The Health Service Executive has been sharply criticised for leaving some neglected children without an allocated social worker despite receiving as many as 30 referrals from separate agencies.

The independent review of Roscommon, South-East Dublin and Waterford health areas was completed last year.

The audits examined 96 cases where neglect was the primary reason for a referral to the Child Protection Service.

Forty-five were deemed to have adequate safeguards in place, 29 needed further assessment and intervention, and 17 cases were deemed to need immediate additional actions to provide adequate safeguarding.

The HSE has confirmed that in those 17 cases immediate actions were taken to ensure that enhanced safeguards and protections were implemented.

The review found no clear profile of family size or number of parents in some homes and a lack of focus on the children's harsh everyday life.

It found that in some cases HSE files contained no clear profile of how many children were in at-risk families or how many parental figures were in the home.

It said very few parents were prosecuted for criminal neglect and child and adolescent mental health services were often limited and ambiguous.

The review criticised the language used by some professionals including words like "dirty" and "unhygienic".

The terms were used to describe situations such as beds saturated in urine, a complete absence of heat, dog excrement on floors and mouldy food adhered to kitchen counters.

The HSE said a key learning from the audits was the need to be alert to the systemic and ongoing impact of neglect.

The executive said children and family services have been undergoing a substantial programme of reform which has included enhanced governance systems, improved workforce development and standardisation of practice.

The HSE has said its response to the report has already prompted a rise in the number children taken into care in neglect-related cases.

It has also highlighted an increase in supervision orders issued for the same reason.

In a statement issued to RTÉ News, it explained that last August, approximately four months after receiving the critical review, it alerted social workers to the systemic and on-going impact of neglect.

It also issued a template for auditing the problem.

The HSE explained it decided to publish the audit now to coincide with follow-up training to be conducted by the author, Lynne Peyton, in the Autumn. She is a Consultant in Children's Services and Social Care based in County Tyrone.

The training will also include a significant contribution from Helen Buckley who chairs the National Review Panel investigating serious incidents and child deaths.