Care unit practice criticised by HIQA

Children at the Ballydowd Special Care Unit were left to urinate on the floor of their locked bedrooms because they were forbidden to go to the bathroom, according to a recent report by The Health Information and Quality Authority (HIQA).
The authority reported a number of troubled children within the special care unit had to urinate on the floor while isolated in a “safe room” for lengthy periods of time.
This revelation is just one in a series that have come to the fore through the report carried out by HIQA in July.
They state that most of their concerns focus on the use of “single separation” – the isolation of disruptive young people in safe rooms or designated locations away from their peers.
Children, aged 11 to 17, are detained at Ballydowd Special Care Unit on foot of a High Court order on the basis that they pose a serious risk to themselves or others.
The report, published on August 31, found some children were kept in isolation for unnecessarily long periods, occasionally without access to toilets.
As a result of this two children urinated on the floor of the safe room as they were not allowed out to go to the toilet.
The inspectors found that since July, three children were put into single separation without a mattress or blankets to sleep on overnight. One young person complained about having to sleep only in tracksuit bottoms without a top or blanket and told staff members that they were freezing throughout the night.
A manager reviewed the complaint and stated that the intervention was justified due to risk of self-harming.
They said that while many of the incidents of single separation periods were under three hours, six lasted over 24 hours.
The report also found that one child was kept in continuous single separation for five days.
Another young person did not have access to a shower until day four of a five-day period of continuous single separation.
Instead the young person was provided with baby wipes.
In response to the findings of HIQA’s inspection, Fred McBridge, chief executive of the child and family agency Tusla, told The Gazette that they accept on some occasions the use of single separation was not adequate.
He said: “Tusla accepts that on occasion when faced with intense and sustained pressure from challenging and violent behaviour, the processes underpinning the use of single separation were not adequate. Tusla regrets this and is currently taking steps to strengthen its decision making procedures and facilities.
“When considering the use of single separation, the key challenge for Tusla is balancing the dignity and rights of the young person concerned with our legislative duty of care toward that young person and that of other young people in the unit, as well as our staff who work in increasingly difficult circumstances.”
McBride added that toilet facilities were restricted when they deemed the individual was at risk of self-harm or at risk to staff or other young people.
Commenting on HIQA’s report, Tanya Ward, chief executive of the Children’s Rights Alliance, said: “Depriving a child of social contact for prolonged periods of time and in inappropriate conditions can be very harmful. The young people in special care are incredibly vulnerable and many have had traumatic experiences in their lives.
“It is our view that single separation facilities without basic sanitation should not be used. Children should not be subjected to inhuman or degrading circumstances at any time.”