Children in care 'forced to urinate on floor' after bathroom ban
Two children in care were forced to urinate on the floor of an isolation unit and another had to wash with baby wipes for four days after being denied access to bathrooms, health watchdogs have found.
The Health Information and Quality Authority (Hiqa) raised serious concerns with Tusla, the Child and Family Agency, over the significant increase of "single separation" detention in a home for troubled youngsters.
One young person was locked in a room for five days at the Ballydowd Special Care Unit in west Dublin.
A snap audit of the home in July following complaints revealed the single separation - intended as a short term response to behaviour issues - was used 149 times involving nine children in the previous six months.
Hiqa said one young person faced the isolation 54 times.
This compared to the technique being used 45 in the 12 months to the previous audit last October.
Inspectors exposed staff for refusing to let two of the children out of isolation to use a bathroom on the basis of risk and the youngster who was locked up for five days had no access to a shower for the first four.
Tusla said access to the bathroom was denied because it was in an alcove in the detention room creating a blind spot for observing staff.
Hiqa said design flaws were no justification for stopping youngsters from using a toilet or shower.
Explaining the need for isolation Hiqa noted that from May to July this year two members of staff in Ballydowd had been seriously assaulted, buildings were repeatedly damaged and a number of children were injuring themselves.
Fred McBride, Tusla's chief operating officer, said it accepts criticisms of the home.
"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," he said.
"Tusla regrets this and is currently taking steps to strengthen its decision-making procedures and facilities."
Hiqa also found viewing panels into separation rooms were closed after food was thrown at staff and subsequently meals were pushed under doors to a youngster.
In another incident a young person complained about having to sleep in tracksuit bottoms without a top or blanket after staff raised fears they would self-harm. The youngster reported being freezing overnight.
Ballydowd has room for 10 youngsters aged from 11 to 17 and is the largest facility of its kind in the country. Two other centres are also used to house young people in care who have emotional and behavioural problems and are subject to court orders.
Hiqa had inspected the facility last October and raised concerns then about the use of single separation.
The repeat visit led to a warning from Hiqa that Tusla's rules on isolation, including it being a last resort, were not consistently put into practice.
It found almost one fifth of the separation incidents lasted more than eight hours and six involved three young people who were put in single separation for more than 24 hours.
A Tusla manager had raised concerns about the frequency of isolation use in Ballydowd prior to the Hiqa inspection.
Elsewhere, staff regularly did not take the initiative to end the isolation when a young person was calm and positively engaged.
Tusla was issued with a series of recommendations to monitor and review the use of isolation techniques and subsequently published an action plan to address the concerns raised by inspectors.
Among them are plans to build a specially designed single occupancy room and new advice on dealing with violent and high-risk youngsters coming in for care.
Tanya Ward, chief executive of the Children's Rights Alliance, said : " 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."