A monitoring programme of Tusla's child protection and welfare services resulted in HIQA escalating identified risks to regional chief officers in the Child and Family Agency.
A report by the Health Information and Quality Authority shows that in a number of cases, regional level responses did not provide necessary assurances to inspectors, which led them to escalate issues to Tusla's CEO.
The issues emerged during a risk-based monitoring programme by HIQA which was established in 2023 to examine child protection, welfare and foster care services in areas where 25% or more children were without an allocated social worker.
According to the report, HIQA inspectors were concerned about 300 children in the Dublin area, who were assessed as being at low or medium priority who were on waiting lists, and escalated these cases.
The placement of children in a Special Emergency Arrangement (SEA) was also brought to the attention of the CEO.
Increased use of Special Emergency Arrangements (SEAs) due to insufficient placements for vulnerable children remains a concern of the watchdog.
The risk programme found there was a failure by Tusla to implement policies and processes and it outlines how children in protection and welfare services can fall through the cracks.
Children prioritised as medium and low risk did not always receive the right support at the right time and were often left on waiting lists.
Those identified as being at immediate risk or high-priority cases received a service in the main.
The level of risk or safety was not always established by Tusla before children were placed on waiting lists for long periods of time, according to the report.
Tusla staff expressed concern that cases on waiting lists which were viewed as low to medium cases could become high priority due to a shortage of social workers.
HIQA inspectors found that resourcing and staffing issues, including staff turnover impacted the delivery of services.
Staff were not receiving regular and effective supervision and support in some child protection and foster care services and a lack of oversight meant gaps in practice were not always identified or prioritised.
The report has acknowledged that Tusla is under "significant pressure to deliver an effective and equitable child protection and welfare and foster care service" to all children and their families.
It has stated that increased demand for services and resourcing challenges have contributed significantly to Tusla's ability to provide a timely and safe service.
It added that significant improvement was required for managing unallocated cases in both child protection and welfare and foster care services.
'Crucial' that children have access to the right service - HIQA
HIQA’s Head of Programme for Children’s Services, Eva Boyle, said: "It is crucial that children have access to the right service for them at the right time to support their development and promote their safety and rights.
"Children have also told us over the years how important it is to have trusted adults that they can speak with. In these services, we found that many children did not have an allocated social worker, and were not receiving a timely and consistent service.
"Where risks were identified, HIQA escalated them to the regional chief officer of the service area in Tusla as appropriate, to ensure review and to provide assurances that the safety and care needs of the children were met."
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A separate report published by HIQA relates to an inspection of Tusla's National Out of Hours Social Work Service (OHS) carried out last August.
The OHS provides emergency placements for children from 6pm to 7am daily and from 9am to 5pm at weekends and bank holidays.
Inspectors found the service was reactive rather than proactive in meeting the emergency needs of vulnerable children and young people.
Poor governance impacted the ability of Tusla to ensure staff received "regular and effective supervision and support" to promote the safe delivery of the service.
Children placed in Special Emergency Arrangements faced poor safeguarding practice from the Out of Hours Service.
Ms Boyle said HIQA had worked closely with Tusla to monitor progress in services provided to children last year.
She said substantial improvements had been made since the inspections were conducted and that Tusla had committed to improving its services for children.
Issues being proactively addressed - TUSLA
Tusla has acknowledged the publication of the two reports.
It noted that HIQA has highlighted challenges previously identified by Tusla, including a significant increase in referrals (32% between 2020-2023), increased complexity of cases presenting, and inadequate resources to meet demand, both staffing and care placements, which impacts the timely delivery of services for children and families.
In respect of the Out of Hours Service, the Child and Family Agency acknowledged that HIQA found improvements were required in some areas, such as governance systems within the service, the oversight of day-to-day practice, and the management of risk.
It said all of the issues identified in both inspections are being proactively addressed.
CEO Kate Duggan said the external oversight provided by HIQA assists the Child and Family Agency in continuously improving the quality of services.
"We are committed to ensuring that we deliver good quality services in line with the resources available to us, and that resources are utilised to ensure those assessed at immediate risk of harm are prioritised for an appropriate response."
She added that the safety and wellbeing of all children and young people referred to their services, or in Tusla's care, remains its driving focus.
"The implementation of our current Reform Programme is focused on the delivery of timely, equitable, integrated and consistent practice across all service areas, improved governance and oversight, digital transformation, and increased placement capacity.
"I am confident that this will positively impact the experience of those using our services, enable better outcomes, support our staff and Foster Cares and build trust and confidence in our services."
