Inspiring Confidence in Children and Family Services

Putting children first and meaning it

Strategic Review of the Delivery and Management

of Children and Family Services
CONFIDENTIAL DRAFT REPORT

Prepared by PA Consulting Group for the HSE

1 October 2009.
Forward

Safeguarding children and promoting their wellbeing are sensitive and Our approach to the review
intricate areas of social policy in which the HSE plays a central – but not sole –
Our approach assessed current management and delivery through a number
role. The HSE has statutory obligations under various Children’s Acts to
of ‘tests’ that public sector bodies widely use in reviewing their capability. In
protect children and to provide supports to their families. Safeguarding
summary these tests are:
children is difficult, challenging work which can deliver clear benefits for
children, their families and professionals interacting with children. • Governance – are there clear lines of responsibility, accountability and
authority in delivering children and family services?
Lapses in service delivery can have severe consequences for children and
their families. They also put the entire delivery of the service under scrutiny. • Strategy and service delivery model – are there clearly articulated goals
In recent years, a number of high profile reviews have put HSE services in and service models to deliver positive outcomes for children?
the public spotlight. The Ferns, Monageer and most recently the Ryan
• Service delivery – how are people delivering services, collaborating to
Commission report all raise important questions about how children at risk
deliver outcomes and coordinating systems?
are currently being safeguarded. The effect of these reviews is to undermine
confidence in the delivery and management of children and family services • Performance management – how are people currently assessing
both within the HSE and more widely. The focus on what goes wrong can performance based on corporate, professional and service
understandably dominate the agenda to the exclusion of building on what requirements?
works well.
For the HSE to deliver positive outcomes for children, all of these strands are
The HSE needs to develop confidence in delivery of children and family equally important.
services. It needs to know that it is doing everything it can and should to
The review was a short, intense process during which we listened to the views
support children at risk and their families. It is not realistic to expect that the
of people delivering services in the HSE and other agencies. We also
HSE can prevent all child abuse but it is realistic to expect that it is doing all
reviewed the wealth of documentation that is already available on the service
that it can to support children. The HSE is therefore asking how it can build
in Ireland and the HSE’s own internal data on children and family services.
confidence in delivering positive outcomes for children and their families. It
commissioned PA Consulting Group to undertake a strategic review of the This report sets out PA’s findings and recommendations to build confidence
delivery and management of child protection services. The review assessed in the HSE’s services for children. We recognise that there is a lot of
current structures, management and governance to see if they: agreement on the key areas requiring attention. We also recognise that
implementing the report will require leadership across all professions and
• Are fit for purpose in achieving safe and high quality child protection
managers working with children. Finally, we are mindful that the HSE is
services, consistent with statutory obligations
undertaking a wider reconfiguration programme and that these
• Ensure and support best practice in clinical and professional recommendations must ‘fit’ with this wider programme as far as possible at
effectiveness this point. We have therefore kept the report deliberately short and succinct to
facilitate communication and implementation across the HSE.
• Facilitate public accountability and public confidence
• Support effective interdisciplinary and interagency relationships
• Are consistent with international best practice regarding Child Protection,
assessment and Intervention.
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 Contents PART A - Findings

Contents
PART A – Findings
Executive Summary
1. Core findings on how children and family services are managed and
delivered:
– Management and Governance
– Strategy and service delivery model
– Delivering services – within the HSE and across agencies Part A includes:
– Managing service performance . 1. Executive summary – overall findings and principal recommendations
PART B – Looking to the Future
2. Principal findings for the four assessment criteria used covering:
3. Guiding principles and inter-locking strands:
– Principles driving management and delivery
– Elements of future service delivery model • Management and governance of the delivery structure
– Foundations for developing the service • Strategy and service development
4. Key recommendations: • Service delivery
– Setting direction and service model– strategy • How performance is managed.
– Service delivery aimed at putting children first
– Intelligence-led delivery
– A simple, clearer and more accountable structure
5. Implementation challenges and plan.
References
Glossary
Appendices
A. Key HSE data on child protection
B. Overview of key processes in Child Protection (HSE Task Force)
C. Model of CPD and professional supervision
D. Consultation and references
E. Overview of approach
F. Glossary of terms
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Executive Summary - Overall Findings
There is significant anxiety within parts of the HSE and by external agencies on
how the HSE is implementing Children First, the framework governing child
protection in Ireland. The key question is whether the service is doing all that it
can to protect children by promoting their wellbeing and providing appropriate
supports for their families. The Office for the Minister for Children and Youth
Affairs (OMCYA) conducted a review of Children First in 2008. It found that the
protection framework is fundamentally sound but that it is not being
implemented consistently.
The recent Implementation Plan on the Ryan Commission presented to
Government by the OMCYA included 20 recommendations and 99 actions to
address identified service deficits in child protection and welfare services. Six
of these recommendations and 35 actions related to the management of
children’s services. The Implementation Plan clearly indicated that any future
resources allocated to the HSE will depend on agreement on significant areas
of service reform. This underlines serious intent to develop a service that puts
the needs of children at the centre of service delivery.
Children First clearly indicates that the protection of children is everybody’s
business. However, social work professionals are the spine of the service as
key professionals engaging with children and their families and so our findings
relate mainly to this profession and to the management structure.
Key findings
• There is an urgent requirement to set and communicate direction for
the service. What is the HSE fundamentally trying to achieve for children
and their families? At the very heart of this question is what child
protection practically means – is it essentially about managing risk and
investigating alleged abuse or is it more about providing the supports
needed for children and their families? There is no shared view about
what the ‘service model’ should look like within the HSE. However, there
is an emerging sense that the focus needs to shift to providing supports
and specialist services for children and their families to prevent the risk of
harm. This is happening in some parts of the HSE but not consistently.
The HSE needs an overall strategy and service model that will provide
guidance to local managers and practitioners on how they should be
delivering services for children. This lack of overall direction has a
profound effect on the outcomes children can expect in different parts of
the country.
• There are significant and, in many cases, unnecessary variations
across LHOs in how Children First is being managed and delivered.
These variations can be traced to the different priorities and practices of
the former Health Boards which have endured with the establishment of
the HSE in 2005. This means that depending on where children at risk
live in Ireland they can expect to receive different services from their Local
Health Office. In some LHOs, children at risk and their families can
expect to receive practical supports that help them to build ‘upward
spirals’ to manage the challenges in their lives. For example, there is a
national pilot programme in Dublin North to provide children at risk and
their families with practical services.1 Other LHOs are also taking similar
approaches but in a more low-profile way. In some LHOs, it is unclear
what children can expect from the HSE other than having the risk
investigated, monitored and possibly with the final outcome of the child
being put in the State’s care.
• More visible leadership is required across all levels of the service as
well as tighter management. Implementing the recommendations of this
report, the Ryan Commission Implementation Plan and the report of the
HSE’s Task Force will not happen without visible leadership at all levels of
the organisation.2 To inspire confidence within the HSE and externally,
tighter management is required on resources, quality of practice,
outcomes for children. The current management ‘style’ tends to be
reactive, crisis-driven and focused on individual cases. There is a lot of
management ‘traffic’ around individual cases but much of this is not
purposeful in the sense of building better delivery to secure better
outcomes. At a fundamental level there is no clear understanding on the
respective roles of professionals working with children and HSE
managers. This contributes to a disconnect between service delivery at
national, regional and local level.
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• Structures for delivering the service need to be simplified and clearer. There
is a distance between front-line staff and the top of the organisation which is
unhelpful in terms of service delivery. In addition:
– It is unclear where responsibility, authority and accountability lies for
children and family services particularly at local level. At a fundamental
level, this means that people within the HSE and outside do not know
who is responsible for child protection.
– At all levels of the delivery system, people can have responsibility without
corresponding authority. There are some inherent tensions between
two critical local roles – the Principal Social Worker (PSW) and the Child
Care Manager (CCM). These can work well but they depend on the
quality of relationships.
– Roles have also been added over the years to manage specific issues,
adding to the complexity of delivery. Roles and responsibilities therefore
need to be simplified and clarified.
• Connections with other services within the HSE and agencies need to be
strengthened. This was a central theme from our discussions and arguably
has to be a central pillar of any change programme. Within the HSE, working
and referring across services is still complicated. There are issues around
how professional and service boundaries constrain referrals between
services. A more profound issue relates to identified service gaps e.g. access
to psychological services for children who clearly have behavioural issues but
are not diagnosed as psychotic. This can often leave social workers
managing very complex cases without appropriate service supports.
• Supports to social workers and their managers are under-developed. Social
work professionals work in one of the most challenging areas in the HSE.
The human scale of what they do is hugely significant. Like all other
professionals, they must exercise their professional judgement on what
children and their families need. Social work managers have a clinical
governance role but also a key role in supporting staff. The approach to
professional supervision and continuing professional development needs to
be developed to support social work professionals.
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• There is inconsistent application of practice in implementing child
protection and supports. There are significant and unhelpful variations in
practice across the LHOs, for example in relation to how cases are
referred, how risk is assessed, thresholds between different levels of
service required. Some variation is inevitable due to differences in need
and services at local level and variations in professional judgement.
However, the extent of the variation undermines confidence in the
delivery system.
• The service is not managed based on current intelligence. The HSE
currently produces a wealth of data on how children and family services
are being delivered. However, this is not being routinely used by
managers across the service to provide intelligence on how the service is
being delivered, how resources are allocated and what outcomes the
service is delivering for children. The current datasets are not perfect but
they represent a sound starting point to develop ‘intelligence-led delivery
of services.
We found a remarkable degree of agreement between people working in the
HSE and other agencies on the key constraints limiting the effectiveness of
child protection. There is an equally shared sense that there has to be a
better way for delivering better outcomes for children across the services as a
whole. The timing may now be opportune to address these constraints to
build confidence in the ability of services to deliver better outcomes for
children. Both the report of the Ryan Commission and the subsequent
Implementation Plan have underlined the urgency of addressing these
constraints and in so doing have given new impetus to addressing the needs
of children.
However, we need to be underline two important messages:
• Firstly there is no single remedy or ‘quick fix’ to address the
management and delivery issues identified in this report. Strengthening
the spine of the service will require change across a number of areas.
• This points to a need for a clear, sensible and understandable change
programme that inspires confidence within and outside the HSE. The
scale of the change is not to be under-estimated and ultimately requires
fundamental change at corporate and individual level to deliver and
support services.
Based on the key findings of this review, the HSE needs to take action at a
number of levels:
• Agree and communicate a clear service model for the future that focuses
on outcomes for children. This should guide both managers and all
practitioners on the priorities for engaging with children at risk.
• Bring consistency to how the HSE delivers services, strengthen
collaboration and provide supports to people working with children and
their families.
• Develop an intelligence-led system that uses data currently available to
improve the service.
• Simplify and make clearer key roles and responsibilities across the
delivery system. Our focus has been to propose changes that are
absolutely necessary to:
– Bring clarity to key roles – both internally and externally,
– Ensure that the structure reflects and drives key functions.
The HSE is currently ‘reconfiguring’ its services at national, regional and
local level. Our proposals take as their starting point the structure agreed
at national level and will be flexible to incorporate PCCC changes at local
level. A key new role is the post of Assistant National Director for Children
and Family Services. This post will provide clear leadership at senior
level in the HSE and should, with appropriate authority and resourcing,
provide the leadership to drive this change programme.
The review’s recommendations are designed to progress these four priorities.
All are essential and together they constitute a significant programme of
service and cultural change the scale of which we do not underestimate.
Together they will provide a clear framework within which everybody working
with children can be clear of their own responsibility, accountability and
authority for ensuring children’s wellbeing.

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 2.1 Governance and management structure

The current roles and responsibilities are unclear and are overly complicated. The
structure needs to be leaner, more transparent with clear lines of responsibility and
accountability and line of sight from front-line services to senior management. This
is essential for effective collaboration across agencies and services.
Our findings
The structure is complex with unclear accountability, responsibility and
authority for decisions.
• There is no clear line of sight from senior management to front-line
delivery which makes delivery complex. It can also undermine confidence
between different layers of the service.

The current management structure can be traced back to the Health Boards and • Authority for managing financial resources in unclear.
did not fundamentally change with the establishment of the HSE. Changes have • It was not clear to external agencies or other HSE services who is
been ‘grafted’ to the structure as needs arose. These have helped to address responsible for child protection. This is a basic requirement for inter-
pressing problems but have added to the complexity of delivery. Figure 1 outlines agency collaboration.
the current management structure. We found that:
• The HSE has added some roles for pragmatic reasons usually to respond
There are significant variations in delivery structures across LHOs and roles are to particular issues. The concept of ‘lead role’ defines current delivery
often unclear. including at senior management level – the service by an Assistant
• The roles of Principal Social Worker and Child Care Manager (CCM) are National Director who does not have operational responsibility across the
central to delivering child protection yet they are particularly confusing and country. The ‘lead role’ model has helped to address some complex
unclear. In four LHOs, the CCM has overall responsibility for children and issues e.g. residential care, unaccompanied minors. However, it is not an
family services. The model in most LHOs is that both PSW and CCM report effective way of securing service change as the roles often do not the
to the General Manager (GM). The PSW tends to have most of the line authority needed to deliver services.
management responsibility with CCM having minimal line management role. • There are questions as to whether the HSE is using some roles e.g.
The PSW and CCM roles work well where there are strong relationships but specialist, senior practitioner, strategy role, to best advantage. The
it contains inherent tensions that are unhelpful and must be addressed. current structure leads to under-utilisation of this considerable resource.
• The role of GM and LHM is a critical connector between social workers and
other PCCC services, linking strategy and implementation, and connecting
‘corporate’ management with what happens at local level for children. Their
role varies between LHOs and it is unclear to what extent both roles are
required for effective delivery.
• The Team Leader role is critical in allocating and assessing cases. They
have a lot of authority, yet many do not have significant experience
particularly in urban areas (see table 46, appendix A). They receive mixed
levels of support depending on where they work.
• There are significant variations in team structures at local level as evident
from figure 1. This makes it difficult for agencies and services to engage.

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2.1 Governance and management structure (contd)

The management style of service delivery tends to be reactive, crisis-

driven.
• Collective management structures vary between LHOs and are
constrained by the poor quality of information that is used to
inform decision-making on the service. There are some good
practices of key PCCC local managers liaising with social work
managers and other disciplines but this is not routine.
• There are very weak performance structures, as evident in
Section 2.4. Formal escalation procedures are in place for
Serious Untoward Incidents (SUIs). There is a tendency
however to micro-manage on the basis of individual cases which
can generate a lot of unhelpful ‘management ‘traffic’. This is not
purposeful in developing services although it may be necessary
for individual cases.
At a profound level, there are questions about the expectations of
social work practitioners and PCCC managers. What should they
legitimately expect of each other in terms of supports and quality
assurance on service delivery? How can normal management
disciplines be applied while respecting the professional judgement of
professional social workers? Central to strengthening delivery is a
shared recognition of each other’s mutual role and how they support
each other.
What this means for the future
The current complexity of roles means that it is difficult for people both
within the HSE and externally to know who is responsible for child
protection in the HSE and therefore how to engage. The structure
should also help to drive a model of services that prioritises early
supports for children and families to prevent escalation of risk.

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 Figure 1: Current management and delivery structure of child protection

Separated
CEO
children seeking
asylum
Inter-country Office of the CEO
adoption
services Children and Family Services
AND Children’s strategy
National Steering Committee National specialists x4
Special Care in
High Support
Director of PCCC Director of Hospitals
Crisis
Intervention
AND Dublin Child Care Assistant National Director Assistant National Director Assistant National Director

LHM Leads – 1 per region

National Specialist x2
+ specialists in 2 regions

4 national services – led by LHMs. Childcare Information officers x6 Long-term (26) Children in Care/aftercare (8)
Fostering (25) CSA team (3)
LHO-wide team (21) Community Team (3)
LHM
Duty (16) Therapeutic team (2)
Local team (16) Support services team (2)
Loca
ld
Specialist for some LHM
Adolescent teams (1)
local elivery +
Family support (11)
Children in Care (10) Shared rearing team (1)
varia
tion
GM
Inter- LHO (10) FWCS (1)
Protection +d welfare (10) Community dev (1)
PSW Child Care Manager
Intake (8) CPC Dept. (1)
Child Protection Notification Management
Other Managers: Alternative Care Managers,
Senior practitioner
Family welfare Conferences. Team

Team Leaders

Social Worker

Admin support

Team structure

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2.2 Overall Strategy and Service Model

There is an urgent need to develop a service model for child protection
that focuses on outcomes for children. It should be based on national
policy and legislation as well as wider experience.
Our Findings
The framework for child protection is clearly articulated at national level
through Children First, the wider policy framework set out in The Agenda for
Children’s Services and through legislation. However, the HSE has struggled
to convert this national framework to a sensible and understandable model for
delivering child protection that reflects international experience and research.
We found that there is confusion on the model for child protection which
varies significantly between LHOs. At a most rudimentary level there are
questions about what is child protection and how it differs – if at all - from
promoting children’s wellbeing and wider family/community supports? There is
emerging agreement that the key to child protection is ensuring that there are
services in place to support children and families through times of crisis. This
is clearly the direction that some LHOs are moving towards.
The nature of child protection with its emphasis on risk can ironically create a
risk-averse culture. The scale of the risk can be understandably ‘enfeebling’,
acting as a barrier to putting needed supports in place for children and their
families in case that they increase the risk.
The following concerns beg an urgent strategic response:
• There are strong anxieties that the needs of children are secondary to the
needs of the delivery system. This applies both to HSE services and to
inter-agency collaboration on children. The role of the education sector is
particularly important but arguably this is where collaboration is weakest.
Children can easily fall through the service cracks.
• The needs of children in care are particularly acute as the HSE becomes
their parent on behalf of the State. HSE data shows that 40% of children
are in care for more than 5 years. This raises important questions about
how these children should be cared for and planning for their future.
Research shows that the age of entry and the speed of action to either
rehabilitate or find long-term alternatives is critical.3 A child over the age of
ten who is in care for a year is likely to be in care for the rest of their
childhood.
• Moreover many of the children in care are severely affected by their
experience of neglect and or abuse. These have long-term consequences
with increasing evidence of damaging neurological effects, particularly on
their ‘executive functioning’ - that is their capacity to manage their own
behaviour and make wise decisions.4 Some stakeholders also raised
concerns about their security while in care.
• The HSE has still not agreed how it is going to implement the Agenda for
Children’s Services – the national policy framework for children and family
services developed by the OMCYA. Apart from the obvious policy gap it
presents, it underlines the HSE’s difficulty in framing strategy and needs
to be addressed as a matter of urgency.
Social work professions are the backbone of child protection service. Yet their
positioning as a profession within the HSE and in other agencies is fraught.
The profession itself feels under-valued and routinely undermined. This is
particularly acute when interacting with the courts which in many ways has
become a ‘flashpoint’ of systemic issues on child protection.
What this means for the future
The absence of a clear model for delivering child protection in the context of
wider children and family supports is a major constraint in the current delivery
structure. It means that the focus tends to be less on what the child needs and
more on what the service is able to deliver. Developing confidence in child
protection means that the HSE must develop a model for child protection that
embraces children’s wellbeing and family supports. Without this wider canvas
to work from, practitioners on the ground will continue to operate within the
bounds of what individual professionals are prepared to provide rather than
what the child, the State or the HSE require. Developing supports for children
and their families as well as investigating the risk will require a fundamental
mind-shift in how people deliver child protection services.
Page 10
 2.3 Service Delivery
There are critical issues in service delivery that undermine confidence in and
the competence of the delivery system. These include unnecessary variation
in practice, uneven collaboration between services and agencies, inadequate
supports for social workers, uncoordinated interaction with the courts service
and unclear responsibility for budgets and resources.
Our Findings
There is unnecessary variation in how child protection services are delivered.
Some variation is inevitable given that the needs of children and the localities they
live in will differ. Individual professionals may also form different assessments of
children’s exposure to risk and how to support their wellbeing. The Ryan
Commission Implementation Plan included examples to highlight the complex cases
that social workers routinely manage. These cases show that it is not possible to
standardise the delivery of services in a formulistic way.
However, the level of inconsistency evident is unhelpful and weakens confidence in
what is being delivered for children and their families. This degree of variation is both
a symptom of the lack of a national service model for children and family services and
a legacy from the different practices that prevailed in the Health Boards. It means that
children can expect to be assessed and treated differently depending on where they
live and that ultimately their outcomes will be different. In particular there are
variations in::
• How cases are allocated and the length of time children can expect to wait. In
effect, ‘unallocated’ cases represent a waiting list (see appendix A for data on
variations)
• How children and their exposure to risk of abuse is assessed. Social workers
apply a number of assessment frameworks but there is no common assessment
framework.
• Different definitions and ‘threshold’s apply across LHOs. For example a ‘case’
can refer to a family or an individual child. There is particular confusion as to
‘threshold’ levels for protection and welfare.
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The HSE is fully aware of the level of variation across LHOs and has taken
steps to address this. The recent report of the Task Force clarifies the key
steps required for investigating child protection issues and where responsibility
lies (see appendix B) although there is low awareness of these changes
among social work managers
The needs of children come second to the demands of the service. This
is well-documented and widely recognised in the HSE and externally.
• Children and their families have to interact with different services and
agencies in different ways without the services conferring on what the
child needs. This raises a bigger problem about how services are
delivered.
• The quality of care planning is very mixed. They often deal with episodes
in the life of a child rather than anticipating key transition points in their
lives and providing appropriate supports.
• The effectiveness of case conferences is uneven – key people from
across services are not always represented and decisions not followed-
through afterwards.
• The HSE has failed some critical groups notably travellers and
unaccompanied children. It is now addressing unaccompanied children..
Recognising these issues, some LHOs are beginning to change their service
model so that they concentrate on what children need and not only
investigating risk or alleged abuse. There are also some excellent practices in
relation to strategy meetings and family conferences. However, they do not
happen as a matter of course and how they are managed can vary.
2.3 Service Delivery
Collaboration between services and agencies is uneven and for the most
part unacceptable from the perspective of the child. There are some
noteworthy examples of solid collaboration at local level but for the most part
the lack of collaboration is a palpable source of frustration for people working in
child protection in the HSE and other agencies.
• Within the HSE, different services may engage with the same child and
family. There are important structural issues limiting collaboration. The
service delivery areas are not co-terminus particularly in relation to
CAMHS (Child and Adult Mental Health Services) which is a critical
service for many children. It can be difficult to refer children between
services so that it is seamless from the child’s perspective. This is a deep
and understandable source of frustration for all practitioners and
managers working to protect children. An even bigger source of frustration
is the ability to refer children for psychological assessment and treatment.
Children who are not assessed to be psychotic but are still a significant
risk to themselves present real problems for the HSE.
• The emerging Primary Care Team (PCT) structure and Primary Care
Networks (PCNs) should provide an important forum for developing the
multidisciplinary approach to putting services in place. Primary care
services will be critical in identifying opportunities for early intervention to
prevent children and their families from sliding into neglect and abuse.
The operational social work linkages between PCTs / PCNs and the
broader child protection services will therefore be crucial.
Collaboration across agencies is also mixed and the level of collaboration
depends on the quality of local relationships. The OMCYA has piloted four
Children’s Services Committees to provide a forum for collaboration across
agencies within particular localities. While new, the feedback is positive.
However, it has taken a lot of energy and commitment to bring them this far.
They have been carefully constructed to ensure that they have the right
people on board. The picture outside of these areas is more mixed and for
the most part external agencies find it difficult to engage with the HSE.
Page 12
• In addition to the HSE, the Gardai also have a statutory role in protecting
children. They have voiced critical concerns about the availability of out-
of-hours service, difficulties in securing child case conferences in some
areas and children in care who go missing. The availability of out-of-
hours services was also highlighted in the Ryan Commission
Implementation Plan and was consistently raised by other agencies.
• Some key educational agencies – notably the National Education Welfare
Board - do not have formal links with the HSE. The NEWB is obliged to
report to the HSE if there has been an education welfare offence. This
would trigger wider concerns around neglect and welfare.
• On a more fundamental level, it is difficult for the HSE to engage with
core educational providers. The governance structures of schools
means that they operate independently. The Department sees its remit
as being to ‘educate’ rather than the welfare of children. Interaction with
educational bodies is a significant gap in developing the full range of
supports for children and their families
• Inter-agency protocols exist particularly with the Gardai. However,
agencies have not developed pathways to indicate what children can
expect.
• External agencies are key deliverers of services for families and children.
The HSE has significantly tightened its management of these agencies to
ensure that services are delivered to identified children and families.
This tighter management is perceptible on the ground and provides a
good foundation for future service development.
Managing resources
There is a gap between the authority for budget and the authority to make
decisions in relation to services. Front-line managers are correctly
responsible for taking decisions in relation to supports and potential care
arrangements for children. However, they do not have corresponding
budgetary authority. This disconnect between national and local level makes
it difficult to effectively manage the service.
 2.3 Service Delivery (contd)
A further specific resourcing issue identified during the review relates to the
level of maternity cover required for social work services. The social work
profession is predominantly female. In addition, their average experience is
8.4 years (see graph 46(a). Together they underline the potential implications
for service delivery in providing cover for maternity leave.
Support for social workers
Professional supervision and Continuing Professional Development are key
supports for social work professionals. In some LHOs – particularly Dublin –
social workers have an average of 3 – 4 years experience. This underlines
the importance of both professional supervision and CPD. The HSE has
developed a supervision policy for all professions which will also apply to social
workers. This focuses on individual supervision. However, it is unclear how
senior social work managers and professionals will have access to
supervision. We also found:
• A lack of understanding and clarity on the critical elements of CPD and
how they contribute to overall practice development.
• Variation in how LHOs provide CPD. Some services have structured
training while this is not the case elsewhere because of the embargo and
other constraints..
• A key gap relates to the supports available for senior social workers.
Many of them are either in senior positions and/or in post for some time
and have not had structured opportunities for CPD.
Under the Health and Social Care Professionals Council Act (2005) social
workers will have to be registered to practice. This will change the context
within which CPD and professional supervision happen in the HSE. The new
Council set up under the Act will enforce standards of practice and education
for social workers.
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Interface with the Courts
How the HSE interacts with the Courts is a ‘flashpoint’ of systemic
weaknesses, exposing key deficits in how they deliver child protection. The
current organisational structure complicates interaction with the Courts. Social
workers often feel exposed in court and this is partly due to the lack of clarity
on accountability. In addition, cases and service arrangements can be
complex. This makes it difficult for the judiciary to identify individual case
histories and to identify the appropriate individuals with the authority to take
forward actions. These factors complicate already intricate and sensitive
cases. There is little corporate-wide coordination of learning in relation to
courts at local level. Individual LHOs will get legal opinion on cases even
though similar cases may be before the courts in other LHOs.
The HSE has taken steps to improve its interaction with the Courts but it is still
a significant area of corporate and individual stress. Tangible changes in how
the HSE interacts with the Courts would also signal its intent to address wider
issues on how it delivers better outcomes for children.
What this means for the future
The level of variation in delivering child protection services is unnecessary
even allowing individual social workers the legitimate space to exercise their
professional judgement. The root cause of these variations is the absence of
a coherent service model together with how professionals collaborate with
other to deliver services. The HSE is already putting in place initiatives to bring
more consistency to practice at local level. However, it also needs to agree a
clear strategy and service model, develop how professionals collaborate with
other services and agencies, and build its supports for social workers. This will
require changes in how social workers deliver services so that there is more
consistency in how they apply their professional expertise in the context of
emerging practice.
The emerging PCT and PCN delivery structure for primary and community
care should address some of the service gaps that constrain social workers in
providing the full range of supports that children need.
 2.3 What the data tells us about service delivery
Figure 2

The HSE collates data on its child protection services E stim ated C hild P opulation in S A H R U D ecile 10 per Total S taff N um ber
monthly and quarterly. This data forms the basis of the T able 49
Annual Report on the Adequacy of Children and Family
Services. In addition, the HSE conducted an extensive 320

Child Population in Dec 10 per Staff

survey of social work and family support in 2008. Drawing

301
284
270
256
on these sources we developed a service profile that V s.

256
253
SAHRU
facilitates review of the data across LHOs (see Appendix A).

222
208
192
This illustrates the possibilities of immediately developing

197
196
184
Number
A verage

168
current data to a workable and valuable management

160
160
132.93

144
144
128
information tool for all managers.

126
116
101
95
86
81
64
The data in Appendix A extracts some of the data available

72
72
69
68
68
68
in the HSE in relation to: need, resources, service activity

37
31
17
0
0
0
and outcomes. For illustrative purposes we have

Cavan/Monaghan

Mayo
Galway

Carlow/Kilkenny

Meath
Dublin South City

South Tipperary

Laois/Offaly

Kerry
Louth

Dublin North
Clare

Dublin South
Cork North Lee

Cork South Lee

Donegal
Dublin North Central

North Cork

Dublin South East

Wexford

North Tipp/East

Sligo/Leitrim
Limerick

Wicklow

Roscommon
Waterford
Dublin South West

Dublin North West

Dublin West

Kildare/West

West Cork
Longford/Westmeath
highlighted key performance issues under each.
1. Need: Distribution of resources does not correlate with
the indicators of child population need Figure 3
The SAHRU* index shows the size of the child population
Numbers
S ource: S A R Hof Key
U 2007 & CWorkforce
ensus 2006 byLoLHO
cal H ealth O ffice
per LHO in the most deprived socio-economic group, who
tend to be most at risk of child protection issues. Figure 2 Table 24 Detail
Principal
shows the number of children in this vulnerable population 60 Social W orker
per child protection staff member by LHO. It shows that 1
2

Stacked Number of Workers

5 3
resourcing is not influenced by the indicators of child 48 1
6
5
2
1
5
1 Child Care
population need. 7
3
5
4
8
3 2 W orker
8 4 8 1 1 1
6 6 1
2. Resources: There are variations in staffing levels that are
36 4
6 1
3 5 1 4 2 6
4 3
8 7 10 2 1 1 1 Senior Social
not indicative of need
1 2 5 4 4 4 3
7 7 2 6 1 1
6 7 5 2 2 3 5
1 W ork
24 5 5 6 6 1 1 2 5 6 1 1
43 5 4 5 2 1 1 Practitioner
As figure 3 illustrates, there is a broad range of child 4 5 2 4 3 1
1 4
38 37 3 2 3 4
33 1 3 3 2 3 1 1
protection workforce size across LHOs. Relating workforce
4 3 4 4 4 1
27 27 26 24 24 1 3 4 Team Leaders
12 23 23 23 22 22 21 20
20 20 19 18 18 3 3 4 2
to workload, or LHO population, does not entirely explain 17 16 15 2 1
2
13 13 12
10 9 8
11
8
the differences in child protection staffing by area. The data 0
6

suggests that child protection workforce is still predicated on

Professionally

Mayo

Cavan/Monaghan
Galway

Carlow/Kilkenny
Meath

Cork South Lee

Cork North Lee

Dublin South
Laois/Offaly

Louth

Kerry

Clare
Dublin North

South Tipperary
Dublin South City

Dublin South East

North Tipp/East
North Cork
Donegal
Dublin North Central

Sligo/Leitrim

Wexford

Roscommon
Limerick

Wicklow

Waterford
Dublin North West

Dublin South West

Dublin West

Kildare/West

West Cork
Longford/Westmeath
Qualified
legacy staffing levels from the old health boards, rather than Social W orker

the requirement for resources in each LHO.

There is also noteworthy variation in years experience and
length of service of staff by LHO, ranging from 4 years in
some of the busiest Dublin LHOs to 12 years in some rural Local Health Office
LHOs with lower referral volumes. Source:
Pagepopulation
*Small Area Health Research Unit - SAHRU - is a national deprivation index. SAHRU Decile 10 refers to the most deprived 14 groups.
 2.3 What the data tells us about service delivery

Figure 4
3. Service activity: The LHO approach to case allocation and
management is inconsistent Allocated Cases by LHO
Table 31
‘Welfare’ is the overall most common reason for a referral (55% of
all referrals) however by LHO, it accounts for between 96% and

Percentage of Cases Allocated

100%

100%
100%
6% of referrals, reflecting the different approaches and emphases

95%
95%
91%
90%
90%
88%
taken by LHO.

88%
88%
85%
80%

85%
82%
81%
81%
81%
71.69%

75%
75%
%
Similar variance is in evidence regarding risk designation. The

70%
69%
Allocated

65%
60%

62%
61%
proportion of cases designated ‘high risk’ averages 41%

56%
55%
51%
49%
Average
nationally. At LHO level this ranges from 81% to 18%.

46%
46%
40%

38%
In some LHOs, a high proportion of cases (up to 70%) are not

30%
26%
20%
allocated to a social worker. Whilst the definition of case
allocation varies, the data points to an unnecessary degree of 0%

Mayo

Cavan/Monaghan

Galway

Carlow/Kilkenny

Meath
Kerry

Laois/Offaly
Dublin South City

Cork North Lee

Dublin South

Cork South Lee

South Tipperary

Louth

Clare
Dublin North
North Cork

North Tipp/East

Donegal

Dublin South East

Wexford

Dublin North Central

Wicklow

Limerick
Sligo/Leitrim

Roscommon

Waterford
Dublin West

Dublin South West

West Cork

Dublin North West

Longford/Westmeath

Kildare/West
variance in approach and suggests potential risk in unmanaged
cases on waiting lists. The caseload per social averages 17.9
nationally. Further analysis shows significant differences by LHO,
as the average caseload ranges from 4 to 40. Figure 5
On average, each social worker spends 7.9 hours per week Length of Stay of Children in Care Local Health Office
Source: HSE National Social W ork Survey
travelling – approximately one working day. This ranges from 2 Table 14
hours to 16 hours, and does not seem to be determined by the

Stacked Number of Children by Length of

450
geographical area covered by the LHO.
102
This analysis provides a starting point for understanding the areas 360

and reasons for variance in service delivery by LHO. 137 140

270
>5 years
4. Outcomes: The outcomes delivered for children vary by LHO 204
46 72 1-5 Years
180 56 99
Available outcome information such as the proportion of the child
Stay 42
142 155 74 54 55 <1 Year
57
46 33 42 40 97
population in care, and the length of stay in care, is highly 56 90 54 69
94 52 36 73 61 82
90 48 61 77 97 82 26 57
57 68
86
variable by LHO. Neighbouring LHOs deliver very different 124 60 62 52 76 83 32 40
35 50 57 64 16 48 62 42
77 73 69 68 65 65 54
51 49 44 43 42 33 33 33 32 30 25 25 35 48 44 33 28 61
outcomes for children. The data also shows that a considerable
24
26 23 21 21 20 19 19 19 17 17 15 13 11 10
0

Mayo
Cavan/Monaghan

Meath
Carlow/Kilkenny

Galway
Cork North Lee

Laois/Offaly

Kerry

Dublin South City

Louth
South Tipperary

Clare
Cork South Lee

Dublin North

North Cork

Dublin South
Dublin North Central

Dublin South East

Donegal

North Tipp/East
Wexford

Sligo/Leitrim
Wicklow

Roscommon
Limerick
Waterford
proportion of children in care, over 40%, have a length of stay of Dublin West
Dublin North West

Kildare/West

Dublin South West

Longford/Westmeath

West Cork
more than 5 years.
The number of children in residential care per 1,000 child
population by LHO averages 0.54 but varies from 0.25 to 1.55.
The number of children in foster care per 1,000 child population Local Health Office
by LHO averages 3.24 but varies from 1.14 to 7.52. So rce Childcare Dataset 2008
Page 15
2.4 Performance management
The service is missing key elements of an effective performance
framework. The available child protection data set provides a good
foundation for a future performance management infrastructure.
Our Findings
Performance management to deliver citizen outcomes is a central tenet of the
Government’s public sector reform programme.5 The review considered
whether current child protection structures have the capacity to monitor and
evaluate performance, and to use this information to adjust policy and service
delivery accordingly. This review found that there is a rich child protection data
set but key elements of an effective performance framework are missing.
• The HSE has made substantial progress in gathering data on its
child protection service. The HSE has comprehensive data collection
processes in place, providing a rich dataset on a regular basis on most
aspects of service delivery, excluding finance. Data collection is however
limited to the child protection service, rather than reflecting the services
and agencies that deal with children. The HSE publishes an annual report
on children and family services which provides comprehensive information
on performance of the service.6 However, there is little evidence that this
is being used to inform current and future delivery of the service.
• Despite the wealth of data, there is an absence of management
information. Data is not collated and interpreted to distil key messages
for those managing and delivering the service, such as demand levels,
service activity and efficiency, and crucially the outcomes delivered for
children. Managers are not routinely using existing data to inform their
approach to service planning and delivery. This is partly because of a
lack of confidence in the accuracy of the data and inconsistency in the
definitions across LHOs. However, these quality issues would be
addressed through more routine use of existing intelligence.
• Financial management information in particular is limited: There are
significant inadequacies in the HSE infrastructure which make financial
reporting on child protection difficult. Financial management information is
not sufficient to manage the service as it cannot allocate and prioritise
resources. Budgets are unclear, and accountability for spend is
disconnected from decision-making regarding the service. Page 16
• Desired outcomes and performance indicators are not defined: The
service would benefit from a clear, shared definition of success for
children articulated into meaningful metrics that the service can use to
monitor and manage delivery. This would inform goals and objectives at
local level, and provide clarity on the performance of the service at all
levels. Defining outcomes for the service is not easy but the process of
doing so helps to shift mind-sets from the HSE can deliver to what it
should deliver.
Addressing these issues would provide:
• the intelligence to focus the service on achieving the desired results for
children
• all levels of the HSE will a clear picture of performance and efficiency.
The governance framework must also provide a structure for considering and
using intelligence to drive the service. The available data is not used to inform
discussion and review service performance at any of the routine local or
national child protection fora. The data could be used to drive priorities and
actions at local level as well as informing strategic decisions on the directions
of the service and the allocation of resources. The reticence in applying data
to develop services raises wider cultural issues relating to performance
management in the HSE and is not confined to child protection.
What this means for the future
The existing data collection provides a foundation for performance
management and allows for the immediate introduction of monthly
management information. this management information would provide vital
support to those managing and delivering child protection services, monitoring
trends, practices and informing future policy and resource allocation. the
collection of supporting data could be expanded to draw on other services
(e.g. CAMHS) and agencies (e.g. gardai) to provide a holistic and system-
wide view that is child-centred. The future development and enhancement of
the service requires an articulation of what success looks like, supported by
outcome metrics to show how the service is delivering. Creating a structure
with the responsibility to review this information and the authority to act upon it
would transform child protection to an intelligence led service.
Part B – Looking to the Future

Part B outlines proposals to build confidence in the management

and delivery of child protection.

Section 4 outlines recommendations to:

Section 3 outlines thinking behind the recommendations:
4.1 Develop strategy and coherent service model
3.1 Foundations for the future
4.2 Deliver child-centred services consistently
3.2 Six principles to guide future management and delivery
4.3 Develop an intelligence-led delivery of services
3.3 Elements of evolving strategy and service delivery model
4.4 Develop a clearer management structure
3.4 Foundations for developing the Service

Page 17
 3. Looking Forward – Foundations for the Future
There is clear evidence from this review of the commitment and initiative of
individuals in the HSE who work with children. They work with and manage
services for the most vulnerable members of society in situations that can be
highly stressful. Despite this evident commitment and competence, overall
confidence in child protection is low. This review has found significant
problems in service delivery which require action at a number of levels:
• Agree and communicate a clear service model for the future that focuses
on outcomes for children. This should guide both managers and all
practitioners on the priorities for engaging with children at risk.
• Bring consistency to how the HSE delivers services, strengthen
collaboration and provide supports to people working with children and
their families
• Develop an intelligence-led system that uses data currently available to
improve the service
• Simplify and make clearer key roles and responsibilities across the
delivery system.
All of these elements are essential and together they constitute a significant
programme of service and cultural change the scale of which we do not
underestimate. Together they will provide a clear framework within which
everybody working with children can be clear of their own responsibility,
accountability and authority for ensuring children’s wellbeing. Ultimately, it is
about people being clear about what’s expected of them and ensuring that they
have the supports to deliver services.
The Ryan Commission Implementation Plan clearly indicated that any
additional resources would depend on significant service reform.
Page 18
The temptation in a review like this is to propose significant structural change.
Embarking on a journey of structural change can give a sometimes false
assurance that change is happening. However, it can often distract from the
main motivation for change and take up too much time and energy to
implement. This review has shied away from major structural change. Our
focus has been to propose changes that are absolutely necessary to:
• Bring clarity to key roles – both internally and externally,
• Ensure that the structure reflects and drives key functions.
The HSE is currently ‘reconfiguring’ its services at national, regional and local
level. Our proposals takes as their starting point the structure agreed at
national level and will be flexible to incorporate PCCC changes at local level. A
key new role is the post of Assistant National Director for Children and Family
Services. This post will provide clear leadership at senior level in the HSE and
should, with appropriate authority and resourcing, provide the leadership to
drive this change programme.
As a general rule, ‘structural’ change is designed to implement strategy and
service models. This was not possible in this review as the service model is
not defined. However, our proposals reflect our understanding of what the
HSE’s service model should include based on emerging practice. In this
section we outline:
• Six Principles guiding our recommendations for the future. These set out
what the proposals must achieve.
• Our thinking on the core elements of the future service model. These are
based on what practitioners and academics have learned about child
protection in Ireland and internationally.
• Foundations for the future which develops recommendations based on the
four parts of our assessment framework.
 3.1 Six Principles to guide future management and delivery

We have identified 6 principles to guide the future delivery of child protection
and our recommendations. They are easy to understand, easy to identify with,
and should garner widespread support across all practitioners and managers
working with children and their families. They reflect what we found during the
review, the national policy and legal framework, International experience and
research on child protection. As such, they provide focus and rationale for
making the changes that we recommend.
A clear requirement of the review is that recommendations should ‘fit’ with the
overall reconfiguration programme that the HSE is developing. At this point,
the national structure is being implemented while structures below regional
management level are not yet fully determined.
We have also taken account of the Ryan Commission Implementation Plan
which includes 35 actions on the management of child protection. Our
recommendations complement the actions identified in the Implementation
Plan.

Principle What we mean by this

Structure capable of delivering change • Future focused leadership at all levels of the HSE
• Helps to drive delivery of clear service model that includes family and community supports

Child Focus • Built around the child; not what the service can deliver with single point of contact for each child/family
• Future focussed service planning for children based on predictable transition events
Simple and clear structure • Clear points of authority, responsibility and accountability at national, regional and local level
• Structured to deliver goals and manage risks
Confident • People in the system are confident and people have confidence in the system.
• Clarity about what the system is there to deliver and supports needed.
• Consistency in how services are delivered
Taking responsibility and being • All professionals are responsible for Child Protection – not just social workers.
accountable - Openness and transparency
• Supports collaboration between professionals, services and agencies - communication and trust
• Professional delivery of services within the context of corporate accountability
Intelligence led • Bring intelligence to decision-making on children’s futures
• Use intelligence for tighter management across all levels on service activity, outcomes and resources

Page 19
3.2 Elements of evolving service delivery model

Social care and well-being is intrinsically and mainly about deprivation and The service model must cover 5 critical points
neglect; about ameliorating the effects of these for individuals, families and • Ensuring an effective system of referral management
communities; about supporting them in building upward spirals in their lives.
Child abuse occurs across all circumstances; often it is about intervening in • All areas need a professionally led team focused on supporting families,
downward spirals, often it is about stopping abuse. in some cases probably over decades. This needs to be proactive, and
SW led. Refocusing professional work on this is a major task. Each case
Leaders of these services in HSE, as across the world, face dilemmas and needs careful planning. (See Monageer)
opportunities in deciding how to direct resources, follow through on plans and • All children in care need to have their own social worker, from day one.
vitally deliver the clarity, confidence, communication and in time the stability Establishing their particular focus (and indeed file), and taking
that is needed. Certain features must be designed into delivery e.g.: responsibility. There should be some degree of ceremony, respect – but
again not too much.
• If children come into care act fast to rebuild family or alternative family
care; • Interagency work needs good communication, feedback, letting people
know what is happening,
• if this is not possible after some weeks, then intensify efforts;
• Forms and IT systems should be practitioner led, research informed and
• after a few months more or perhaps a year then recognise that the child system delivered.
may be in care long term, avoid repeated admissions;
Parents, families and communities vary enormously. They all have strengths
as well as weaknesses. They face different challenges. It is a professional Figure 6: Hierarchy of support
Level 4 services for children and families
task to recognise pro-actively what these might be; how unexpected Children
transitions may effect stresses in personal and family coping, how predictable in care
transitions may effect families as well as individuals.
Figure 6 illustrates the hierarchy of supports for children and families based Level 3 Specialist services
on the Implementation Plan arising from the Ryan Commission. Children and families with
risk of significant harm

Level 2 Support services

Children and families in
need

Level 1
Universal Services
All children and families

Page 20
 3.3 Foundations for developing the service

Figure 7 illustrates the foundations for building confidence in child Figure 7: Overview of recommendations
protection services in the HSE. The four elements are based on the
assessment framework for reviewing services.
• Implementation of Agenda for • Clear roles, responsibility
They are all essential building blocks of change although there may
Children’s Services and accountability at local
be slightly different timescales for implementing them.
• Clear service model based on level
practice • Collective management
• The first and most urgent requirement is to develop the service
model which focuses on outcomes for children.
• We are proposing minimal change to the structure to avoid
distracting from the overall change programme. Most of the
d
an del
change proposed can be implemented relatively easily.
y o
eg m

G
• The HSE already has a number of initiatives to bring
t

ov na
ra e

M
consistency in how services are delivered. The
St rvic

er ge
a
recommendations in this review support and complement these

na m
se

nc en
initiatives. In addition, we focus on a number of key areas

e t
central to effective service delivery – some of which can be

&
implemented immediately, others will require longer timescale.
• The HSE can immediately make significant strides towards the Positive outcomes
‘intelligence-led’ service delivery. It already collates data that, for children

Se
while not perfect, is a valuable starting point for looking at the
d

r
service and collaborating across services.
le

vi
e-

ce
nc
On their own, individual recommendations will have limited impact.

de
However, if implemented as a coherent programme of change, they e
llig

l
iv
te
should significantly affect how the HSE protects children.

er
Clarify service model In

y
This report also includes a proposed implementation plan. Making it •
happen will put significant demands on individuals at national, • Implement Task Force
regional and local level to make them happen. The new Assistant recommendations
National Director for Children and Family Services will play a key role • Develop future resource model • Convert existing data to
and will need to be supported and resourced to do so. Once they are • Strengthen internal and external management information
in post, they may want to vary the implementation plan to ensure that collaboration • KPIs linking the service activity
it reflects their priorities. • Strengthen professional to service goals
supervision and CPD • File management and
• Streamline interface with the information sharing
Courts

Page 21
 RECOMMENDATIONS
4.1 Develop coherent service model
4.1.1 Develop immediate response to the Agenda for Children’s Services
The Agenda for Children’s Services is the Government’s policy framework on
children and family services. The HSE needs to adopt a detailed plan for
implementing the Agenda to underline its overall commitment to children and
family services and to inform its future service model. This is also a
requirement of the Ryan Commission Implementation Plan.
4.1.2. Urgent priority to articulate and communicate service model
The HSE has an immediate need to articulate a clear model of services for
children and families to guide how practitioners deliver services. An early
priority of the new AND for Children and Family Services will be to develop this
service model in conjunction with social work managers.
The service model should reflect the Agenda for Children’s Services and
include guidance on:
• Early intervention
• Family supports
• Permanency planning – managing expected and unexpected transitions
• Crisis management including out of hours services
• Children in care and aftercare
• Working with other agencies.
The development of the service model is an important opportunity to work with
senior social work managers and other practitioners to get a shared view on
how the HSE can support children and their families. It is therefore an early
opportunity to put down some leadership ‘markers’ across the service. We
would therefore recommend that the new AND should develop the service
model through discussion with senior social work practitioners, CCMs, LHMs
and other relevant practitioners working with children. While it a pressing need
for the HSE, it is critical to develop a sustainable, coherent and workable
model.
Page 22
4.2 Child-centred service delivery
4.2.1 Implement recommendations of the Task Force to bring
consistency to child protection process
The HSE set up a task force to review key processes governing child
protection together with key roles and responsibilities. Appendix B illustrates
the key steps in the child protection pathway. The HSE should urgently take
steps to implement this level of consistency. It will provide assurance that
LHOs are consistent in their approach to investigating child protection. In
addition, the new AND for Children and Family Services needs to clarify key
definitions and thresholds governing areas such as:
• Allocated/unallocated cases
• Case files – should they be defined in terms of families and/or children
• Definition and treatment of risk.
The HSE’s current data on children and family services provides rich
information on the varying practices that apply across LHOs and the outcomes
they deliver. The AND for Children and Family Services should review the
implications of this data to understand resourcing and practice of service
delivery.
4.2.2 Develop future resource model that reflects need
A central finding from this review is that the current allocation of resources
does not necessarily reflect children’s need. The recent Survey6) provided
valuable information on the allocation of resources across LHOs. Appendix A
illustrates where resources are located. We recommend that:
• Data on resources should be routinely collected either through the
ChildCare Data set or annually through the section 8 review, Survey of
Adequacy of Children and Family Services.
 RECOMMENDATIONS
4.2 Child-centred service delivery
• Additional posts allocated to the HSE under the Ryan Implementation
Plan should be allocated on the basis of need rather than automatically
where the original post was vacated. This should help to redress the
resource imbalance and particularly prioritise the Dublin area.
• The AND for Children and Family Services should continually review
resource allocation levels with LHMs and local managers of children and
family services to ensure that they correspond to need.
• The AND should review the relationship between resourcing and service
delivery and in particular propose options to provide cover for maternity
leave where it is affecting service delivery. Options to consider include
the possibility of ‘roaming’ teams to provide cover where it is needed.
4.2.3 Strengthen collaboration with other services in the HSE.
There are some significant structural constraints that affect cross-service
working. The HSE is addressing these constraints as part of its current
transformation programme. Pending this wider programme of change, the
following measures could strengthen cross-service working:
• More structured multi-disciplinary fora at local level to collectively review
cases and services. The new Manager of Children and Families Services
at local level will convene these fora. These fora will help to:
– Address cross-service issues for individual children and ensure that
services are targetted in a focused way for individual children and
their families. This will provide a basis for setting outcomes for
children and families from external providers.
– Identify wider service issues affecting families
– Review range of supports provided by all services for children.
These fora will be ‘intelligence-led’ drawing on data available to practitioners.
.
Page 23
• A key barrier limiting cross-service working is how professionals talk to
each other. How professions value themselves and their professional
standing becomes a factor. Elsewhere, we make recommendations to
strengthen CPD and professional supervision. These will enhance cross-
professional working. PCT’s and PCNs will also stimulate new ways of
working for primary services and this should have a knock-on effect in
child protection.
• Review how the service interacts with children to listen to their concerns in
line with the recommendations of the Ryan Commission Implementation
Plan.
4.2.4 Strengthen collaboration with other agencies
This is a challenge that goes beyond the HSE and raises more fundamental
questions on inter-agency working in the public sector and also about the
professional standing of social work practitioners
• In the past year, the HSE has tightened its management of services
delivered through the voluntary sector. These relationships need to be
further managed so that:
– there are clear national and local arrangements in place governing
service delivery
– Services are delivered for identified families and children rather than
through programmes.
• The new Manager of Children and Family Services at GM level will play a
key role in collaborating with other agencies. For the most part,
collaboration on the ground depends on the quality of local relationships.
The Manager will help to facilitate these relationships by putting local
arrangements in place as appropriate. An early priority is to develop
collaboration with the Gardai and the NEWB. Engaging with all
educational bodies will be central to future services.
 RECOMMENDATIONS
4.2 Child-centred service delivery
• Develop pathways to facilitate inter-agency working.
• Collaboration with other agencies should focus on sharing information and
intelligence. Current data sets are not geared towards inter-agency
working but they could be refined and adapted to make them meaningful.
Within the limits of data protection, information sharing should also identify
the needs of individual families who need support. The proposed National
Chlldcare Information System will assist collaboration but does not
depend on it.
• The AND for Children and Family Services will play key role in developing
national framework for inter-agency working which will form the
parameters of local relationships.
4.2.5 Strengthen professional supervision and CPD
The HSE has agreed a staff supervision policy and this needs to be
implemented urgently. The policy covers roles and responsibilities of the
organisation, the supervisor and supervisee; the contract; This will ensure that
there is a rigorous process of professional supervision in place before the
statutory requirements under the Health and Social Care Professionals Act
2005 applies. However, it does not explicitly address the needs of social work
managers. Their needs also need to be addressed. These could be
addressed through informal group supervision or through CPD. The most
realistic option is through CPD.
The ultimate responsibility for CPD lies with individual social workers and their
managers. However, we are recommending that the HSE should support the
development of CPD by:
• Clarifying the implications of the registration process with the Health and
Social Professionals Council and the National Social Work Qualifications
Board
• Engaging with Schools of Social Science to see how they could support
CPD for the HSE.
• Developing a framework for delivering CPD that covers:
– Professional competence and practice
– Management competence. All social work managers will be
required to manage people and their service and need to be Page 24
supported in this.
– Personal competences.
Delivery of CPD will be through a number of routes.
• Programmes of CPD support should be concentrated initially to :
– Develop competences of social workers who have most recently
completed their qualifications. The Survey on Social Work Services
conducted in 2008 suggests that some LHOs – particularly in Dublin
– have particular development needs because of low average
experience. Dublin also coincides with the highest volumes of
referrals.
– Develop management competences of all social work managers.
The HSE is currently developing programmes to build leadership
competence throughout all services. The option of prioritising social
work managers for a pilot customised programme should be
assessed.
4.2.7 Streamline interface with the Courts System
Simplifying the management and delivery structure for child protection should
yield improvements in how the service interfaces with the Courts. In addition,
the AND for Children and Family Services should take responsibility to support
LHOs in interacting with district courts and the High Court through:
• Taking a coordinating role in relation to court representation in the short-
term. This should include support to social work professionals and
managers who represent the HSE through, for example, an expert witness
programme and/or coaching. This would both professionalise how the
HSE interacts with the Courts and develop the confidence and
competence of individuals representing the HSE.
• Overseeing the consolidation and sharing of legal opinion on practice and
related guidance.
Our understanding is that the HSE is planning to set up its own Legal Service.
Once this is established it will be a critical central resource for LHOs in
coordinating court cases.
 RECOMMENDATIONS
4.3 Performance Management: Developing an intelligence-led system

4.3.1 Implement immediate management information based on existing 4.3.4 Develop a workforce model for the service
data
The analysis of existing data shows variance in workforce allocation and
Existing data collection processes provide sufficient data with which to develop utilisation at LHO level. The refreshed structure provides an opportunity to re-
a monthly management information report, covering aspects such as: visit resourcing by LHO, based on child population need and service demand.
The operational consistency promoted by the taskforce work will also help the
• Access: including demand for services
service move towards more uniform caseload levels.
• Efficiency: including activity by LHO
These factors will be important to incorporate in a workforce model showing
• Integration: reflecting joint-working internal and external to the HSE how resources will be organised in the new structure.
• Outcomes for children. 4.3.5 Long-term development of intelligence-led system
Appendix A provides a template to illustrate how this data could be presented Both the Ryan Commission Implementation Plan and the Knowledge
and applied to provide individual LHO performance and aggregate Management Strategy provide detailed proposals for the longer term
performance at regional and national level. The proposed categories currently development of information systems and information sharing. The HSE is
apply to HealthStat. There is scope to expand data gathered at local level to committed to implementing these recommendations in conjunction with the
include delivery of services for children, family conference, strategy meetings OMCYA and the Department of Health and Children. These cover
which some LHOs are already collating.
• Integrated case management to facilitate delivery of services
4.3.2 Develop outcome-based performance metrics
• Development of National Child Care Information System to support front-
Linked to the development of the service model, the system requires a shared line staff and managers across all agencies interacting with children.
definition of what success looks for children, translated to a set of clear metrics
to monitor benefits delivered.
4.3.3 Clarify budget and expenditure reporting
The budget allocated to each function of the future model at LHO level must be
clarified. It is essential that local managers are aware of the budgetary
framework within which service decisions are made. This requires:
• Clarification of the budget at national, regional and LHO level
• Development of monthly financial reporting on expenditure.

Page 25
4.4 Towards a clearer structure

In line with our six principles, we are proposing changes to the management We considered two principal options to adapt the structures.
structure to ensure that there are clear points of accountability, responsibility
1. A ‘command and control’ type model with all services reporting to the new
and authority at national, regional and local level for children and family
AND for Children’s Services post.
services.
2. An integrated model of delivery that positions children and family services
Our proposals reflect a number of ‘givens’:
within the overall PCCC framework.
• The HSE is currently re-configuring its national structure and senior lines
We briefly outline what the first option might look like, its benefits and
of responsibility at regional level. This includes a new and potentially
drawbacks. It is a very attractive option for bringing clarity and
crucial element in providing leadership for children and family services –
transparency to the management structure and strengthening social work.
the post of Assistant National Director for Children and Family Services.
It would also give real ‘bite’ to the new Ass. National Director role.
• At this point it is unclear what the structure below the proposed Regional
However, it suffers from a real disadvantage in that it is contrary to the
Operations Director is likely to be. Our understanding is that at a
stated ambition of the HSE which is towards service integration. This
minimum the HSE is likely to combine some of the smaller LHOs to bring
model would be akin to developing a national service. It would also
more consistency in LHO size. However, the scale of any re-
create new risks of further isolating social work from other services and
configuration at local level is unclear at this point and any wider
professions to the detriment of children.
management implications.
On balance therefore we have opted for the integrationist model. We are
• The PCT and PCN will be the central axis around which primary care
also proposing that core elements of a future service model (children in
services will be provided to children and their families. Social work
care and children’s wellbeing) should be reflected in the management
services will therefore need to interact operationally with PCTs and PCNs
structure at local level to help drive change in children and family
to ensure that primary supports as well as more therapeutic supports are
services.
in place for children at risk. PCT’s will be population-based and the local
social work structure needs to be co-terminus with PCT/PCN boundaries. We are assuming that the HSE will streamline the LHO structure with
smaller LHOs being amalgamated. This means that the proposed
Within these ‘givens’ there is still some uncertainty around the future overall
structure should be viable in all LHOs. If this amalgamation does not
model of delivery of PCCC services. For this reason, we are proposing the
happen the proposed structure at local level will need to be adjusted to
minimum changes required to bring clarity to people’s roles in the context of
reflect the needs of smaller LHOs.
what child protection and welfare require.

Page 26
 3.2 Option 1: ‘Command and Control’ management structure for Children and Family Services

Key Features of this option are: Figure 8: ‘Command and control’ management structure
‰ The local structure reports directly to the AND for Children and
Family Services
CEO
‰ There are no formal operational connections to the PCCC and
regional structure
ND for Quality & Clinical Integrated Services Directorate
‰ Local structure – defined on the basis of case loads allocated by Governance
team. Variations of this structure at local level could include
dedicated managers for children in care and for children’s well
being as outlined in option 2. ND - Reconfiguration ND - Performance & Fin.Mgt

The strengths of the option are: RDOs x 4 AND CFS

AND MH
+ Strengthens the ‘spine’ of social work department
AND Disability
+ Brings clarity to both the strategic and operational structure with a
clear line of sight from top to bottom AND OP
+ Able to deliver change in relation to Child Protection – bringing
consistency of implementation of Children First
Regional
+ Focussed on child protection and families/welfare
Head of CFS: Region X4
+ At local level focus on individual cases
Weaknesses
− The potential effort in strengthening social work could distract CFS Manager
from the core purpose – delivering positive outcomes for children. X 32

− The structure does not encourage move to emerging service Local

Team Leaders
model XN
− It is removed from PCCC and could be isolating from core
services and make cross-service interaction more difficult
Social workers XN
− The signalling and messages run counter to integration
messages of the HSE.
− It is potentially isolationist and stigmatising for social work
professionals. Page 27
 Option 2: Recommended option: ‘Integrated PCCC model’

Key features of integrationist option: Figure 9: Integrated Model

• The AND for Children and Family Services will provide
CEO
overall direction although operational responsibility will be
through the RDOs. This is in line with the HSE’s current
reconfiguration programme. The AND will be allocated a ND for Quality & Clinical Integrated Services Directorate
team from the current specialist roles who will have Governance
responsibility for overseeing development of core services.
• The re-configured PCCC structure is the primary delivery ND Reconfiguration ND Performance & Fin.Mgt
route for Children and Family Services i.e. via Regional
Director and LHM or the GM
AND CFS
• A full GM post for Children and Family Services – this will RDOs x 4
be the direct point of contact for inter-agency and inter- AND MH
service collaboration at local level. There will be
management responsibility for Children in Care and for AND Disability
other children and family services related to children’s Local level
LHM or GM
welfare. This single role replaces the current roles of CCM AND OP
and PSW, which are not required under the new structure.
• The core delivery structure below manager level i.e. Team
Leaders and social worker - will be similar to what exists at
Manager for Children
present. There will be a dedicated referral team led by a
PSW to handle all referrals.. They will report to the and Family Services
Manager for Children’s Welfare to minimise the potential
number of service handover points for children.
• The new structure will be integrated to Primary Care Manager – Children’s Manager –
Teams and Networks to ensure that families are getting Welfare Children in Care
supports early. Team Leaders will play a central role with
PCTs/PCNs. Key Worker will co-ordinate service for Team Leaders Network
Referral team Team Leaders
children. Key worker will be determined by referral path
(PSW lead))
into the system e.g. through family services, child
protection referral. Child Protection Team Leader retains Social workers Social workers PCT
accountability where there is a Child Protection issue
• Senior social work practitioners will have a key role in
particular difficult cases and in providing CPD and
professional supervision.
Page 28
 Option 2: LHO level view of recommended option: ‘Integrated PCCC model’

Key enablers of integrationist option:

• This model is designed to ensure clear accountability and
responsibility at LHO level through the allocation of
responsibility for children’s welfare and children in care with
a separate referral team managed by a PSW. This structure
would not however be viable for smaller LHOs. The model Figure 10: LHO level view of Integrated Model
assumes that the number of LHOs will reduce as part of
HSE re-structuring and that if necessary in the interim,
Children and Family Services would be shared across LHM or GM
smaller LHOs.
• The two legacy roles of Child Care Manager and Principal
Social Worker will not be required within this model. Within
this simplified structure, the role of Manager for Children Manager for Children
and Family Services replaces both these roles. This should
and Family Services
not generate an additional resource requirement. Current
PSWs and Child Care managers will retain their current
Terms and Conditions and will be allocated to new roles of
Manager for Children’s Welfare and Manager for Children Manager – Children’s Manager –
in Care. Any new appointments at this management level Welfare Children in Care
will be at PSW grade or equivalent.
Network
Referral team Team Leaders Team Leaders
(PSW lead))

Social workers Social workers PCT

• The Manager for Children and Family Services reports to
one management point within this structure. This will either
be the LHM or GM of the LHO. We would recommend
that the qualifications for this post should ideally include
social work qualification and substantial experience in child
protection.

Page 29
Understanding our recommended organisational structure

The principal strengths of the proposed management structure is that it:
• Is integrated with the emerging services models for PCCC and
specialist services in the HSE. As PCTs and PCNs develop, this
should correspondingly strengthen children and family services.
• Allocates a single point of accountability at local level for children and
family services with clear responsibility for clinical and management
leadership.
• Allocates responsibility for delivering key service elements locally i.e.
Managers of Children in Care and Children’s Welfare. This will help
to drive delivery of new service model.
However, there are also a number of potential drawbacks:
• The PCCC structure and services are still not fully evolved at
local/regional level. This brings an element of uncertainty to the
model.
• The new role at GM level of Manager for Children’s and Family
Services carries important responsibility and accountability for
clinical governance and management of the services. They will
report to the LHM or GM but take guidance from the AND/CFS which
potentially brings ambiguity and confusion to responsibility for
operational delivery.

Figure 11 Proposed management roles linked to support framework for children and families7

Manager -
Children in
Level 4 Care
Children
in care
Manager –
Children and
Level 3 Specialist services Family
Children and families Services
with risk of
Manager -
significant harm
Children’s
Welfare Local Health
Manager or
Level 2 Support services General Manager
Children and families
in need

PCT/
Level 1 PCN
Universal Services
All children and families

Page 30
Key roles in further detail
AND for Children and Family Services
Under the HSE’s current reconfiguration, this is a new and critical role in
leading the HSE’s delivery of children and family services in line with
Government policy. In addition the new AND will be the key link to the
Department of Health and Children in relation to children and family services.
The AND will be responsible for defining the delivery model at national model
but will not have operational responsibility for delivering services at regional
and local level. Their role will be critical in terms of providing national
leadership but what will give them the authority to truly give the role ‘clout’ and
exercise their remit? The risk is that the AND role will be become subsidiary to
the operational needs of the regions and it will be difficult to find a meaningful
way of engaging with services on the ground. The AND therefore needs the
resources to give effect to its intended remit.
We recommend that the AND:
• Has a small Office staffed by all existing specialists with responsibility for
key areas requiring attention e.g.
– Development of strategy and service model at national level – an
immediate priority
– Development of learning culture through routine evaluation of
services and in particular developing a framework of CPD and
professional supervision
– Development of ‘intelligence’ to guide system development. The
current information officers are an important resource and should
report directly to the Office while operating within the regions.
– Facilitate development of local services by providing national
framework of support e.g.
• National Framework to assist local delivery in relation to critical
issues e.g. separated children seeking asylum, inter-country
adoption services, special care in high support, crisis
intervention – interaction with the courts.
Page 31
• National framework for external providers with local
management and targets
• Resource allocation model to ensure that they are located
where they are most needed.
– Drive programme of change associated with implementing the
recommendations of this review and also the Ryan Implementation
Plan.
• Plays a central role in setting performance objectives for the service as a
whole and its constituent elements. They would have overall
responsibility for setting goals and KPIs through the National Service Plan.
Manager for Children and Family Services
This post will be at GM level and will provide both clinical and management
leadership at local level. As such they will be the principal point of contact in
relation to all children and family services at local level for the HSE and other
agencies. They will:
• Provide leadership in setting and delivering local goals as agreed with the
LHM and in line with national goals set by the AND.
• Be critical connector with other HSE services in particular overseeing
linkages at local level with PCTs and PCNs – this will include
development of pathways between level 1 and 2 services (see figure 10)
• Be principal point of contact for other agencies related to children and
family services.
• Provide local coordination of HSE interaction with the Courts Service.
• Be responsible for resources and management of budgets at local level
(budget holder)
The role of Manager for Children and Family Services is not an additional
management post. It replaces the two legacy roles of Child Care Manager and
Principal Social Worker. The Child Care Manager and Principal Social Worker
roles will be allocated to either Children’s Wellbeing or Children in Care.
Roles ( contd)
• Oversee and report on performance including:
– Service activity
– Progress to goals
– Resourcing
– Serious cases.
• Have overall responsibility for quality assurance including professional
supervision and CPD.
Manager - Children in Care
The key responsibility will be to oversee the provision of services for all
children in care. They will:
• Ensure that there is a sufficient supply of fostering and residential services
for children at risk
• Ensure that there are good quality care plans in place for children that are
forward-looking and anticipate future transition events in children’s lives.
• Monitor and assess the outcomes being delivered for children
• Oversee provision of services for children in care – both within the HSE
and other agencies
• Match the needs of children to the services that are available.
• Ensure that there are sound consultation mechanisms in place to ensure
that they listen to children’s needs and concerns.
• Oversee the provision of aftercare services for children.
• Manage interaction with the Court services at a local level.
Page 32
Referral Manager
A PSW will lead the intake team and will report directly to the Manager for
Children’s Welfare. While they could report directly to the Local Manager for
Children’s and Family Services, we are recommending that they report to the
Manager for Children’s Wellbeing in order to reduce the possible number of
handover points for children. Their role will be to:
• Manage the initial referral to the service speedily and efficiently
• Interact with PCT and PCNs to identify potential referrals.
• Conduct initial screening in line with recommendations of the Task Force
• Conduct initial assessment in line with recommendations of the Task
Force
• Review current referral and assessment processes to ensure that they
make the referral process as simple as possible for people/agencies
referring.
Cases will be managed on the basis of a quick turnaround. The PSW will have
a small team comprising TL and social workers. The size of the team will vary
according to the size of the LHO.
Manager - Children’s Welfare
This role will provide professional leadership focused on supporting families
and children in the first instance. The lead will ensure that support services
and specialist services are in place for children (level 2 and 3 of the support
framework) at risk. They will:
• Liaise with PCTs and PCNs in providing services for children and families
• Oversee the referral process
• Ensure that cases are allocated, risk assessed and service provided
• Oversee provision of care planning for children
Roles ( contd)

• Liaise with PCTs and PCNs in providing services for children and families
• Oversee the referral process
• Ensure that cases are allocated, risk assessed and service provided
• Oversee provision of care planning for children
• Liaise with external providers of services to ensure that they are targeted
on families and children that are most at risk.
• Provide professional supervision to all Team Leaders
• Identify CPD requirements of Team Leaders.
Team Leaders
They will continue to play a critical role in managing individual cases which will
include:
• Allocating cases to social workers
• Monitoring individual caseloads
• Brokering services for children and their families
• Connecting with PCT and PCN
• Supervising staff including professional development
Some Team Leaders may be allocated specific responsibility to develop parts
of the service model where there are identified gaps locally e.g. increase
supply of fostering places, develop family services.
Senior Practitioner Role
This is a key resource for the HSE. Their role is essentially to:
• Manage particularly complex cases (level 3 of figure 6)
• Developing CPD within the LHO
• Developing professional supervision structures within the LHO and
providing professional supervision for Team Leaders and social workers
as appropriate.

Page 33
4.3 Implementation constraints and challenges

We should not overestimate the scale of the implementation challenge • The scale of the change is overwhelming. In addition to this report, the
particularly in the current service environment. The key constraints are likely HSE must also implement the Ryan Commission Implementation Plan.
to be:
These constraints are potentially significant challenges. Managing them will
• Progress in reconfiguring the HSE at regional and local level is require a rigour and discipline in following through the change management
slower than anticipated due to current budgetary constraints. The programme. The HSE can therefore not afford to take a piecemeal approach
proposed management changes are linked to the overall PCCC to implementation although it is clear that it cannot achieve everything at
reconfiguration programme. Any delays may also affect implementation once.
of proposed recommendations. In this eventuality, we recommend that
In the following section we outline key elements of a draft implementation plan
– in those areas where there is both a PSW and CCM, one is allocated for discussion with the HSE. This sets out the key workstreams to implement
as the single point of contact for children and family services in the recommendations and proposed timeframe. The Assistant National Director
LHO. This single change is the minimum required to bring clarity to for Children and Family Services should be responsible for achieving the
the structure at local level. Implementation Plan.
– Specialists in child protection are allocated to the AND for Children
and Family Services.
• There is resistance to the recommendations by people working in
children and family services either at professional or management
level. Our sense is that most people will want to understand the personal
impact of proposed changes for them. This is not unreasonable and
means that the change programme must include a strong communications
programme to sell the benefits of the change.
• There is no appetite in the HSE to deliver the changes proposed.
Without leadership at all levels, the programme will not succeed. Our
distinct sense is that there is commitment for a sensible change
programme that will make the work of social work professionals and
managers less stressful while delivering better outcomes for children. The
new AND post for Children and Family Services will be a critical role. But
they can’t do it on their own and will need both the staffing resources and
commitment from the most senior levels of the organisation to drive
change. They will also need to identify key advocates for change at
regional and local level.

Page 34
4.4 Implementation plan (indicative)

Work streams/ Project

Recommendations Deliverables Scheduling
1 Develop a strategic and coherent 1.1 Develop a service model Immediate
service model

1.2 Implementation of service model Immediate

1.3 Develop a response to the Agenda for Immediate

Children's Services

2 Deliver child centred services
consistently
2.1 Implement recommendations from the Immediate
task force to bring consistency to child
protection processes
2.2 Develop future resource model that Short-term
reflects need

2.3 Strengthen collaboration with other Short term

services in the HSE

2.4 Strengthen collaboration with other Medium term

external agencies

2.5 Strengthen professional supervision Immediate

(See No. 6)

2.6 Strengthen continuing professional Short term

development and education
(See No. 6)
2.7 Stream line interface with the courts Medium term
system
Page 35
4.4 Implementation plan (Continued)

3 Develop an intelligence lead system 3.1 Implement management information Immediate

based on existing data

3.2 Develop outcome-based performance Short term

metrics

3.3 Clarify budget and expenditure Short term

reporting

3.4 Develop a workforce model for the Medium term

service

4 Develop a clear management structure 4.1 Implement integrated PCCC model Short term

4.2 Implement new roles within the PCCC Short term

model

5 Implement change of HSE Child 5.1 Develop a project management office Immediate
protection services using a coordinated
project management approach
5.2 Develop a comprehensive Immediate
communications plan

6 Professional supervision and CPD 6.1 Develop a work stream to review Short term
initiative professional supervision and CPD
findings

Page 36
References

1. Differential Response Model (DRM): This is a national pilot that is being 4. This has been demonstrated for instance by the work of the Family
implemented in Dublin North LHO based on a service model from Futures Consortium in London over the last 12 years.
Minnesota which puts the emphasis on child welfare in the first instance.
The Minnesota experience has proven that a focus on children’s welfare 5. Report of the Task Force on the Public Service – Transforming Public
reduces the level of risk and potential abuse. Features of the model are Services; citizene centred performance focused, 2008.
that decisions are evidence-based, there is group supervision, social 6. Annual Review of Adequacy of Services for Children and Families. This
workers demonstrated leadership and feel strongly supported in working report contains aggregate information on the service as a whole and the
with children and families.The DRM requires a fundamental mind shift in appendix includes detailed information for each LHO on performance.
how services are delivered and social workers are fully engaged in its
implementation. There are variations of this model in a number of other 7. Based on the Support Framework for children and families taken from the
LHOs. Implementation Plan prepared by the OMCYA in response to the Report
of the Commission to Inquire into Child Abuse, 2009.
2. The Implementation Plan of the Ryan Commission was published in July
2009 and sets out a far-reaching programme of change on children’s
welfare and protection. The HSE also set up a Task Force in 2008 to
review current practices in delivery of child protection and bring more
consistency to how they were applied. The work of the Task Force was
broken down to 8 individual but inter-related tasks. The first was the
Survey of Social Work and Family Supports which was published in April
2009. The remaining tasks covered different dimensions of core business
processes and their governance. The report of the Task Force was
subsequently validated by Helen Buckley, School of Social Work and
Social Policy, TCD.
3. UK services were heavily influenced by a two year study in the 1970‘s
entitled and be further studies in the 1980’s. A team at York University
have repeated a study conducted in the 1970s ‘Children Who Wait’ which
developed a model of the care system and how long children are likely to
remain in care. This work strongly influenced the development of UK
services. Much depends on age of entry and the speed of action to either
rehabilitate or find long-term alternatives. A child over the age of ten who
is in care for a year is likely to be in care for the rest of their childhood.
The recent York study demonstrates the vital importance of proactive
planning and action. It found that:
– 89% who entered care stayed for at least a week
– If they stayed for a week, 90% would stay for 4 weeks
– If they stayed for 4 weeks, 89% would stay 12 weeks
– If they stayed for 12 weeks, 91% would stay for 26 weeks
– If they stayed for 26 weeks, 83% would stay for 52 weeks

Page 37
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Murphy FD, Buckely H, Joyce Larain’ (2005) The Ferns Report. Government
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Stakeholders consulted

HSE: Workshop with front line managers representing 7 LHOs and a cross-section of grades such as Principal Social Worker, Child
Care Manager, Team Leaders,
Workshop with the National Steering Committee
Workshop with LHMs and GMs from five LHOs
Meetings with HSE senior management
Field visits to three LHOs
Consultation with HSE Departments who link in with Child protection e.g. Children and Adult Mental Health Services
External agencies:
Office of the Minister for Children and Youth Affairs
Department of Education and Science
HIQA/Social Services Inspectorate
National Education and Welfare Board
National Social Work Qualifications Board
Probation Service
An Garda Siochana
Barnardos
Extern
Children's Rights Alliance
Children’s Ombudsman
Children's Acts Advisory board
Family Support Agency
Irish Association of Social Workers
Limerick Regeneration
Member of the Judiciary

Page 39
Glossary

AND: Assistant national director

CAAB: Children's acts advisory board.
CCM: Child care manager
CPD: Continuing professional development
CSCs: Children services committees
HIQA: Health information and quality authority
HSE: Health service executive
LHO: The local Health Service Executive office, which
health and social care in an area
LHM: Local health manager
OMCYA: Office of the Minister for Children and Youth Affairs
PSW: Principle social worker
PCCC: Primary, Community and Continuing Care (PCCC)
delivers health and personal social services in the
community and other settings including patient
homes
PCN: Primary care network
PCT: Primary care team
PS: Professional supervision
SW : Social worker
TL: Team leader

Page 40
Appendices

Appendices
A. Key data analysis
B. Overview of key processes in Child Protection (HSE Task Force)
C. Model of CPD and professional supervision
D. Sources of information
E. Overview of approach
F. Glossary of terms
G. References/footnotes

Page 41
 Percentage of Child Population in most
Percentage of Population in most deprived
deprived EDs
EDs

0%
2%
5%
7%
10%
12%
0%
10%
20%
30%
40%
50%
Dublin South West 12%
Dublin West 10% Dublin South West 49%
Dublin North West 10% Dublin North Central 44%

Source: SAHRU 2007

Louth 9% Dublin North West 42%
Dublin North Central 8% Dublin West 39%
Cork North Lee 7% Dublin South City 36%
Waterford 6% Louth 36%
South Tipperary 6% Cork North Lee 29%

Source: SARHU 2007 & Census 2006

Dublin South City 6% Waterford 26%
A. Indicators of Need

Donegal 6% South Tipperary 24%

Limerick 5% Limerick 22%

Donegal 21%
Carlow/Kilkenny 5%
Carlow/Kilkenny 20%
Wexford 5%
Wexford 19%
Galway 4%
Galway 18%
Laois/Offaly 4%
Laois/Offaly 15%
Longford/Westmeath 4%
Wicklow 14%
Wicklow 4%
Longford/Westmeath 14%
Sligo/Leitrim 3%
Sligo/Leitrim 14%
Cavan/Monaghan 3%
Cork South Lee 13%
Cork South Lee 3%
Dublin South 12%

Local Health Office

Dublin South 3%

Local Health Office

Cavan/Monaghan 12%
Clare 2% North Tipp/East 9%
Mayo 2% Mayo 9%
North Tipp/East 2% Clare 9%
Dublin North 2% Dublin North 8%
Kerry 2% Kerry 8%
Kildare/West 2% Kildare/West 6%
Meath 1% Meath 3%
North Cork 1% North Cork 3%
Roscommon 1% Roscommon 3%
Dublin South East Dublin South East 0%

4.58%
17.96%

West Cork West Cork 0%

% Child
1. SAHRU: Percentage Population in most Deprived Electoral Divisions (Decile 10)

Average
% EDs

Population
Average

Population in the most Deprived EDs Percentage of Child Population in most

Page 42
(thousands) deprived EDs
0
16
32
48
64
80
0%
6%
12%
18%
24%
30%

Dublin North West 77

Meath 27%
Dublin South West 72
Donegal 27%
Dublin North Central 55
Kildare/West 27%

Source: SAHRU 2007

Source: SAHRU 2007

Dublin West 52
Laois/Offaly 27%
Dublin South City 49
Wexford 26%
Cork North Lee 49
Longford/Westmeath 26%
Galway 43 26%
Louth
Louth 40
Cavan/Monaghan 26%
Limerick 34 Clare 26%
Donegal 32 Dublin West 26%
Waterford 31 Carlow/Kilkenny 26%
Wexford 25 South Tipperary 26%
Carlow/Kilkenny 25 Wicklow 25%
Cork South Lee 22 Waterford 25%
South Tipperary 21 Mayo 25%
Laois/Offaly 20 Dublin North 25%
Dublin North 18 North Tipp/East 25%
Longford/Westmeath 16 Roscommon 25%
Wicklow 15 Cork North Lee 25%
Dublin South 15 North Cork 24%
Local Health Office
Local Health Office

Cavan/Monaghan 14 Sligo/Leitrim 24%

Sligo/Leitrim 12 Dublin South West 24%
Kildare/West 12 Galway 24%
Kerry 11 Limerick 24%
Mayo 11 Kerry 24%
Clare 10 Cork South Lee 23%
North Tipp/East 9 Dublin North West 23%
Meath 5 Dublin South 22%
North Cork 2 Dublin North Central 18%
Roscommon 2 Dublin South City 17%
Dublin South East 0 Dublin South East
24950
24.60%

West Cork 0 West Cork

3. SAHRU: % Children contained in Total Population of most Deprived Electoral Divisions (Decile 10) 4. SAHRU: Population in the most Deprived Electoral Divisions (Decile 10)
2. SAHRU: % Children contained in Population of most Deprived Electoral Divisions (Decile 10)

% Child

Average

in EDs -

Average
Decile 10
Population

Population
 Percentage of Child Population of Total
Percentage of Child Population Non-Retained
Population

0%
6%
12%
18%
24%
30%
0%
6%
12%
18%
24%
30%
Dublin City 28% Meath 27%
Dublin South 25%
Donegal 27%
WaterfordCity 23%
Kildare/West 27%

Source: SAHRU 2007

Wicklow 23%
Laois/Offaly 27%
Tipperary South 22%
Wexford 26%
LimerickCity 22%
Longford/Westmeath 26%
Louth 22%
Louth 26%
Offaly 21%
Monaghan 21% Cavan/Monaghan 26%

Cork City 20% West Cork 26%

Source: Dept of Education 1999 Cohort

A. Indicators of Need

Kildare 20% Clare 26%

GalwayCity 20% Dublin West 26%
LimerickCounty 20% Carlow/Kilkenny 26%
Wexford 20% South Tipperary 26%
Dublin Fingal 19% Wicklow 25%
Laois 19% Waterford 25%
Donegal 19% Mayo 25%
Carlow 17% Dublin North 25%
Meath 17%
North Tipp/East 25%
Cork County 17%
Roscommon 25%

County Council
Kilkenny 17%
Cork North Lee 25%
Dublin South/Rathdown 17%

Local Health Office

North Cork 24%
Sligo 17%
5. Percentage Child Population of LHO Population

Sligo/Leitrim 24%
Clare 16%
Dublin South West 24%
Mayo 15%
Cavan 15% Galway 24%

Longford 15% Limerick 24%

7 a) Leaving Certificate Non-Retention by County Council

WaterfordCounty 15% Kerry 24%
Westmeath 15% Cork South Lee 23%
Roscommon 14% Dublin North West 23%
Tipperary North 14% Dublin South 22%
Kerry 14% Dublin South East 18%
GalwayCounty 12% Dublin North Central 18%

18.24%
24.45%

Leitrim 9% Dublin South City 17%

non-
% Child

Leaving
Average

Average
retention
Certificate
Population

Percentage of Child Population Non-Retained Number of Children per 1,000 LHO

Page 43
Population
0%
4%
8%
12%
16%
20%
0
60
120
180
240
300

Dublin City 17%

Meath 274
Louth 8%
Donegal 274
Wexford 8%
Source: SAHRU 2007

Kildare/West 270
LimerickCity 7%
Laois/Offaly 270
WaterfordCity 7%
Wexford 265
Clare 7%
7% Longford/Westmeath 264
Laois
Donegal 7% Louth 263
Wicklow 6% Cavan/Monaghan 263
West Cork 258
Source: Dept of Education 1999 Cohort

Dublin South 6%
Longford 6% Clare 257
Offaly 6% Dublin West 257
GalwayCity 6% Carlow/Kilkenny 256
LimerickCounty 6% South Tipperary 255
Dublin South/Rathdown 5% Wicklow 255
Westmeath 5% Waterford 252
Cork City 5% Mayo 250
Kildare 5% Dublin North 248
Cork County 5%
North Tipp/East 248
Tipperary South 5%
Roscommon 247
County Council

Monaghan 5%
Cork North Lee 246
Dublin Fingal 5%
Local Health Office
6. Number of Children per 1,000 LHO Population

North Cork 244

Mayo 5%
Sligo/Leitrim 243
Sligo 4%
Dublin South West 239
Roscommon 4%
Galway 239
Kerry 4%
7 b) Junior Certificate Non-Retention by County Council

Meath 4% Limerick 237

Kilkenny 4% Kerry 236

WaterfordCounty 4% Cork South Lee 232
Cavan 4% Dublin North West 230
Tipperary North 3% Dublin South 223
GalwayCounty 3% Dublin South East 185
Leitrim 3% Dublin North Central 181
5.43%
244.46

Carlow 3% Dublin South City 166

non-
Junior
Average
Children

Average
retention
per 1,000
population

Certificate
 Child Population in Dec 10 per Staff Number

0
64
128
192
256
320
Louth 301
Galway 284
Dublin South City 270
Dublin South West 256
Cork North Lee 253
Dublin North West 222
Dublin North Central 208
Dublin West 197
Waterford 196

Source: SARHU 2007 & Census 2006

Cork South Lee 184
A. Indicators of Need

Carlow/Kilkenny 168
Wexford 160
South Tipperary 160
Limerick 144
Donegal 144
Cavan/Monaghan 126
Laois/Offaly 116
Dublin North 101
Clare 95
North Tipp/East 86

Local Health Office

Wicklow 81
Longford/Westmeath 72
Mayo 72
Kildare/West 69
Dublin South 68
Sligo/Leitrim 68
Kerry 68
Meath 37
North Cork 31
Roscommon 17
Dublin South East 0
132.93

West Cork 0
8. SAHRU: Estimated Child Population per Total Staff Number (Decile 10)

Vs.
SAHRU

Average

0
4

0
4
6
8
2
81
2
29
11
6
65
12
0
02
23

%
%
%
%
%
%

Page 44
 Stacked Percentage of Reports Reports per 1,000 Child Population

0
10
20
30
40
50

0%
20%
40%
60%
80%
100%
Dublin South East 50
Sligo/Leitrim Longford/Westmeath 39
Galway Roscommon 37
B. Demand

Dublin South East Wexford 32

Limerick South Tipperary 30
Mayo Galway 29
Dublin South City Limerick 27
Dublin South Sligo/Leitrim 26
Waterford Louth 25
Clare
Laois/Offaly 24
Cork South Lee
Cavan/Monaghan 23

Source: HSE National Social Work Survey

North Tipp/East
North Tipp/East 22
Donegal
Donegal 22
Carlow/Kilkenny
Meath 21

Source: CSO 2006, 2007;HSE IDS 2006 and 2007

Cork North Lee
Dublin South City 21
South Tipperary
Mayo 20
Wicklow
Waterford 20
Dublin North Central
North Cork 20
Cavan/Monaghan
Dublin West 18
Dublin North
Carlow/Kilkenny 18

Local Health Office

North Cork

Local Health Office

Clare 17
Dublin North West
Cork North Lee 17

11. Percentages of Reported Abuse Types by LHO

Wexford
Kerry 16
Dublin West
West Cork 16
Laois/Offaly
Dublin South West 16
9. Volume of Reports by LHO per 1,000 child population

Kildare/West
Dublin North Central 16
Dublin South West
Dublin North West 14
Longford/Westmeath
Cork South Lee 13
Kerry
Wicklow 12
West Cork
Roscommon Dublin South 11
21.42

Meath Dublin North 10

Louth Kildare/West 6
1,000

Sexual
Neglect
children

Welfare
Average

Physical
Emotional
Report per

Number of Children in Care per 1,000 LHO Percentage of Reports

Page 45
Population
0%
12%
24%
36%
48%
60%

0.00
0.35
0.70
1.05
1.40
1.75

Dublin North Central 1.55

Dublin North West 1.03
Cork North Lee 0.89
Roscommon 0.77
Welfare
55.04%

Laois/Offaly 0.73
Dublin West 0.69
10. Reason for Report

Dublin South City 0.64

Limerick 0.64
Waterford 0.63
Louth 0.61
South Tipperary 0.57
Source: Interim Dataset 2006 & Census 2006
Neglect
17.13%

Wexford 0.57
Dublin South West 0.54
Source: CSO 2006, 2007;HSE IDS 2006 and 2007

Wicklow 0.54
Carlow/Kilkenny 0.49
Dublin South 0.49
Dublin South East 0.48
Cork South Lee 0.46
10.22%

Clare 0.44
West Cork 0.44
Sexual Abuse

Local Health Office

Type of Abuse

Kerry 0.41
North Cork 0.40
Kildare/West 0.39
Cavan/Monaghan 0.37
Longford/Westmeath 0.37
8.99%

12. Children in Care per 1,000 Children population by LHO

Mayo 0.36
North Tipp/East 0.34
Physical Abuse

Sligo/Leitrim 0.34
Donegal 0.31
Meath 0.31
0.54

Galway 0.30
Dublin North 0.25
8.63%

Emotional Abuse

1,000
Child in

children
care per

Average
 Stacked Percentage of Cases in Risk Percentage of Cases
Category

0%
15%
30%
45%
60%
75%

0%
20%
40%
60%
80%
100%
Kerry
B. Demand

Mayo

18%18%

28% 31%

54% 51%
North Tipp/East

34%
Cavan/Monaghan

35%

Source: HSE Survey 2008

Wicklow

39%

44% 41%41%
Source: Interim Dataset 2006
70.13%

Cork North Lee

Dublin South East

Neglect of Child
Dublin North

22% 24% 20%25% 22% 24%

39% 43% 43%

36% 35% 33%

Galway
South Tipperary
Limerick

31% 29% 33%

38% 40% 37%

West Cork

33%

31%31%30% 30%
Clare

Child
North Cork

37% 39% 40%

35% 35%

26%25%
15.40%
Cork South Lee

53%

25%
Roscommon

46%

34%
Physical Abuse of
Louth

43%

22% 20% 19%

Longford/Westmeath

16%
15. Risk Assessment of Total Cases by LHO
Dublin South City

38% 41%40%

43% 46%
13. Primary Reason for Children being in Care

Wexford
Dublin North Central

Local Health Office

27% 25%
62% 64%
Sligo/Leitrim

70%

20%
Child
7.92%

Dublin South

51%

39%
Laois/Offaly

32%

59%
Reason for Child Being in Care
Sexual Abuse of

Dublin North West

11%11% 10%10% 9% 9%
77%

14%
Carlow/Kilkenny

6%
Kildare/West

55% 56%

39% 38%
Donegal

4%
46%

50%
Dublin South West

81%

17%
Dublin West

20%

80%
Waterford

80%

20%
Child
6.54%

Meath

0% 0% 0%
54%

46%
National
41%

36%

23%
Emotional Abuse of

Low
High

Medium

Number of Children in Care per 1,000 LHO

Page 46
Population
0.00
1.60
3.20
4.80
6.40
8.00

Dublin North Central 7.52

Cork North Lee 5.58
Laois/Offaly 5.22
Dublin West 4.68
Roscommon 4.62
South Tipperary 4.34
Dublin North West 4.33
Limerick 4.30
Waterford 4.30
Wexford 4.22
Source: HSE National Social Work Survey

Dublin South City 4.14

Louth 3.59
Cavan/Monaghan 3.04
West Cork 3.03
Mayo 2.97
Clare 2.91
Carlow/Kilkenny 2.78
Dublin South West 2.73
Kildare/West 2.68
Dublin South East 2.64
Local Health Office

Longford/Westmeath 2.60
Kerry 2.51
Dublin South 2.48
Cork South Lee 2.19
Sligo/Leitrim 2.18
Wicklow 2.05
Meath 2.04
Donegal 2.04
14. Children in Foster Care per 1,000 Child Population by LHO

Galway 1.90
North Cork 1.83
3.24

Dublin North 1.22

North Tipp/East 1.14
Pop
Foster

Average
Care per
Children in

1,000 Child
 Number of Graded Staff Percentage with Initial Assessment

0
7
14
21
28
35
0%
20%
40%
60%
80%
100%

2 2
1 case

1
Dublin South City 100%
100%
C. Activity

Dublin South West

1
Dublin West 100%

4
2 cases Kildare/West

1
100%
Wicklow
Laois/Offaly 100%
Dublin North West 100%

2
3 cases

5
Dublin North Central 100%
Dublin North 100%

Source: HSE Survey, December 2008

Limerick 95%

3
4 cases

4
Longford/Westmeath 94%

Source: Interim Dataset 2006 & Census 2006

Sligo/Leitrim 90%
Dublin South 90%
5 cases Wicklow 90%

13
North Tipp/East

1
89%
Limerick
South Tipperary 80%

3
18. Case Load by Grade (up to 10 cases)
6 cases Roscommon 78%

Case Load
11
North Cork 77%
Clare 76%

1
7 cases Waterford 75%
16. Proportion of Reports with Initial Assessment

13
Carlow/Kilkenny 68%

Local Health Office Kerry 66%

8 cases Donegal 57%

29
Dublin South East 43%
West Cork 38%

2
9 cases Cavan/Monaghan 23%

21
Mayo 21%
Meath 17%

2
10 cases 33 Cork South Lee 15%
Galway 9%
Average

Louth 7%
Cork North Lee 3%
65.71%

Wexford 0%

Senior
Principal
% Initial assessment

Qualified
Total 60%

Practitioner
Team Leader

Professionally

Social Worker
Social Worker

Percentage of Cases Allocated

Average Caseload per Social Worker

Page 47
0
8
16
24
32
40

0%
20%
40%
60%
80%
100%

West Cork 40
West Cork 100%
North Cork 38
Mayo 100%
Kerry 33
Sligo/Leitrim 95%
Wexford 31
Kerry 95%
Dublin South City 26
North Cork 91%
Galway 26
Wicklow 90%
Louth 25
Dublin South City 90%
Roscommon 25
North Tipp/East 88%
Cork North Lee 22
Cork North Lee 88%
Clare 20
Cavan/Monaghan 88%
19. Allocated Cases by LHO
Source: HSE National Social Work Survey

Cavan/Monaghan 19
Source: HSE National Social Work Survey

Dublin South 85%

Cork South Lee 19
Longford/Westmeath 85%
Laois/Offaly 19
Galway 82%
Carlow/Kilkenny 18
Cork South Lee 81%
Mayo 17
Limerick 81%
Sligo/Leitrim 17
Dublin West 81%
South Tipperary 16
South Tipperary 75%
Longford/Westmeath 15
Donegal 75%
Wicklow 15
Carlow/Kilkenny 70%
17. Caseload per Social Worker across LHOs

Limerick 13
Laois/Offaly 69%
Local Health Office

Local Health Office

North Tipp/East 13
Dublin South West 65%
Dublin North Central 12
Roscommon 62%
Dublin South East 61% Dublin South 12

Wexford 56% Dublin South West 12

Louth 55% Waterford 12

Dublin North Central 51% Dublin North 11

Clare 49% Dublin West 11

Dublin North 46% Meath 10

Meath 46% Dublin South East 9

Dublin North West 38% Donegal 8

17.91

Waterford 30% Kildare/West 5

71.69%

Kildare/West 26% Dublin North West 4

%
per
Social
Worker

Average
Average
Average

Allocated
 Number of Court Orders Average Hours Social worker Spends
Travelling per Week

0
13
26
39
52
65
0
3
6
10
13
16
Dublin North West 61

Galway 56 Dublin North West 16

Limerick 39 Cork North Lee 11

C. Activity

Roscommon 37 Dublin South West 11

33 Wicklow 11
Dublin North Central
Mayo 10
Cork South Lee 29
Dublin West 10
Dublin North 27
Dublin South East 10
South Tipperary 27

Source: Childcare Dataset 2008

Dublin South 9
Cork North Lee 24
North Cork 9
Meath 24
Roscommon 9
Wexford 23

Source: HSE National Social Work Survey

Limerick 9
Donegal 17
Dublin South City 9
Kerry 17
Kerry 8
Dublin South West 16
Dublin North Central 8

22. Number of Court Orders by LHO

Cavan/Monaghan 15 West Cork 8

Waterford 15 Wexford 8

Kildare/West 14 Dublin North 8

Carlow/Kilkenny 13 North Tipp/East 7

Clare 13 Laois/Offaly 7

Dublin West 13 Kildare/West 7

Local Health Office

Local Health Office
Laois/Offaly 13 Louth 6

Clare 6
Dublin South City 12
Meath 6
Longford/Westmeath 12
Longford/Westmeath 6
North Tipp/East 12
Carlow/Kilkenny 6
North Cork 11
Sligo/Leitrim 4
Mayo 10
Cavan/Monaghan 4
Wicklow 10
Galway 3
Dublin South 8
Cork South Lee 2
Sligo/Leitrim 8
South Tipperary
West Cork 6
7.88

Waterford
Dublin South East 4

19.34
Donegal
20. Average Hours Social worker Spends Travelling per Week by LHO

Louth 0
Week
Average

Court
No, of

Orders
Avg. Hours

Average
per SW per

Number of Court Cases

Page 48
0
24
48
72
96
120

Dublin North Central 118

Kerry 114

Meath 113

Galway 111

Laois/Offaly 79

Dublin South East 76

Limerick 73

Wexford 72

Kildare/West 54

Dublin North West 53

Dublin South 52

Dublin South West 41

Clare 39

Dublin South City 36

West Cork 34
21. Number of Court Cases by LHO

Donegal 34

Dublin North 27

Mayo 27

Dublin West 26

North Tipp/East 24
Source: HSE National Social Work Survey Local Health Office

Wicklow 19

Louth 18

Sligo/Leitrim 18

Longford/Westmeath 17

South Tipperary 17

North Cork 16

Carlow/Kilkenny 13

Cork North Lee 0

Waterford 0

Cavan/Monaghan
Cork South Lee
45.55

Roscommon
No of
Cases

Average
 Percentage of Children in Care as Percentage Stacked Percentage of Cases in Status
of Referrals Category

0%
20%
40%
60%
80%
100%

0%
20%
40%
60%
80%
100%
1
Dublin North Central 99% North Cork 100% 1
Dublin North West 71% Cork South Lee 100%
Kildare/West 66% Meath 90% 10%
E. Outcomes

Cork North Lee 51% North Tipp/East 89% 11%

Dublin South 46%
Galway 89% 9%2%
Wicklow 44%
Louth 84% 16%

Source: Childcare Dataset 2008

Dublin West 38%
South Tipperary 84% 10%6%
Cork South Lee 37%
Carlow/Kilkenny 70% 13% 7% 10%
Dublin South West 34%
Waterford 32% Dublin South West 69% 2%10% 19%

Source: HSE National Social Work Survey

Dublin South City 31% Longford/Westmeath 68% 32%
Laois/Offaly 30% Roscommon 68% 16% 16%
Carlow/Kilkenny 28% Dublin West 60% 3% 18% 19%
West Cork 27% Sligo/Leitrim 60% 5% 25% 10%
Dublin North 27%

25. Children in Care as % of Referrals

23. Confirmation of Abuse/Non-Abuse

Dublin South City 58% 4% 22% 16%

Clare 25%
Wicklow 58% 11%5% 26%
Kerry 25%
Limerick 57% 43%
41 47 90 25 50 30 285 38 25 285 20 164 19 60

Louth 25%
24% Mayo 56% 22% 22%
Limerick
Roscommon 21% Dublin North 48% 2% 29% 21%

Local Health Office

Local Health Office

North Cork 20% Kildare/West 48% 2%
7% 43%
South Tipperary 19% Dublin North West 46% 3%13% 39%
Wexford 18% Laois/Offaly 44% 56%
Mayo 18% 43% 7% 33% 17%
Wexford
Cavan/Monaghan 17%
Dublin North Central 41% 2%8% 48%
North Tipp/East 15%
Dublin South East 39% 44% 17%
Meath 15%
Clare 39% 2% 59%
Donegal 14%
Sligo/Leitrim 13% Waterford 30% 9% 18% 42%
Dublin South 21% 26% 53%
9 380 428 197 52 30 124 18 49 76 19

Galway 11%
1

10% Cork North Lee 100%

30.02%
Dublin South East
2

Longford/Westmeath 10% Donegal 100%

%
% In-

Abuse
N-Value

conclusive

Average
% Ongoing

Non-Abuse
%Confirmed

% Confirmed

Stacked Number of Children by Length of Number of Children Subject of New

Page 49
Stay Supervision Order
0
7
14
21
28
35

0
90
180
270
360
450
9

Dublin North
Dublin North West
102

204

124

Cork South Lee

17 17
13

Dublin North Central

137

142

Limerick
13

Kildare/West
90
3

Roscommon
Dublin West
46 72

73

Clare
11

Cork North Lee

140

North Tipp/East
12 11 11 11
22

Waterford
Source: Childcare Dataset 2008 Limerick
Source: Childcare Dataset 2008

Wexford Galway
155 74 54

48 61

77 73 69 68 65 65

Cork South Lee

42

94

Dublin North Central

10 10
10 11

26. Length of Stay in Care

Dublin South West

55
9
6

South Tipperary
Laois/Offaly
2

Sligo/Leitrim
Limerick
56 99

77 97 82
6

Wexford
Kerry
52

35
9

Dublin North West

Carlow/Kilkenny
46

54 51 49 44 43 42
6
9

Laois/Offaly
Cavan/Monaghan
33
6

Kerry
10

Dublin North
60 86 62
3

Dublin South City Cavan/Monaghan

42 56

52
3

Wicklow Meath
40
3

Galway Wicklow
57

76 83
8

Dublin South East

26

Mayo
South Tipperary
54

50 57
4

Cork North Lee

Local Health Office
12

Local Health Office

North Cork
25
1
3

West Cork
Roscommon
36
3
3

Louth
Dublin South
32 64 16
25
5

North Cork
24. Children Subject of New Supervision Order by LHO

Donegal
57
2
2

Waterford
Louth
97

Kildare/West
5

Mayo
57

Wicklow
1
1

Clare Dublin South City

1
1

Meath Dublin West

61 82

48 62 35 48 44
2
1

Longford/Westmeath Dublin South

68

33 33 33 32 30 26 23 21 21 20 19 19 19 17 17 15
2
1

North Tipp/East
40
33 28

Dublin South West

West Cork
4
1

69

61

Longford/Westmeath
Sligo/Leitrim
42
24
13 11 10
1

Carlow/Kilkenny
Male

<1 Year
Female

>5 years
1-5 Years
 Number of Child Abuse Reports Number of Separated Children Cases

0.0
1.6
3.2
4.8
6.4
8.0

0
320
640
960
1280
1600
Galway 1586
Longford/Westmeath 1161

2
Wexford 1099

Abuse
Dublin South East 1015
E. Outcomes

Confirmed
Limerick 953
Meath 947
Laois/Offaly 899

Source: Childcare Dataset 2008

Donegal 870
Louth 722

2
Cork North Lee 717

Source: HSE National Social Work Survey

Abuse
Cavan/Monaghan 703
South Tipperary 676

29. Child Abuse Reports by LHO

Confirmed Non-
Mayo 622
Dublin West 620
Dublin North West 615
27. Outcomes for Separated Children

Waterford 604
6

Sligo/Leitrim 581
Dublin South West 555

In-conclusive
North Tipp/East 548

Status of Case
Carlow/Kilkenny 547

Local Health Office

Kerry 542
Roscommon 541
Dublin North 522
Cork South Lee 518
Ongoing

Clare 496
Dublin South City 456
North Cork 392
Dublin North Central 356
Wicklow 338
Kildare/West 323
8

657.56
Dublin South 299
West Cork 219
Total Number

CAR

Average
Number of Children Offered Services Stacked Number of Children by Family

Page 50
Welfare Consequences
0
220
440
660
880
1100
0
8
16
24
32
40

Galway 1023
1
1
1
1

Roscommon
33

Longford/Westmeath 487
1

Wexford
24

Limerick 391
4
1

Donegal
Mayo 327
1

Sligo/Leitrim
Clare 276
3

Kerry
19 19 18

North Tipp/East 264

1
3

Galway
17

Source: Childcare Dataset 2008

Roscommon 160
Source: Childcare Dataset 2008 Longford/Westmeath
Carlow/Kilkenny 87
1

Cork North Lee

Kerry 83
1

Mayo
15 14 14
11

Cavan/Monaghan 60 Cavan/Monaghan
Cork North Lee 56
3

Laois/Offaly
Sligo/Leitrim 54 Dublin North
12 12 11

North Cork 40
9
2
1

Limerick
Meath 30
8
1

Dublin North West

West Cork 25
8
1

Dublin North Central

Donegal 11
7

North Cork
Cork South Lee 2
7

Louth
Dublin North
7

Meath
Dublin North Central
3

Clare
Dublin North West
2
1

Cork South Lee

Local Health Office
28. Outcomes of Family Welfare Consequences

Local Health Office

Dublin South
1
1

Dublin South
30. Number of Children Offered Services by LHO

Dublin South City

1
1

Dublin South East

Dublin South East
1
1

Wicklow
Dublin South West
1

Carlow/Kilkenny
Dublin West
1

West Cork
Kildare/West Dublin South City
Laois/Offaly Dublin South West
Louth Dublin West
South Tipperary
1
1

North Tipp/East
Waterford South Tipperary
198.59

Wexford
2

Waterford
Wicklow Kildare/West
No

Care

other
Order

Special

Plan for

No. of
services
Voluntary

Average
Children
Agreement

Care Order
Care Order

Supervision
 Stacked Number of Services Offered

0
540
1080
1620
2160
2700
Galway
Roscommon

129050

836
Longford/Westmeath

88

1290 319
Limerick

76
1026 309

487391
E. Outcomes

Mayo
Clare

15
261
4
8
North Tipp/East

Source: Childcare Dataset 2008

8
Meath

250
South Tipperary
Carlow/Kilkenny

327276264258231 14 4
5
Kerry

81 74
Cavan/Monaghan

97 83 60
Sligo/Leitrim

6 51
Cork North Lee

57 23
North Cork
West Cork 6 33 40
56 40 25
31. Stacked Number of Services Offered

Donegal
25 11 2

Cork South Lee

Dublin South
Dublin South East

Local Health Office

Wicklow
Dublin North
Dublin North Central
Dublin North West
Dublin South City
Dublin South West
Dublin West
Kildare/West
Laois/Offaly
Louth
Waterford
Wexford
Offered
Services
Services
Unknown

Availed of
Didn't Avail

Number of Admissions to Care

Page 51
0
26
52
78
104
130

Galway
Dublin North West
Dublin North Central
Dublin North
Wexford
Cork North Lee
Cork South Lee
Source: Childcare Dataset 2008

Kerry
Cavan/Monaghan
Kildare/West
Limerick
Waterford
Wicklow
South Tipperary
Clare
Longford/Westmeath
Roscommon
Carlow/Kilkenny
Laois/Offaly
North Tipp/East
Local Health Office

Meath
Donegal
32. Stacked outcome of Admissions to care by LHO

Mayo
Dublin South West
North Cork
Louth
West Cork
Dublin West
Dublin South City
Dublin South East
Sligo/Leitrim
Dublin South
Other

Special

General
General

Relative
Placement
Residential
Residential
Residential
Care Order

Foster Care
Foster Care
Foster Care
Special Care

Pre-Adoption
High Support
At home under
 Number of Senior Social Work Practioners Number of Principal Social Workers

0
2
4
5
7
9
0.0
1.2
2.4
3.6
4.8
6.0
Dublin South West 8.3 6.0
Kerry
Dublin West 6.0 Limerick 2.5
Kerry 5.0 Donegal 2.0
Donegal 5.0 Dublin North Central 2.0
F. Workforce

Dublin North 5.0 Longford Westmeath 2.0

Wicklow 4.5 Louth 2.0

Sligo Leitrim West Cavan 2.0
Limerick 4.0
Galway 1.5
Galway 4.0
Carlow Kilkenny 1.0
Cork South Lee 4.0
Kildare/West Cavan Monaghan 1.0
4.0
Wicklow Clare 1.0
Laois/Offaly 4.0
Cork South Lee 1.0
South Tipperary 4.0 Dublin North 1.0
Longford/Westmeath 3.0 Dublin North West 1.0
33. Principal Social Workers by LHO

Clare 3.0 Dublin South 1.0

North Tipp/East
3.0 Dublin South East 1.0
Limerick
Carlow/Kilkenny 2.8 Dublin South West 1.0

Dublin South East 2.0 Dublin West 1.0

35. Senior Social Work Practitioners by LHO

Kildare West Wicklow 1.0
Cavan/Monaghan 2.0
Laois Offaly 1.0

Local Health Office

Mayo 2.0
Mayo 1.0

Local Health Office

Meath 2.0
Meath 1.0
North Cork 2.0
North Cork 1.0
Wexford 2.0 North Tipperary East Limerick 1.0
Dublin South City 2.0 Roscommon 1.0
Waterford 1.2 South Tipperary 1.0
Dublin North West 1.0 Waterford 1.0
Roscommon 1.0 West Cork 1.0

West Cork 1.0 Wexford 1.0

Wicklow 1.0
Dublin North Central 0.0
1.31

Cork North Lee 0.0

Louth 0.0
Dublin South City 0.0

Average
Sligo/Leitrim 0.0

Practitioner
2.75
Dublin South 0.0
Cork North Lee 0.0

Senior Social Work

Social
Worker

Average
Principal

Number of Professionally Qualified Social Number of Team Leaders

Page 52
Workers
0
2
4
6
8
10

Limerick 10.0
0
10
20
30
40
50

Dublin South West 7.8

Dublin North West 43.0
Dublin West 7.2
Donegal 38.0
Donegal 7.0
Dublin North Central 37.0
Longford/Westmeath 7.0
Cork North Lee 33.3
Dublin North 7.0
Dublin South West 26.6
Kildare/West 7.0
Dublin West 26.5
Sligo/Leitrim 6.0
Limerick 26.5
Galway 6.0
Longford/Westmeath 24.0
Dublin North West 6.0
34. Team Leaders by LHO

Dublin North 24.0

Laois/Offaly 6.0
Sligo/Leitrim 23.1
Cork North Lee 6.0
Kildare/West 23.0 Kerry 5.0
Meath 23.0 Dublin North Central 5.0
Wicklow 22.1 Louth 5.0
Dublin South 22.0 Meath 5.0
Laois/Offaly 21.0 Dublin South 5.0
Galway 20.4 Wicklow 5.0
Dublin South City 20.0 Dublin South City 5.0
Waterford 19.8 Mayo 4.4
Local Health Office

Louth 19.3 Carlow/Kilkenny 4.0

Mayo 18.0 North Tipp/East 4.0
Local Health Office
36. Professionally Qualified Social Workers by LHO

Kerry 17.5 Waterford 4.0

Wexford 16.5 Clare 4.0

Dublin South East 15.6 South Tipperary 3.4

Cork South Lee 14.9 Cavan/Monaghan 3.0

Cork South Lee 3.0
Cavan/Monaghan 13.0
Roscommon 3.0
Clare 12.6
Wexford 3.0
Carlow/Kilkenny 12.3
Dublin South East 2.8
South Tipperary 9.5
4.99

North Cork 2.0

Roscommon 9.0
West Cork 1.0
Average

North Tipp/East 8.0

20.39

North Cork 7.5

Social Worker

West Cork 5.5

Team

Professionally Qualified
Leaders

Average
 Number of Child Care Workers Number of Link Social Workers (Fostering)

0.0
1.6
3.2
4.8
6.4
8.0
0.0
1.2
2.4
3.6
4.8
6.0
Longford/Westmeath 8.0
Dublin South 6.0
Dublin West 7.6
Dublin South East 5.6
Dublin South East 5.8 Longford/Westmeath 4.0
Waterford 5.7 Kildare/West 4.0
F. Workforce

Wicklow 5.5 Dublin South West 3.5

Dublin North West 5.0 Mayo 3.0
Dublin South West 5.0 Roscommon 3.0
Wexford 5.0 Clare 2.8
Kildare/West Carlow/Kilkenny 2.0
4.0
Wicklow
Laois/Offaly 4.0 Cavan/Monaghan 2.0
South Tipperary 2.0
North Cork 4.0
Kerry 0.0
Roscommon 4.0

39. Child Care Workers by LHO

Limerick 0.0
Cork North Lee 4.0
Donegal 0.0
South Tipperary 3.9
Dublin North Central 0.0
Carlow/Kilkenny 3.8
Louth 0.0
Dublin South 3.5
Sligo/Leitrim 0.0
Kerry 3.0 Galway 0.0
Dublin North Central 3.0
37. Link Social Workers (Fostering) by LHO

Cork South Lee 0.0

Cavan/Monaghan 3.0 Dublin North 0.0

Local Health Office

Mayo 3.0 Dublin North West 0.0

Local Health Office

Meath 3.0 Dublin West 0.0
Donegal 2.5 Laois/Offaly 0.0

Cork South Lee 2.0 Meath 0.0

Dublin South City 2.0 North Cork 0.0

North Tipp/East 0.0
West Cork 1.5
Waterford 0.0
Sligo/Leitrim 1.0
West Cork 0.0
Galway 1.0
Wexford 0.0
Dublin North 1.0
Wicklow 0.0
1.18

Clare 0.9
North Tipp/East Cork North Lee 0.0
0.8
Limerick Dublin South City 0.0

3.35
Louth 0.7
Limerick 0.0
Worker

Care
Child
Average

Worker

Average
(Fostering)
Link Social

Number of Fostering Social Workers Number of Basic Grade Social Workers

Page 53
0.0
0.2
0.4
0.6
0.8
1.0

0.0
4.0
8.0
12.0
16.0
20.0

Limerick 1.0
Dublin North West 20.0
Mayo 1.0
Wexford 14.2
North Tipp/East 1.0
Dublin West 12.2
South Tipperary 1.0
Carlow/Kilkenny 11.7
Donegal 0.6
Laois/Offaly 11.0
Kerry 0.0
Longford/Westmeath 10.0
Dublin North Central 0.0
Dublin South East 10.0
Longford/Westmeath 0.0
Dublin South West 9.6
Louth 0.0
Dublin South 9.0
Sligo/Leitrim 0.0
Limerick 8.8
Galway 0.0
South Tipperary 8.1
Carlow/Kilkenny 0.0
Waterford 7.7
Cavan/Monaghan 0.0
Louth 6.8
Clare 0.0
Wicklow 6.5
Cork South Lee 0.0
Cavan/Monaghan 5.0
40. Fostering Social Workers by LHO

Dublin North 0.0

North Tipp/East 5.0
Dublin North West 0.0
38. Basic Grade Social Workers by LHO

Dublin North 4.5

Dublin South East 0.0
Sligo/Leitrim 4.0
Mayo 3.0 Dublin South West 0.0

Kerry 2.4 Dublin West 0.0

Local Health Office

Local Health Office

Donegal 2.2 Kildare/West 0.0

Roscommon 2.0 Laois/Offaly 0.0

Clare 1.7 Meath 0.0

North Cork 1.3 North Cork 0.0

Meath 1.0 Roscommon 0.0

Dublin North Central 0.0 Dublin South 0.0

Galway 0.0 Waterford 0.0

Cork South Lee 0.0 West Cork 0.0

Kildare/West 0.0 Wexford 0.0

West Cork 0.0 Wicklow 0.0

0.14

5.55

Cork North Lee 0.0 Cork North Lee 0.0

Dublin South City 0.0 Dublin South City 0.0

Social
Basic

Worker
Social
Grade

Average
Worker

Fostering
Average
 Number of Aftercare Workers Number of Project Workers

0.0
0.2
0.4
0.6
0.8
1.0
0.0
1.2
2.4
3.6
4.8
6.0
Louth 1.0 Sligo/Leitrim 6.0
Cavan/Monaghan 1.0 Meath 3.0
Dublin North 1.0 Limerick 2.5
Dublin South East 1.0 Donegal 2.0
F. Workforce

Dublin West 1.0 Dublin North 2.0

Mayo 1.0 Dublin South 2.0
Meath 1.0 Dublin North Central 1.0
North Tipp/East 1.0 Dublin South East 1.0
Dublin South 1.0 Dublin South West 1.0
Wicklow 1.0 Dublin West 1.0
41. Project Workers by LHO

Cork South Lee 0.5 Mayo 1.0

43. Aftercare Workers by LHO

South Tipperary 0.5 North Tipp/East 1.0
Kerry 0.0 Kerry 0.0
Limerick 0.0 Longford/Westmeath 0.0
Donegal 0.0 Louth 0.0
Dublin North Central 0.0 Galway 0.0
Longford/Westmeath 0.0 Carlow/Kilkenny 0.0
Sligo/Leitrim 0.0 Cavan/Monaghan 0.0
Galway 0.0 Clare 0.0
Carlow/Kilkenny 0.0 Cork South Lee 0.0

Local Health Office

Local Health Office
Clare 0.0 Dublin North West 0.0
Dublin North West 0.0 Kildare/West 0.0
Dublin South West 0.0 Laois/Offaly 0.0
Kildare/West 0.0 North Cork 0.0
Laois/Offaly 0.0 Roscommon 0.0
North Cork 0.0 South Tipperary 0.0
Roscommon 0.0 Waterford 0.0
Waterford 0.0 West Cork 0.0
West Cork 0.0 Wexford 0.0
Wexford 0.0 Wicklow 0.0

0.34
0.73

Cork North Lee 0.0 Cork North Lee 0.0

Dublin South City 0.0 Dublin South City 0.0

Worker
Project
Worker

Average
Average

Aftercare

Number of CCL's Number of Access Workers

Page 54
0.0
1.2
2.4
3.6
4.8
6.0
0.0
1.0
2.0
3.0
4.0
5.0

Cork North Lee 4.0 Dublin West 5.0

Galway 3.0 Dublin North West 4.0
Sligo/Leitrim 2.4 Dublin South West 4.0
Cork South Lee 2.0 Wicklow 3.0
Kerry Kildare/West 2.0
44. CCL's by LHO

Limerick Donegal 1.0

Donegal Cork South Lee 1.0
Dublin North Central Dublin South East 1.0
Longford/Westmeath Dublin South 1.0
Louth Dublin South City 1.0
42. Access Workers by LHO

Carlow/Kilkenny Kerry 0.0

Cavan/Monaghan Limerick 0.0
Clare Dublin North Central 0.0
Dublin North Longford/Westmeath 0.0
Dublin North West Louth 0.0
Dublin South East Sligo/Leitrim 0.0
Dublin South West Galway 0.0
Dublin West Carlow/Kilkenny 0.0
Kildare/West Cavan/Monaghan 0.0
Laois/Offaly Clare 0.0
Local Health Office
Local Health Office

Mayo Dublin North 0.0

Meath Laois/Offaly 0.0
North Cork Mayo 0.0
North Tipp/East Meath 0.0
Roscommon North Cork 0.0
Dublin South North Tipp/East 0.0
South Tipperary Roscommon 0.0
Waterford South Tipperary 0.0
West Cork Waterford 0.0
Wexford West Cork 0.0
0.36
0.72

Wicklow Wexford 0.0

Dublin South City Cork North Lee 0.0
CCL
Access
Worker

Average

Average
 Number of Access Workers Stacked Number of Workers

0
12
24
36
48
60

0
4
7
11
14
18
1
5
1
6
Dublin North West

43
Carlow/Kilkenny 15

3
5

7
2
10 Donegal
Donegal

2
3
5
Dublin North Central

38 37
Roscommon 9

4
6
Cork North Lee

33
Clare 8

1
5

8
Kerry 8 Dublin South West
F. Workforce

1
8

7
6
Cork South Lee 7 Dublin West

4
3
Limerick

27 27 26
Mayo 7 2
8

10 3
7
Galway 7 Longford/Westmeath
1
1

7
5
Dublin West 6 Dublin North
2
1
6
North Cork 6 Sligo/Leitrim
1
4
4

South Tipperary 6 Kildare/West 7

1
3
2
5
Longford/Westmeath 6 Meath
1
6
5
5

Wexford 6 Wicklow
1
4
5

Limerick 6 Dublin South 24 24 23 23 23 22 22

1
4
4
6

Cavan/Monaghan 6 Laois/Offaly
2
1
4
6

Laois/Offaly 6 Galway
2
2
5

North Tipp/East 5 Dublin South City

1
6
1
4

Louth 4 Waterford
5

Louth
21 20 20 20 19

Dublin South 4
2 3
1 2
4
1

Cork North Lee 4 Mayo

Local Health Office

Local Health Office

6
3
45.Stacked Numbers of Key Workforce by LHO

5
5

Sligo/Leitrim 4 Kerry
1
5
2
3

Meath 4 Wexford
1
6
2
3

Wicklow 4 Dublin South East

18 18 17 16
1
2
4
3

West Cork 3 Cork South Lee

1
3
3
2

Waterford 3 Cavan/Monaghan

46 b) Average Experience of Staff in Department by LHO

1
1
3
4

Kildare/West 3 Clare
15 13 13
1
4
3
4

Dublin North Central 3 Carlow/Kilkenny

12
1
4
4
3

Dublin South East 3 South Tipperary

1
4
1
3

10 9

Dublin North West 3 Roscommon

1
1
3
4

Dublin North 2 North Tipp/East

5.32
8
1
4
2
2

Dublin South City 2 North Cork

6
1
2
1

Dublin South West 0

1

West Cork
Work
Worker
Principal

Qualified

Avg

Dept
Child Care

Practitioner
Senior Social

Years in

Average
Professionally

Social Worker
Social Worker

Team Leaders

0
0
6
0
2
1
0
8
1
0
4
2
0
0
3

Number of Administrative Staff Number of Access Workers

Page 55
0
3
6
10
13
16
0
4
8
12
16
20

Donegal
14

Carlow/Kilkenny 18
1

Sligo/Leitrim
Clare 15
1

Kerry
12 12

Kerry 12
5

Meath
North Cork 12
4

Dublin North Central Cork South Lee 12

Limerick Donegal 11
Cork North Lee
10 10

Galway 11
2

Galway Roscommon 11
2

Kildare/West Mayo 10
8

Cavan/Monaghan Wexford 10
2

Dublin South West Limerick 9

Source: HSE National Social Work Survey
2

Dublin North West West Cork 9

3

6
47. Administrative Staff by LHO

Waterford South Tipperary 9

3

Dublin North Louth 9

1

Laois/Offaly North Tipp/East 9

6

Longford/Westmeath Dublin South 9

3

Carlow/Kilkenny Longford/Westmeath 8
4

Wexford Dublin South East 8

46 a) Average Experience of Staff by LHO

Mayo Dublin West 8

2

Dublin South East Cavan/Monaghan 8

Local Health Office
Local Health Office

North Tipp/East Wicklow 7

2

Roscommon Sligo/Leitrim 7
2

Clare Laois/Offaly 7
5

Wicklow Meath 6
1

Dublin South City Dublin South West 5

4

Dublin West Cork North Lee 5

4

Dublin South Dublin North Central 5

2

Louth Kildare/West 5
4

South Tipperary Dublin North 4

1

West Cork Dublin South City 4

8.40

Cork South Lee Dublin North West 3

North Cork Waterford 2
Avg

Support
Years

Additional

Employed
Average
 Appendix B: Overview of key processes identified by HSE Task Force – (1) Child Protection, Child Welfare and
Family Welfare

GM

FSC

CCM

PSW
Team
Leader

Social
worker

Intake/ Screening Initial Notification CP CP Work with Strategy Child Family

Referral Prelim. assessment to Gardai conference Plan child + family meeting Welfare welfare
inquiry
PSW provides PSW requests Social worker
PSW notifies CCM TL TL allocates PSW requests
duty system CCM decides manages
TL allocates TL case liaison signs convenes SW develops FWC service
TL manages it CCM chairs case and
and signs off off and FSP manager decides
and signs off Determines risk maintains
chairs TL signs off FWC coordinator
CCM list on CPNS record
convenes

Child Protection Child Welfare Family Welfare

Increased level of risk and/or Unmet need

Page 56
 (2) Children in Care, Closure, Case Transfer, Aftercare, Homeless children

AND

LHM
GM

CCM

PSW

Team
Leader

Social
worker

Referral Decision Supervision Application Care Plan Child care Case closure Case Aftercare Homeless
to place order to SCADC review, discharge, transfer services children
in care transfer
TL refers to PSW - GM initiates AND - Special SW draws up TL signs of on PSW signoff PSW GM signs off Decision to
foster, Voluntary, care or Care TL signs off review on child authorises provide
residential, emergency, supervision Admission PSW signs off protection CCM on accommodation
relative interim care order Discharge on discharge CPNS
PSW signs off Committee TL signs off on TL signoff on
exceptional LHM signs off transfer child welfare
care application for
SAP

Increased level of risk and/or Unmet need

Page 57
 Appendix C: Professional supervision and Continuing professional development (to be revised)

Professional supervision and CPD are the key elements in creating a The Health and Social Care Professional Council- registration for Social work:
professional and competency driven service, and could impact on future Social work is one of 12 professional groups that will require statutory
registration. This will require a more structured approach to supervision and
professional registration. However the findings point to a lack of clarity and CPD at HSE and individual level. Ultimately the responsibility for CPD rests
a wide variation in its provision. with individual professionals. However, given the gap between what currently
exists and what is required, a corporate approach is also needed.
Professional development refers to a process whereby individual professionals The key features of CPD should include:
increase their level of knowledge and refine or learn new skills to apply in their
professional practice and workplace. CPD is the ongoing process of developing • Acknowledgement of the importance of providing for CPD and the
and updating the knowledge and skills necessary to ensure competent practice. It respective responsibilities of HSE corporately and individual
works in a ‘top down’ manner where the development needs of the relevant social professionals. This commitment needs to be reflected in budgets and
work department are planned for as well as ‘bottom up’ where the individual social protected time allocation to CPD as well.
workers professional needs. It has both formal and informal dimension as
illustrated below. • A CPD strategy and implementation plan: Training and development
should be planned both at a national level (core skills and competencies
necessary to roll out the business processes etc, legislative and statutory
The CPD structure requirements, multidisciplinary training, management competences) and
Continuing be supported at a regional and LHO level. Each LHO must also devise a
CPD plan to reflect current and future service needs, the individual social
professional worker needs as well as leveraging the national CPD strategy. (This
development could be done using the HSE Departmental and individual CPD planning
tools available on HSE Land)
• Individuals with responsibility for roll out of the CPD strategy: Key social
workers identified in each LHO to organise and coordinate CPD in line
Professional with the national and departmental CPD programme. This would ensure
Generic CPD that front line professionals are involved in the on going development of
CPD courses.
• Universities and social work courses: The role of universities in the area
of CPD could be strengthened. Social work departments support
Informal CPD Formal CPD Informal CPD universities by providing practice placements to social work students.
Formal CPD
•Professional •HSE training and Quality placements can only be provided if the university reciprocates
• CP In-services, •Professional and provides CPD to the departments to develop their practice education
supervision 1:1 development
journal clubs etc supervision 1:1 skills. Skills which add value to the day to day social work role. A
•Reflective •Multidisciplinary •Responsibility in
connection with the universities also links research and the work setting
•Short courses in practice and supports evidence based practice
training in CP certain areas to
CP/addiction etc
•Further reading •Post graduate develop skills • Multidisciplinary CPD training: During the review some good examples of
•Post graduate e.g. Literature multidisciplinary training emerged which had fostered multidisciplinary
courses e.g. MSC working. This should be a key element of the CPD programme.
courses in SW/ reviews etc in health care
student education
management etc

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2.2 Continuing professional development. Recommendations

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 Appendix 4: HSE’s requirements for the review and overview of approach

HSE’s requirement:
The purpose of the review is to assess the
existing management organisational child
protection arrangements including structures,
Project tasks Week 1 Week 2 Week 3 Week 4 Week 5 Week 6
management and governance arrangements and
consider if they: Task 1: Project start up & Planning

‰ Are fit for purpose in achieving safe and high Task 2: Review core documentation
quality child protection services, consistent with
Task 3: High level consultation
statutory obligations
‰ Ensure and support best practice in clinical Task 4: Data Analysis

and professional effectiveness Task 5: Establish the ‘ as is’ child

protection. pathway.
‰ Facilitate public accountability and public Task 6: International benchmarking
confidence
Task 7: Develop findings & options
‰ Support effective interdisciplinary and
interagency relationships Task 8: Develop final report and
implementation plan
‰ Are consistent with international best practice HSE Project Leader/ Steering
regarding Child Protection, assessment and group meetings.
Intervention
Deliverables Task 1: Task 2: Task 4: Task 5+6: Task 3: Task 7+8:
Project Summary Assessment - High level Document - Findings and
initiation of key of resource map of summarising options
document findings allocation pathway findings - Final report &
and activity - International implementatio
benchmark plan.

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