Case studies

Conor is a teenager with a diagnosis of autism, depression and anxiety. At the time the complaint was made to the OCO, Conor had been staying in a paediatric ward at a hospital for almost five months supported by two staff members at all times. The HSE Disability Services had not identified a place for him to stay as he could not return to his family home. His parent contacted us as they were so concerned about the inappropriate nature of the hospital care placement, the delay by the HSE in securing an appropriate placement for him and the absence of appropriate supports to help him. It was made known that his weight increased significantly during this time, he had little exercise, no treatment other than medication, no therapeutic support, no access to education whatsoever and his social stimulus was limited to staff and parental visits.

What we did:

We wrote to the HSE Disability Services and HSE CAMHS services asking about their planning for Conor and why he had remained in the hospital for so long when there was no medical need. We also met with Conor in the hospital and he told us how much he felt he was missing out on.

Outcome:

After we got involved, the relevant services started to plan more proactively for his care. Nine months after his admission the HSE secured an individual placement for him that was supported by a private care services provider.

Emily was 6 years old with a physical disability and needed a new wheelchair as she had out grown the one she was using. Her mother told us that she had repeatedly tried without success to get this matter resolved with the HSE but was told that there was no funding to purchase a new wheelchair from the HSE Primary Care team in the area. Emily’s mother contacted us as she was very concerned about Emily’s safety in her current chair. She was worried that Emily could easily fall while using it and a fall along with her medical condition could result in a serious injury or death.

What we did:

We wrote to the HSE area and they told us that the budget available to Community Healthcare for the provision of nonstandard Aids & Appliances falls far short of the applications for these items. They told us that a multi-disciplinary group meets regularly to review all applications on behalf of children and adults and decisions are made based on priority on a case by case basis. The number of children waiting for medical and surgical aids and appliances in this area at end of 2 https://www.oco.ie/app/uploads/2011/04/InvestofHSEreapplicforpoweredwheelchair.pdf June 2018 was 132 and while Emily was categorised as a high priority (Priority 1) there was not enough money to purchase the wheelchair for her. The HSE area told us that this was because the allocated budget in the area was not enough to meet demand.

The outcome:

The HSE were able to identify funding from savings in other areas and they were able to purchase Emily’s wheelchair. We were concerned about the delays in purchasing much needed equipment for children with physical disabilities. This issue had been previously identified by the Office in 20112. In response to this complaint in 2018 we were told that the HSE National Aids & Appliances Service Improvement Programme were drafting a Procedure on the Management of the Aids and Appliances Budget as practice varies across the country. We asked the HSE to consider separate Adult and Paediatric budgets for aids and appliances due to the particular vulnerabilities of children like Emily.

Steven’s mother made a complaint to the OCO about the Calculated Grading System. Steven, who was 17, had studied a subject outside of school with a tutor but had been refused a calculated grade for the subject. Steven’s mother could not understand why her son was not provided with a grade given that the work he had done with his tutor had been documented. Steven’s mother explained how this had caused immense stress for Steven as he had worked very hard in the subject and had hoped that the grade he would receive would contribute to the points he needed to get his course of choice at university. He had exhausted local procedures with the Department, including the independent appeals mechanism.

What we did:

We wrote to the Calculated Grade Executive Office (CGEO) in the Department of Education to seek clarity on why Steven had not been given a calculated grade and the rationale behind this decision. We also asked for all information collected by the CGEO that helped inform their decision as well as information passed to the Independent Appeals Scrutineer (IAS) when Steven submitted an appeal. We analysed all of the information provided and cross referenced this against the appeals protocol set out by the Department of Education for both the CGEO and the IAS.

Outcome:

In this particular case it appeared that both the CGEO and the IAS adhered to the appeals policies and procedures set out by the Department of Education to deal with appeals of the Calculated Grading System.

With this being said we know there was a number of challenges with the calculated grades processes and we hope that any learning from 2020 will drive improvements for students in 2021.

Joe’s mother contacted us in late October 2019. She told us that Joe, aged 13 years, had been enrolled in a post primary school, but did not attend as they subsequently had to move homes. However, when Joe left the school, his parent asked that the school refund the fee they had charged that was attached to the application form to have Joe enrolled. Joe’s mother had tried to engage with the school but they had refused to refund the money on the basis that it was non-refundable upon being offered a place in the school.

What we did:

We wrote to the school to find out why they had refused to refund Joe’s mother the fee and why they had charged it in the first place, as it is against the Education (Admission to School) Act 2018, to charge fees that are a condition of an application for admission or continued enrolment of a student in a school. The school then contacted the Ombudsman for Children’s Office and stated that they would return the money to Joe’s mother immediately.

Outcome:

The school returned the money to Joe's mother just before Christmas.

Eoghan has special needs. He had previously attended mainstream primary schools, but when he was in 5th class he joined a special school because of his challenging behaviour. His mother contacted us at the end of that school year because she was concerned about the school’s use of seclusion to manage Eoghan’s challenging behaviour. Eoghan’s mother was concerned about the amount of time her son had spent in seclusion. She was concerned that seclusion was not always being used appropriately, or as a measure of last resort. She told us that Eoghan had spent a lot of time excluded from the classroom, with little opportunity to engage in physical activity, or to interact with his classmates during the school day.

What we did:

The Ombudsman for Children’s Office has varied and flexible mechanisms for dealing with complaints about public services. Early resolution is an alternative process to a formal investigation. Shortly before the new school year was about to commence, the office wrote to the school to encourage them to engage with Eoghan’s mother for the purpose of discussing strategies for managing Eoghan’s behaviour moving forward.

Outcome:

The school met with Eoghan’s mother, and provided our office with information about the plans for managing Eoghan’s behaviour. Eoghan’s mother subsequently contacted us to say that Eoghan was working well with his new teacher, doing well with his school work, and enjoying being back in class with his friends. She said that Eoghan was coming home from school full of talk about his day, and that he had told her “I love school”.

Ann has been in receipt of the special needs transport grant to enable her to attend her local school. However, when her family moved house her school was no longer her nearest school. The application for a grant to maintain her current school placement was refused as it was deemed by the School Transport Appeals Board (STAB) not to be the nearest school to her new home. Her nearest school was now a Gaelscoil which was unsuitable due to her special needs and also because Ann could not speak Irish.

Furthermore her family had moved house previously and the application for special needs transport has been supported on that occasion. STAB advised that transport may be applied for on a concessionary basis. However this was deemed unsuitable for Ann due to the lack of supervision on such transport.

Ann herself wished to remain in her current school as she was happy there and had made great progress especially socially.

OCO examination of the complaint:

We examined the complaint by seeking a response from the Department of Education and Skills in relation to this case including the rationale for the decision and querying previous approval for this grant when the family had moved house before.

Outcome:

The Department of Education and Skills reviewed the case and discovered that Ann’s ligibility for school transport was originally considered under the terms of the School Transport Scheme for Children with Special Educational Needs and under the terms of this scheme she was ineligible for school transport.

However, the Department determined that as Ann was attending a post primary school they felt that the criteria used to determine eligibility for school transport should reflect the same criteria used to determine eligibility under the Department’s Post Primary School Transport Scheme. Under the terms of this scheme children are eligible for school transport if they meet the distance criterion and are attending their nearest education centre. An education centre can be comprised of a number of post primary schools.

Therefore, Ann’s school was eligible and as there was no suitable transport service, the Special Transport Grant was offered to her parent to fund the cost of her private transport arrangements.

The Department also told the OCO that these eligibility criterion will apply to all cases similar to Ann.

We received a complaint on behalf of Martin about how his school handled his reports of bullying. Martin felt intimidated by a group of peers, which resulted in his irregular school attendance during his sixth year.

What We Did:

We contacted the school about its response to the allegations of bullying and the handling of the subsequent complaints made by Martin’s parent. It became apparent that this situation had the potential to negatively affect Martin’s Leaving Certificate and we highlighted this with the school.

The Outcome:

The school provided us with a comprehensive response.  This detailed the immediate investigation of the allegations of bullying and interviews with the relevant students. Teachers provided supports, including counselling, to the young people affected and sought to address the situation using restorative practices. The school demonstrated a proactive approach to counter-act bullying in the school. However we encouraged the school to make the procedure that follows an allegation of bullying clearer in their Anti-Bullying Policy. With regard to Martin’s Leaving Certificate, in agreement with the family, the school and State Examinations Commission agreed to special arrangements with a view to minimising any potential negative impact.

We received complaints concerning the length of time that four families had been waiting for social housing in the same local authority area. The complaints were made on behalf of nine children (one family had four children, one had three and two had one child each).

• Two complaints related primarily to the local authority’s decision to defer the family’s application because of parental antisocial behaviour.
• Two complaints related to children with a disability. One family was waiting for a house while the other was waiting for adaptations to their house.

What we did:

We met the local authority and asked them to explain how it:

• Operates its allocation scheme and prioritises applications;
• Makes decisions regarding the deferral of applications;
• Considers and balances children’s needs when making decisions about housing allocation;
• Communicates with families.

Allocation scheme and prioritisation

The local authority told us that its allocation scheme and prioritisation criteria are set out in the Housing Act, which sets the first category of need as homelessness. If families are classed as homeless they do not get additional priority if a child has a disability. The local authority told us that one of the families with a child with a disability had been housed, while planning for the necessary adaptations for the other were at an advanced stage.

They also told us that the families had been waiting so long because the children’s parents had refused other offers of housing.

Deferrals

The local authority told us that staff members make decisions about applicants’ risk of antisocial behaviour or offending based on the severity and frequency of prior behaviour. The local authority acknowledged that its use of hotels as emergency accommodation for families with children was not ideal but it did not have any homeless units for them considering children’s needs

The local authority stated that children’s needs are considered on a case by case basis but the need to do this is not explicit in housing legislation. The local authority advised that it is represented by junior staff on the Children and Young People’s Service Committee (CYPSC). We advised that CYPSCs are a useful forum where children’s issues can be discussed by the local authority with other key stakeholders in the area.

Communication with families

The local authority advised that it communicated with the applicants regularly. However, a parent told us that the local authority had phoned her to tell her that her application for adaptations to her house had been approved but she had received nothing in writing.

Outcome

Children of families who are waiting for social housing or disability adaptations experience adversity by having to stay in inappropriate emergency accommodation for lengthy periods of time or to live in a house that has not been adapted to suit their needs. However, in these cases these adverse effects were not directly due to the local authority’s administrative actions. Therefore, we did not investigate these complaints further.

However, we wrote to the local authority and advised it to:

• Develop local guidance for staff on decision-making regarding deferrals in the absence of national guidance. Concepts such as the frequency and severity of offending should be defined clearly so that decisions are consistent.
• Consider making changes to some administrative practices that did not require legislative change. For example, communicating effectively with service users and following up with written communication regarding any key decisions.
• Ensure representation at the CYPSC is at an appropriate level of seniority.

Finally, we intend to pursue a number of areas with the new Department of Housing, Community, Planning and Local Government and to highlight the need to meet the commitments set out in Better Outcomes Brighter Futures, the national children’s policy framework published by the Department of Children and Youth Affairs in 2014. We also met with Department representatives during consultations on the Rebuilding Ireland Plan outlining our concerns.

In March 2018, we received a complaint from a Traveller Advocacy Group about conditions at a Local Authority run halting site, where 66 children and their families are living. This complaint developed into an in-depth investigation, the details of which are set out in our No End in Site report. The complaint included concerns about extreme overcrowding; a lack of progress on housing applications for some families; inadequate heating systems in the trailers and welfare units; illegal dumping on an adjacent site; persistent problem with rodent infestation; inadequate sanitation on the site; unsafe and inadequate electrical wiring throughout; safety concerns regarding the entrance and egress to the site; high rates of childhood illness related to the site conditions and; no amenities or safe play areas for children.

What we did:

To progress this investigation we first reviewed of all the advocacy groups and Local Authority files/records. We then interviewed 11 families who wished to make specific complaints on behalf of their children. After this we interviewed representatives of the Local Authority including the CEO, the Director of Housing, the Manager of the Traveller Accommodation Unit, the site caretaker and the Chief Fire Officer. In the circumstances we also met conducted interviews with the HSE Director of Public Health Nursing and the Principal Officer with the DHPLG.

An important part of this investigation was that we visited the site on three occasions and met with 17 children aged between 3 and 17 years who told us about their experiences living on the site.

Outcome:

As a result of our investigation the Local Authority has agreed to act on all of the recommendations we made within identified timelines and for this to be overseen directly by the CEO. Those commitments include;

• A review of the housing applications and complaints made by the 11 families;
• An independent audit of all applications from the site and action on any recommendations that come from same
• A range of actions to address the health and safety concerns both immediate and longer term
• To ensure the Traveller Accommodation Unit is adequately resourced and this to include with new complaints process.
• To link in with other children’s services in the area to consider a range of ways to improve the lives of children
• To engage with children, parents and local services to identify ways of making things better.

Andrew’s mother contacted us in February 2019. She told us that her son has severe disabilities since birth and requires 24 hour care. As Andrew has no functional use of his body his housing needs were complex. His mother explained that Andrew requires accommodation that facilitated sufficient space for a wheelchair, a hoist and medical equipment. At the time of initial contact with the OCO Andrew was sharing a bedroom with his parents and younger sibling. Andrew’s mother was frustrated by an ongoing lack of communication from her local authority in relation to the commencement of adaptive works on the family home. She told us that she had experienced ongoing difficulties accessing suitable housing for Andrew since his infancy.

What we did:

We contacted the local authority who told us there had been delays in commencing the project at Andrew’s home due to the complexity of the works planned. We asked them to keep Andrew’s mum informed as to the likely commencement date of the project. We also asked the local authority to ensure that the contractors responsible for the project liaise regularly with Andrew’s mother throughout the works in order to minimise disruption to Andrew’s daily routine. We followed this up by contacting Andrew’s mother for her feedback as to whether communication had improved. She told us that further and better communication had occurred.

 Outcome:

Local resolution was achieved and the local authority ensured that Andrew’s mum was kept informed as to the status of the building works to their home. The project commenced during summer 2019 and was successfully completed.

The OCO received a complaint from a mother on behalf of her children. It was explained that the family had been forced to leave their home due to serious anti-social behaviour which had culminated in an assault on the mother, witnessed by the children. Following this the Council housed the family in a hotel and granted priority to the family under the Exceptional Social Grounds Scheme. During this period the family home was broken into, damaged and much of the family’s belongings were lost due to vandalism and theft.

After four months in the hotel accommodation the Council informed the family that the house was to be refurbished and that they would then be expected to move back in. The family did not feel that this would be possible due to on-going and increased threats that they were being subjected to by those in the area. They understood that to stop the move back the Council were requesting a letter from An Garda Siochana to state that the lives of the family were in danger. While a letter from the Gardaí was provided it did not go so far as to state that the family’s lives were in danger. The mother sought to appeal the decision of the Council but expressed that it was not clear how they were expected to do
so. Frustration at the communication with the Council during this period was expressed.

The family also felt that the extended stay in hotel accommodation was having a negative effect on the family, including the children’s school attendance and extra-curricular activities, which they could no longer continue. In addition, it was stated that the children’s pet dog had to be given up. In complaining to the OCO the mother sought a delay to the proposed move to the family home as well as a long-term housing solution.

Outcome:

Following a preliminary examination by the OCO the Council first agreed to delay the proposed move back to the home where the family had suffered the anti-social behaviour. Following this, the Council then approved a property for the family and subsequently provided them with the keys. The family were delighted with the outcome and felt that they would be safe and secure in the area that they moved to.

Maria contacted us to complain about her experiences while placed in an emergency hostel for a number of weeks by Tusla, the Child and Family Agency. Maria had been in care for a number of years and during that time had 18 separate care placements. She told us that she did not have a proper home or residential unit. She told us that while she was living in the emergency placement she was out walking the streets all day and then went out at night as there was nothing else to do. She also told us that this caused her difficulties in accessing education and curtailed her relationship with her sibling.

What we did:

We met with Maria and asked Tusla for their views of the complaint. We were deeply concerned that Maria, a child in state care, would end up homeless. We were also concerned about the model of care whereby highly vulnerable children were without adult supervision for any period of time. Furthermore it emerged in the course of this investigation that during her time in that placement, Maria was exposed to drink and drug misuse, other criminal activities and that she was sexually exploited. We recognise that Tusla has a difficult task in fulfilling their statutory role with young people with complex needs in state care and whose placements have broken down. This can be compounded by the limited availability of a range of specific resources or facilities, as well as experienced staff to meet Maria’s needs and those of other young people. However, due to the very nature of their circumstances these young people require greater specialised care and support packages. We found that in many ways the social work team had done their very best for Maria. Maria had complex needs and difficult early life experiences. As a result she struggled to cooperate with services and many of her placements broke down. We determined that the type of emergency accommodation provided at this hostel is not suitable for children who require a safe secure environment. This is due to the lack of 24 hour access to adults charged with their care. We recommended Tusla ensures that any emergency residential accomodation for children provides 24 hour care with adult supervision. A similar view has previously been articulated in this Office's 2012 report; Statement on the examination and proposed investigation of HSE homeless Service provision to children who are homeless and accommodated under Section 5 of the Child Care Act (1991). We also recommended that Tusla take strategic action to ensure that there is a sufficient range of appropriate placements to meet the needs of young people whose placements may be at risk of breakdown, for whatever reasons.

Outcome:

After a period of engagement with Tusla we received confirmation that the service in question would change to 24/7 service, a step we very much welcomed. Tusla told us they had developed a number of residential respite centres to support children living at home or in foster care that require additional supports to maintain their placement and also to support people with the transition from special care. They also told us that they are engaged in an interdepartmental group to devise a strategy to address the additional challenges posed by the significant mental health issues displayed by some young people in their services, the high level of criminality that some young people are engaged in, and the associated risks that this places them at.

Jay and Jim, two unrelated separated children seeking international protection and who were in the care of Tusla contacted us. Their complaints concerned the aftercare planning and, in particular, Tusla’s stated intention to move both children from residential care to direct provision accommodation as soon as they turned 18 years old. They were deeply concerned about sharing a bedroom with unknown men, they were concerned about the impact on their education and also about living on €38.80 per week as they were not entitled to any aftercare allowance as they were asylum seekers.

What we did:

Both of the children were moved into direct provision, which is the current accepted policy in Ireland for children that have turned 18 years and do not yet have a decision on their asylum application. We wrote to Tusla outlining our concerns regarding the exercise of their discretion to extend a care placement for a separated child beyond 18 years of age where such a person is determined to be ‘exceptionally vulnerable’. We outlined our position stating that:
• separated children leaving care should receive equity of care, and aftercare services on par with, other children leaving care
• separated children should have an initial vulnerability assessment within 30 days of their arrival in the State, and a mechanism for identifying their vulnerabilities should remain in place throughout the international protection process, not just until they turn 18 years old
• aged-out minors should be treated as a particularly vulnerable group and should be given the option, if they choose, to transition to some form of independent living or aftercare supported living, if their foster care arrangement cannot continue
• all aged-out minors should also receive an aftercare service based on their individually assessed needs
• the State’s use of Reception and Integration accommodation centres or the International Accommodation Service and its ‘policy of dispersal’ with respect to aged-out minors should end.

Outcome:

The Child and Family Agency informed us that the matters raised in our correspondence would be considered in the context of the development of new national policies, procedures, protocols and guidelines in this area, and would be discussed at their National Policy Oversight Committee. This committee approves policies that inform the work of Tusla. We will continue to purse this matter with them.

Jenny contacted us directly when she was 18 years of age as she was unhappy that her aftercare plan had been changed without consultation and that she would be moved out her foster care placement following the completion of her Leaving Certificate in June 2017. She had been told previously that she would be staying in her foster care placement until she completed college. She told us that this has greatly affected her and her preparations for her Leaving Certificate.

What we did:

We wrote to the public body and they met with Jenny.

The outcome:

The public body agreed that Jenny could stay in her foster care placement until she was offered a college placement and they would work closely with her to seek new accommodation for college. They also agreed to communicate more closely with her about her future plans. While Jenny accepted this alternative plan she remained unhappy that her plan had changed without consultation and caused her unnecessary stress at an already difficult time in her life.

Molly was born with Down Syndrome and severe autism. She was abandoned at birth by her biological parents and has grown up with her foster family after being placed there when she was four months old. Molly is dependent on her foster carers in all areas of her care, including feeding, toileting, bathing, and dressing. Molly’s foster carer made a complaint to us about the level of supports and services being provided by Tusla and the HSE to meet Molly’s needs and support her placement.

What we did:

In 2018 the Ombudsman for Children’s Office published Molly’s case, a report detailing a complaint we received about a child with a disability who is in foster care. Twelve months later we returned to this case to track the progress made by the HSE and Tusla on the commitments they made. We found that there was a lack of coordination between Tusla and the HSE, which meant that services and supports provided by both organisations were insufficient. Neither agency viewed Molly holistically as a child who was both disabled and in care. Instead Tusla recognised her protection and welfare needs, but made no distinction with regard to her disability requirements. The HSE recognised her disability needs but made no distinction with regard to her protection and welfare vulnerabilities as a child in care. We also found that this is a problem facing many children with disabilities in care. We were told by Tusla that in 2015 there were 472 children with a diagnosed moderate to severe disability in foster care placements in Ireland.

Outcome:

While it is important to acknowledge the progress that has been made especially for Molly herself, we felt that not enough has changed since the publication of Molly’s case in 2018. As a result we committed to monitor these issues in 2019, engaging with both the HSE and Tusla. A further update was published in 2020.

Jamie is a 16 year old young person who attended our outreach clinic at Oberstown Children's Detention Campus. Jamie who was under the care of Tusla, informed us that he was due for release in a couple of months. He had been living in a residential care centre prior to his sentence and told us he had been happy living there. Jamie was concerned that there was uncertainty about whether he would be going back to the centre or whether he would be placed elsewhere as a care plan had not been agreed for him. Jamie told us he was worried he would end up homeless.

What we did:

We made contact with the social work team responsible for Jamie’s care. The Principal Social Worker advised us that there had been uncertainty about whether the placement could meet Jamie’s needs. Tusla had requested a detailed plan from the residential centre about how they planned to engage with Jamie during his time in Oberstown to prepare him for returning to their care. This plan had now been received and the social work team had decided to support this plan and would be recommending that the plan be endorsed by senior management.

The outcome:

Tusla wrote to us setting out that it had been agreed that Jamie would return to his residential centre on his release from Oberstown. We spoke with Jamie and he told us that he was delighted that this decision had been made and that he was feeling optimistic for his future.

Play facilities are really important for children living in direct provision and there is a requirement that appropriate play, recreation and study facilities be provided in centres that host families. As part of the Ombudsman for Children’s Office outreach programme we visited Emergency Reception Orientation Centres (EROCs) and Direct Provision accommodation around the country. At one centre, where a number of children were living, the indoor play area was found to be almost devoid of toys except for a small pile of soft toys and table football. Parents told us that when it was too wet or cold to play outside the children generally just went to their rooms. At the outdoor play area we noticed that the equipment was in a very poor state of repair, the surrounding grass was littered with discarded items and a rat poison container was exposed and accessible to any children using the area. Due to the lack of a gate, the service deliveries area was also accessible to any children using the area. One parent told us that she did not allow her children to use the playground as she felt it was unsafe.

What we did:

We shared our observations and concerns with the manager onsite that day who agreed that improvements needed to be made, especially in the outside area.

Outcome:

A commitment was made by the Management Company to improve the play areas for children. A return visit to the centre later revealed a well-stocked indoor play area and new equipment in the garden area. The outdoor area had been tidied and the gate replaced. They also recruited a children’s co-coordinator to give children a structured environment for play and to help them with their homework in the evenings. Additional daily activities are being provided such as homework club, drama club, arts and crafts, book club, nature conservation, community project, games tournaments, video club etc.

The Complaint

An anonymous complaint was received about James who was living in Oberstown. The complainant raised a number of serious concerns in relation to James’s self-harming behaviour and contended that there was a lack of psychiatric support and supervision being provided to him. In addition, the complainant alleged that staff were not provided with sufficient training and support to deal with the mental health needs and incidents of self-harm by the young people on the campus.

OCO Examination

The OCO conducted a preliminary examination of the complaint and sought details from Oberstown in relation to the assessment of James’s mental health and the measures being taken to meet his mental health needs. The OCO also met with James and staff members and sought their views on the matter.

A review of this information showed that James had been assessed by a psychiatrist in Oberstown and separately in hospital following admissions to A&E. He was found to have behavioural difficulties but not to have a psychiatric condition. Therapeutic intervention by the Oberstown Assessment Consultation Therapy Service (ACTS) team and increased supervision was recommended by the psychiatrists involved. At the time of the OCO’s examination the therapeutic intervention recommended in these assessments was being provided by the ACTS team in Oberstown. Support for staff was being addressed through the provision of inputs from the ACTS team and staff counselling.

However, in the course of the preliminary examination, the OCO became aware that no medical records from the hospital were contained in his medical files held by Oberstown. It is the view of the OCO that holding complete and up-to-date records is essential for the on-going treatment and care of the young people residing in Oberstown and is good administrative practice. The Office encouraged Oberstown to request the young man’s medical reports from the hospital and ensure that these are placed on his files. Further, the Office encouraged Oberstown to ensure that reports are obtained in respect of all incidents of medical care availed of in external settings while a young person is detained there under the Children Act 2001.

Outcome

Oberstown sought the medical reports of the young man’s assessments by the hospital. In addition, Oberstown introduced a standard operating practice whereby the clinical nurse manager now sources the relevant medical files from external settings so as to ensure relevant information on the young people is maintained on file.