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A report from the Children’s Ombudsman’s office shows that Tusla and the HSE had significant deficiencies in caring for a profoundly disabled child.
The report says there were unacceptable delays and mismanagement of the child’s care.
He remained in hospital and community respite settings for 29 months, despite being medically ready for discharge.
In 2016, at the age of three, Jack was involved in a serious traffic accident in another country that resulted in a brain injury and life-changing injuries that require 24-hour care.
Almost a year after his accident, his mother released him from the hospital abroad and brought him back to Ireland, where he was immediately admitted to hospital.
Four months later, when he was deemed medically ready for discharge, his mother expressed concern that she would not be able to properly care for him at home.
As time passed, the multidisciplinary team at the hospital became concerned about the lack of an HSE exit plan for Jack.
He alerted the Children’s Ombudsman office to Jack’s case in January 2018.
Three months later, a senior social worker at the hospital made a referral to Tusla regarding the circumstances of Jack’s family.
Tusla declined the referral, along with follow-up referrals by a medical team, on the grounds that there were no child protection issues and it was a matter for HSE alone.
The report says Tusla should have completed an initial evaluation of Jack and his family when the medical social worker informed them of his concerns.
It says Tusla refused on the basis that these were issues for HSE Disability Services and Jack did not meet his threshold for care.
The ombudsman said the decision was “improperly informed by Jack who has a disability.”
The report notes that Jack’s eventual placement with a host family by HSE Disability Services was done without any legal or formal regulatory framework or proper authority, according to the Ombudsman.
The report finds that the administrative actions of both HSE and Tusla had a negative impact on Jack’s life.
While he was in the hospital, there were periods when he had no educational support and was isolated from contact with other children, including his younger sister.
Jack’s consultant and his mother told the Children’s Ombudsman that as of November 2019 they noticed a deterioration in their general health and well-being.
The Ombudsman’s office has said that if HSE and Tusla had worked together at an early stage, Jack may have had the opportunity, with the right support, to grow up with his family.
“Even if it had not been possible for him to return home, he could have been transferred earlier to a more homelike environment and even gone to school,” the report says.
It also notes that the eventual placement of Jack with a host family by HSE Disability Services was done without any legal or formal regulatory framework or proper authority.
“We found no indication that Jack’s mother was aware of these concerns and that no effort appears to have been made to directly contact Jack’s father regarding the location of his son,” he said.
The report found systemic failures on the part of the HSE to provide adequate supports and services to children with disabilities, like Jack, who lived in inappropriate settings.
During the investigation, the HSE revealed that at least 356 other children with disabilities were assessed as requiring residential care placements.
The report has made a series of recommendations to HSE and Tusla.
He said HSE Disability Services should immediately and systematically review all cases where a child remains in a hospital beyond their medical need.
He said that a National Review of HSE Disability Services should be conducted to review the current need for alternative care for children with disabilities whose parents or caregivers are assessed as unwilling or unable to provide their continuing care.
Has asked Tusla to issue guidance immediately to all areas of social work, that child welfare and protection referrals on children with disabilities should be evaluated and administered in the same manner as all other referrals and in accordance with policies and procedures national.
In February 2020, the HSE, under the auspices of a charity, placed Jack in the care of a host family.
Within this arrangement, Jack can attend school where he has two classmates.
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