of risk to these children was not assessed in a timely manner and children and families did not receive the service they needed within a reasonable time frame.

The inspection also found that there had been a systems breakdown in validating and communicating data to management at a regional and national level from October 2023 to May 2024. As a result, inaccurate data about unallocated cases was provided to HIQA. While this system of validation was rectified in June 2024, at the time of the inspection, inaccurate data continued to be published on the Tusla website.

The area was using a paper-based system to screen new referrals, which was later uploaded to the Tusla Case Management system (TCM). This resulted in some cases having inaccurate dates recorded on TCM for when the referral was screened. This meant oversight at regional and national management levels were impacted.

While there was clear evidence that experienced, skilled social workers and social care leaders were carrying out challenging work, the level of referrals to the Midlands service area and the high number of unallocated cases, meant there were delays at both preliminary enquiry and initial assessment stages of the assessment process. This meant the quality and safety of the child protection and welfare service, from referral through to the initial assessment stage, required significant improvement to ensure it met the needs of all the children and their families who required the service.

Where cases were allocated, there was clear and effective communication with children and their families. However, where children and families were on waiting lists, there was either no communication or communication was poor. This meant that in many cases children and families were not informed about how long they would be waiting for a service from Tusla.

Notes: 

• HIQA is authorised by the Minister for Children, Disability and Equality under Section 8(1)(c) of the Health Act 2007 to monitor the quality of services provided by the Child and Family Agency (Tusla) to protect children and promote their welfare. HIQA monitors Tusla’s performance against National Standards for the Protection and Welfare of Children and advises the Minister and Tusla. 
• In 2023, HIQA commenced a risk-based monitoring programme to monitor service areas where over 25% of children were unallocated a social worker. This programme aimed to assess the effectiveness of Tusla’s national service improvement plan in response to a large number of children, nationwide, referred to Tusla, who did not have an allocated social worker. HIQA’s findings from this programme can be read here.