Safeguarding of Children and Staff in Care Homes

Question for Urgent Oral Answer — Health – in the Northern Ireland Assembly at 3:15 pm on 15 March 2022.

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Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party 3:15, 15 March 2022

Mr Colin McGrath has given notice of a question for urgent oral answer to the Minister of Health. I remind Members that, if they wish to ask a supplementary question, they should rise continually in their place. The Member who tabled the question will be called automatically to ask a supplementary question.

Photo of Colin McGrath Colin McGrath Social Democratic and Labour Party

Mr McGrath asked the Minister of Health to provide an update on the actions his Department will take to safeguard children and staff at care homes following the Regulation and Quality Improvement Authority (RQIA) decision to deregister a centre run by Praxis Care after inspectors found significant shortcomings that placed children and staff at risk.

Photo of Robin Swann Robin Swann UUP

I am aware that the RQIA undertook an inspection of a children's services residential care home for children in January this year. The inspection findings are clearly very disturbing and found staffing deficits which, in RQIA's assessment, compromised the provision of quality care for children with complex needs.

The South Eastern Trust has fully engaged with Praxis Care and the RQIA to explore the challenges in children's services and provide the support that is necessary to ensure safe care. As an immediate and decisive response, the trust redeployed statutory staff to address critical vacancies in the care home in order to maintain service provision. The trust developed a contingency plan to take ownership of the children's service, engaging families and the children to ensure transparency and provide assurance that decisive action was being taken. The children's service is now registered with the appropriate trust and additional trust staff have been redeployed to address deficits.

To be clear, the trust has now taken full leadership, management and oversight responsibilities in the children's service and will continue to work with the RQIA to ensure the delivery of safe and quality care. In the longer term, my officials are working with the Health and Social Care Board and all trusts to develop a framework to redesign services for children with disabilities and complex needs.

Photo of Colin McGrath Colin McGrath Social Democratic and Labour Party

I thank the Minister for his response. We have spent months and years in this place talking about the impact of inadequate care in mother-and-baby units and other institutions that the state places children in the care of, and we have always referred to that in the past tense. Yet here we are in 2022 discussing a children's care home in which the situation has deteriorated such that the trust has had to step in and take over. The root of the problem appears to have been staff shortages and staff inadequacies. There is an inference from the RQIA's statement that a result of those difficulties is that they impact upon the care of some of the most vulnerable in our community.

I appreciate that we have difficulties in many areas of the health service because of workforce challenges. However, I would like to know when the Department first became aware of the problems that were being faced and how much intervention there was from the RQIA prior to the decision to deregister the home? Surely the staffing issue did not occur overnight.

Photo of Robin Swann Robin Swann UUP

As I said in my opening statement, the RQIA undertook an inspection in January this year. It then served a notice of intent in February. It has acted in a speedy way to undertake work with the South Eastern Trust, which acted immediately to put in place provisions. There was a proactive response from the RQIA and the South Eastern Trust. They mobilised quickly to make sure that additional support was provided to those children who needed it.

Photo of Colm Gildernew Colm Gildernew Sinn Féin

Minister, supporting and keeping children safe is clearly a paramount requirement of us all. I welcome the trust's stepping in to manage and deliver those key services. Has the trust asked for or been given additional resources to take on the running of the care home? Could this open the way for other failing care homes to be rescued?

Photo of Robin Swann Robin Swann UUP

The RQIA and the South Eastern Trust interacted on what needed to be done to address the RQIA's findings about those significant staffing deficits, including staff competency, in the care that was being provided. The RQIA also had concerns about the leadership and governance structures, which required the decision to be taken at speed.

The Member will be aware of the other processes that have been put in place by the RQIA in other trusts. At this point, the trust has not asked for additional resource to be able to do that. It mobilised its own staff as quickly as was needed to make sure that it was able to maintain safe staffing levels and that the care of the residents was maximised at that point.

Photo of Pam Cameron Pam Cameron DUP

I thank the Minister for his answers to the questions so far on what is a very concerning subject. What engagement has the Department or the RQIA had with the parents or next of kin of the children who have been placed at risk in that centre to reassure them and provide clarity on the situation?

Photo of Robin Swann Robin Swann UUP

I thank the Member. That is one of the main cruxes of the issue. In my answer to the initial question, I said that there was engagement about the care not only with the parents but the children themselves. I also indicated that there was engagement by the RQIA not just following the inspection and in the decisions taken but, as is required in an RQIA inspection, through its interaction with the children and young people about the support and services with which they were being provided and whether that met their needs. There was engagement by the RQIA throughout the entirety of the process.

Photo of Paula Bradshaw Paula Bradshaw Alliance

I was shocked but not necessarily surprised when I saw the news this morning about that form of accommodation. Minister, you will recall that I wrote to you not that long ago about a constituent of mine whose discharge from the Iveagh Centre has been delayed for several years. That cuts across into the Northern Ireland Commissioner for Children and Young People (NICCY) report, 'Still Waiting', on the lack of appropriate care packages in the community for young people. An enduring concern that we on the Health Committee have is that a lot of those children will end up in adult services and then become institutionalised. What is the Department of Health doing about providing proper care for children in community settings?

Photo of Robin Swann Robin Swann UUP

I thank the Member for her point. She will be aware of the Children's Homes Regulations (Northern Ireland) 2005 and the requirement from the Department of Health to publish minimum standards for children's homes as well. In those, standard 4 relates to safeguarding children and young people and the other work that needs to be done to make sure that there is support for each individual, that that is assessed based on individual need and that there is an individual care pathway as well.

The Member will also be aware that, on 21 January, I announced an independent review of children's social care services. That review commenced in February. It is being led by Professor Ray Jones and supported by an expert panel, and it is expected to take approximately 16 months. That review will be fundamental to the examination of children's services. It will focus on quality, equity, resilience and sustainability to ensure that our services are capable of responding to the current and potential future demand level and complexity of need; are effectively meeting the needs of the children, young people and families with a range of vulnerabilities; sufficiently and supportively engaging them in the decisions that affect their lives; and are adequately supporting staff and carers in the exercise of their statutory and other duties in the course of their caring responsibilities.

As I have announced, even with regard to the legislation that we completed this morning, this is the start of a process, and a lot of work has to be done to ensure that the issues that Mr McGrath mentioned do not happen again. The RQIA's intervention and inspection, and the quick action of the South Eastern Trust, proves that we are in a very different place from where we were when some of those inquiries initially took place.

Photo of Órlaithí Flynn Órlaithí Flynn Sinn Féin

As we all know, protecting children in care is the main aim of our social care services. With that in mind, will the Minister tell the House whether there have been any safeguarding referrals as a result of that extraordinary action?

Photo of Robin Swann Robin Swann UUP

I am not in a position to answer that question at this time, but I can follow up with the Member directly or through the Health Committee.

Photo of Dolores Kelly Dolores Kelly Social Democratic and Labour Party

As other Members have said, the safeguarding of children and young people is our priority. On reflection, are we paying the staff who are tasked to work in the care homes well enough, and have they the right skills, talents and attributes to look after our most vulnerable, given that there is, I am sure, a disparity between the pay scales of the third sector — the voluntary and community sector or charity sector; whatever you want to call it — and trusts?

Photo of Robin Swann Robin Swann UUP

I thank the Member. She indicates a challenge that we have across all of the care sectors as regards the support of the staff in the sector by way of what they are being paid and the compensation that is there. Professor Ray Jones will also look at that as part of the review into children's social care services that I announced, because we cannot rely entirely on the third sector, the social sector, to carry out that function. It is also important that those services are inspected by the RQIA to make sure that they are serving at a standard that supports the people who are using the facilities and that the RQIA acts where it sees that action is needed. In this case, it has.

Photo of Gerry Carroll Gerry Carroll People Before Profit Alliance

I thank the Member for raising the issue. My thoughts are with the young people who have been failed and put at risk. The Minister practically stated that the recruitment and retention of staff may have exacerbated some of those inexcusable failures. What assessment has he and his team made of the suggestion that such services should not be supplied by charities but by the state and the NHS, to avoid a repeat of any of these cataclysmic and heartbreaking failures?

Photo of Robin Swann Robin Swann UUP

The Member and I have had discussions about what is a mixed economy in relation to our social care and social provision, where we rely not only on third-sector providers in the voluntary and community sector but on the private sector. Part of the remit of the review of adult social care is to look at how we rebalance how much is supplied by trusts versus what is being provided by the private and voluntary and community sectors. I believe that the trusts and the Department should be doing more centrally, because that is what our National Health Service is about: providing a health service at all points. I know that that is one of the points on which the Member and I agree.

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

That concludes questions on the question for urgent oral answer. I ask Members to take their ease while we move to the next item of business.