Professionalization of Social Care in Ireland: Analytical Essay

Introduction

The following assignment will discuss how social care has been professionalized in Ireland, it examines social care in Ireland in both the past and the present. It briefly explores 4 very high-profile cases that gained huge media attention. Two of these cases are around incest, neglect, and child abuse both mental and physical. Another case is about elderly people in a residential home who were neglected and not given the care they deserved. The final case discussed is about people with intellectual disabilities who were also abused and neglected in a residential care home.

This assignment looks at how our most vulnerable members of society where let down by the health care systems. All of the reports done on these cases had shocking revelations. It highlights how social care in Ireland has had massive failings. What these cases did bring about called for major changes for social care in Ireland.

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We also look at recommendations that where made in reports done following these cases to change some of the legislation.

Finally, this assignment discusses the importance of 2 agencies that were set up following these disturbing cases. These 2 agencies were CORU and HIQA. CORU and HIQA's main aim is to protect vulnerable people in our society. This assignment briefly touches on how these agencies have professionalized social care over the years.

Social Care in Ireland has had major failings in the past. When people ask what social care is or what exactly do social care workers do, it can be quite difficult to elaborate on as it has such a broad spectrum. However, a definition that was agreed over a decade ago by the Irish Association of Social Care is that Social Care is “a profession committed to the planning and delivery of quality care and other support services for individuals and groups with identified needs” (Lalor & Share, 2013, pg. 4).

Social Care work has not always been designated as a regulated profession, this only happened in 2005. One of the main reasons that recommendations, where made to get Social Care work in Ireland instigated by CORU, was The Kilkenny Incest Report. The Kilkenny Incest case was a case about a Father who raped and assaulted his daughter over a period of 15 years. In a court hearing for this case, it emerged that the victim had been in contact numerous times with general practitioners, public health nurses, and social workers (McGuinness, 1993). According to the Kilkenny Incest Report, the victim at one stage openly admitted to a social worker that her father was the father of her baby and yet nothing was done she continued living in the same house as her father. She presented numerous times to the hospital, doctors, and school with varying injuries, and because she had “good” excuses for these injuries nothing was done about it. This shows a massive failing in the system. Recommendations, where made in the final section of The Kilkenny Incest Report one of these, was a call for a change in the constitution to include the constitutional rights of children (McGuinness, 1993).

Another case that rocked the nation and highlighted the flaws in the social care system was The Roscommon Case. This was another case of incest, abuse, and neglect. In an interview with RTE, Mary Harney, Minister for Health and Children at that time, stated that this was possibly the most appalling case of abuse that she had ever read (RTE, 2009). Once again this family had countless interactions with the health services, public health nurses, social workers, and family support workers. As stated by Gibbons et al. (2010) the Western Health Board and other services were involved with the Roscommon family from 1989 to 2004. The question everyone asks is how was the abuse and neglect missed? Why was nothing done sooner to help these kids? Numerous visits were made to the family home by public health nurses and social workers, reports show that there were major concerns for the children’s well-being. It was clear that both parents were problematic drinkers, there was no food in the house, at times there was no electricity. It was confirmed by the Western Health Board core group in November 1999 that these children were neglected (Gibbons et al. 2010). So what went wrong? According to a report by Gibbons et al (2010), there were a number of inter-related factors that contributed to the failure of the services involved in this case. These included putting more value on using family support in a situation where child protection should have been the number one priority and concern, the assessment process and inter-disciplinary working was ineffective, the management systems was weak, the training and professional development were inadequate, there was faulty decision making, this case failed to learn from previous case reviews and overall there was poor knowledge of the relevant child care legislation. The rule of optimism was evident in this case, the professionals who worked with this family had claimed that they were ‘hopeful’ that there would be improvements.

As previously mentioned Social Care work was not always designated as a regulated profession, however, with the arrival of CORU, this is all changing. The role of CORU is to “protect the public by promoting high standards of professional conduct, education, training, and competence through statutory registration and regulation of health and social care professionals in accordance with the health and social care professionals act 2005” (Gov. ie). In order to regulate the health and social care professions CORU will do the following:

• Set Standards that health and social care professionals must meet.
• Promote CPD to ensure professional`s skills and knowledge are up to date.
• Conduct fitness to practice hearings in cases where professionals do not meet the required standards
• Ensure that the relevant educational bodies deliver qualifications that ensure professionals can provide the most appropriate care
• Maintain and publish a register of health and social care professionals who meet CORU standards (CORU.ie)

Another body under the aegis of the department of health that focuses on quality and safety for the public is HIQA. HIQA was established under the health act 2007, it is an independent authority established to drive high-quality and safe care for people using health and social care services in Ireland, in particular children in residential care, older people, and people with disabilities. HIQAs' role is to inspect and review health and social care services to ensure they meet appropriate standards, they also support informed decisions on how services are delivered (HIQA.ie).

Although it is a great thing to have both CORU and HIQA some may argue that they came a little to late. Certainly, this would apply in the case of what happened in the Leas Cross nursing home. Leas Cross was a high-profile case in the media and it was the main reason that HIQA was set up.

In the O’Neill report on Leas cross, it found that the care in the nursing home was deficient on many levels and there was also consistent findings of institutional abuse (RTE.ie, 2006). The principal findings of the report on Leas Cross where that the care been given to the residents was deficient on many levels, the staff where inadequately trained, and overall the standards of care been given where extremely poor (O’Neill, 2006). This case highlighted the urgent need for crucial changes to be made in social care.

The introduction of HIQA and CORU showed the commitment of the Health service in finally professionalizing social care. HIQA have the right to inspect all public and private residential homes without warning. HIQA was also given authority, under the 2007 Health Act, to fine and when necessary shut down a home if there are concerns about the level of care been given (ÓCionnaith, 2011). This can be seen in the Áras Attracta residential home scandal. Áras Attracta is a residential care home for people with intellectual disabilities. Between July 2015 to May 2017 HIQA carried out 14 inspections of this home and found that the HSE were consistently failing to provide appropriate and adequate care for the residents, due to this HIQA issued the HSE with notices to cancel the registration of all 3 Áras Attracta centres if conditions didn’t improve (HIQA.ie, 2017). However as reported in the Irish Times by Pollark (2018) HIQA withdrew the proposal to close the centres following an inspection in January 2018, there where still concerns around the level of care been given so the HSE has been given a time frame to make these improvements and further inspections will be carried out.

Conclusion

This assignment looked at how social care has developed over the years in Ireland. It discussed 4 disturbing high-profile cases that happened in Ireland in previous years. These cases ranged from incest, neglect, child abuse both physical and mental, neglect of the elderly in care homes, and neglect and abuse of people with intellectual disabilities in residential care. Each of these cases received a lot of media attention and following these, major changes in social care where called for.

This assignment also highlighted how social care in Ireland failed to protect our most vulnerable members of society.

All of the reports done on these cases had shocking revelations

Finally, this assignment goes on to talk about the two agencies that where set up in the aftermath of two of these disturbing cases. It looks at the importance of these agencies in social care and what their role is in protecting the public.

This assignment briefly touched on how these agencies have professionalized social care over the years.

References

1. Coru. ie. What is Coru? Available at: https://www.coru.ie/about-us/what-is-coru/ (Accessed on 6/10/2019).
2. O’Cionnaith, F., (2011). Irish Examiner. What has changed since Leas Cross? Available at: https://www.irishexaminer.com/ireland/what-has-changed-since-leas-cross-157382.html (Accessed on 8/10/2019)
3. Gibbons, N., Harrison, P., Lunny, L., O’Neill, G. (2010). Roscommon child care case. Report of the inquiry team to the Health Service Executive. Available at: https://www.tulsa.ie/uploads/content/publication_Roscommonchildcarecase.pdf. (Accessed on 4/10/2019).
4. Gov.ie. Bodies under the Aegis of the Department of Health. Available at: https://www.gov.ie/en/organisation-information/9c9c03-bodies-under-the-aegis-of-the-department-of-health/#health-and-social-care-professionals-council-coru?referrer=/health-and-social-care-professionals-council-coru/ (Accessed on 6/10/2019).
5. HIQA.ie (2017). HIQA publishes an overview report of monitoring activity in Áras Attracta. Available at: https://www.hiqa.ie/hiqa-news-updates/hiqa-publishes-overview-report-monitoring-activity-aras-attracta (Accessed on 7/10/2019).
6. HIQA.ie. About us. Available at: https://www.hiqa.ie/about-us (Accessed on 7/10/2019).
7. Lalor, K., & Share, P. (2013). Understanding Social Care.
8. McGuinness, C. (1993). Report of the Kilkenny Incest Investigation. Dublin: The stationary office.
9. O’Neill, D., (2006). Leas Cross review. Health Service Executive, Naas.
10. Pollark, S., (2018). Irish Times. Health inspectors withdraw a proposal to close Áras Attracta. Available at: https://www.irishtimes.com/news/health/health-inspectors-withdraw-proposal-to-close-áras-attracta-1.3428793 (Accessed on 8/10/2019).
11. RTE.ie, (2006). Leas cross report finds ‘systematic abuse’. Available at https://www.rte.ie/news/2006/1110/82375-leascross/ (Accessed on 7/10/2019).
12. RTE.ie, (2009). Mother gets seven years in an incest case. Available at: https://www.rte.ie/news/2009/0122/113023-roscommon/ (Accessed on 4/10/2019).