Members below a copy of a letter sent to the Chief Social Worker, Mr Sean Holland.

Maria Morgan
Assistant Secretary

Dear Sean,

I hope this letter finds you well. NIPSA wanted to write to you in relation to the document that was recently published on the Department of Health (DOH) Website, “Covid–19: Guidance for Residential Children’s Homes In Northern Ireland”.

It is important to put on record the scale and complexity of issues our members in residential childcare are facing. There are particular challenges in managing young people who refuse to comply with even basic public health guidelines on a day and daily basis. Risk-taking, non-compliance and management of these and other issues are intrinsic parts of their presentation for residential childcare staff.

It is NIPSA’s view that an unambiguous steer from the DOH in relation to the public protection agenda as it relates to those young people deliberately putting themselves and others at risk is absent. Both the majority of young people in residential accommodation trying to avoid Covid risks through compliance with Government direction and the staff working in these units demand and expect no less from the DOH. In that context the document provided by the DOH feels distinctly underwhelming.

NIPSA members working across residential childcare are reporting not just risk-taking and non-compliant behaviours amongst a cohort of young people in residential care, but more sinister incidents. Some young people appear to be weaponising Covid both with peers and staff. For example, deliberately coughing upon or spitting at staff and peers or using their saliva on door handles cups etc. alongside specific threats to individuals.

This is clearly unacceptable and it has already been necessary on occasion to phone the PSNI when these events have occurred. Some facilities have had to take the position of refusing to have a young person back at the unit where their behaviour has clearly went beyond the pale in this regard.

These scenarios are key factors in the spiraling levels of absence due to self-isolation and other stress related conditions in residential children’s units.

We also are of the view that with dwindling workforce reserves, due to the Covid crisis generally, new ways of working particularly with non-compliant young people and their families, who would normally be supported in a residential setting, must be sanctioned as a matter of urgency by the Department and the employers.

Critically this is to protect the rights and lives both of these challenging young people and the majority of other young people within the residential population who wish to get through the crisis with the minimum risk to themselves and those around them. The duty of care owed to individuals working across this sector by both their employers and the Department is of course central to NIPSA’s thinking on this matter

What was once unthinkable is now in this emergency all too real, as the Covid–19 pandemic has forced all Health Trust’s to act outside of normative and established arrangements to deal with the real time issues so that services can be maintained.

NIPSA believes there is a compelling duty for the Department to act on a pro tem reinterpretation of the duties of the Children’s Order in a way that ensures Trusts can continue to act as responsible parents in fact as well as in theory. This is both in terms of public protection and also act to promote the safety of those children and young people in care who have a reasonable expectation that Health Trusts will endeavor to protect them from Covid risk rather than exposing them to vicarious risk as the current policies do in effect.

For instance, a much more urgent focus on progressive shared care arrangements should be enforced alongside an enabling framework to expedite young people to return home wherever possible. Active risk management, rather than risk mitigation or containment across residential childcare is the critical aspect missing in the DOH’s Guidance. We are concerned that aspects of the guidance appears to take a carry on regardless attitude, which amounts to an abdication of responsibility from the decisions which the corporate parent should be addressing.

Guidance on appropriate alternative delivery models to support young people whose non-compliant behaviours and lifestyle make them a real public protection risk must be urgently implemented. In NIPSA’s view, this should include clear contracting and thresholding arrangements with all accommodated young people which make clear that any Covid weaponising actions or behaviours will be viewed as an immediate public safety issue and responded to in accord with existing zero tolerance policies, with no exceptions.

We also notice that the guidance does not address the issue of staff required to sleep-in as part of their shift. NIPSA would regard this as a major oversight. Many children’s units can be unsettled at night and therefore further expose staff, many who have already been on shift for up to 10 hours to heightened risk. While NIPSA has a general view regarding sleeping-in arrangements in that they are a major health and safety risk generally to staff, we are of the view that given the specific circumstances all sleeping-in arrangements should be stood down. It is NIPSA’s view this would be a confidence building measure in that it reduces the risk for staff to be exposed to Covid–19 and would send a positive message to staff that the DOH and Health Trust’s view the safety of residential staff as a priority.

NIPSA is making these points with a clear appreciation that even with large scale infusions of redeployed staff, our members believe that within a few weeks a number of residential facilities may well be forced to close. This is due to the inherent difficulties that derive from staffing requirements in this highly challenging and complex area. This is driven not just by the pandemic pressures present across all services but by the conscious life style choices of some young people and the totally unacceptable behaviour of an even smaller number of individuals

Given the scale of these issues, the complexity they present and the seriousness of the matters we are touching on, NIPSA is seeking a discussion with you as a matter of urgency. We will also need to raise with you the matter of PPE and Testing and its availability to our members working in residential care across the HSC.

Yours,

Maria Morgan

NIPSA Assistant Secretary