Concerns about continuity of care as Tusla changes 3,000 children’s social workers

In the first two months of this year, Tusla changed the social workers for 12 percent of its cases, according to a Tusla spokesperson. 

The move, done as part of a major restructuring, means that 3,049 children lost the social worker who they had built a relationship with. 

Some of those children are in the care of the state. Others are living with their own families.

Even before this sweep of change, many children will have had multiple social workers, given high staff turnover in the organisation, says Aisling Bruen, who has experience of care and is also a social care professional. 

But vulnerable children rely on those relationships. “If you read any research with care-experienced voices, every piece of research talks about the importance of continuity of care,” she says. 

“This is literally your ABC of social care,” says Bruen. “We learn this in the first year of college.” 

A Tusla spokesperson says that the agency needed to make the changes to improve access to services and to share out caseloads fairly.

They also needed to make sure young people in long-term care in an area got a social worker from the local area, they said, “enabling access to local services and to provide more integrated support to them”.

Caroline Strong, CEO of the Irish Association of Social Workers, says children in care often move, so the approach could mean more changes in social workers in the future.

“A lot of placements break down,” she says. “That's the care experience, unfortunately – every time a placement breaks down it disrupts attachment and causes trauma.”

On top of that, in some cases, children have lost out on therapy after they moved to a new area, because Tusla doesn’t fund those supports in all areas, she says. 

The Social Democrats TD and spokesperson on children, Aidan Farrelly, says social workers have contacted him concerned about how the changeover was handled. Some were struggling to track down the new social worker, he said.

“The volume of social workers in Tulsa who have gotten in touch and expressed their concern about recently undertaken reforms is a cause for urgent concern,” he says. 

The restructuring

Until January this year, Tusla divided the country up into 17 geographical areas. Now, it has shifted to 30 smaller areas, which it calls “networks”. 

“The new networks are designed more evenly, taking into account population and local disadvantage, so children and families have fairer access to our services,” said a Tusla spokesperson. 

Tusla used deprivation index data to carve up the new areas, says a report issued in February. 

“Local teams are now more integrated and efficient, bringing together early support, child safety and children in care professionals, so children and families get the right help based on their needs,” said the spokesperson. 

But Strong, of the Irish Association of Social Workers, says that hasn’t always happened in reality.

For some children, “the new area did not support therapeutic services the child was midway through and the support was ceased with no preparation or warning”, says a report the association prepared for Minister for Children Norma Foley, a Fianna Fáil TD.

Strong says that back in January when the changes were introduced – at the same time as a new computer system – Tusla social workers were under pressure. “There was kind of a push that all of this had to be done by a certain date.” 

In some areas, local managers pushed back on the timelines, she said. Some social workers she has talked to in Dublin are still concerned, she said, "but it's not as rushed as they feared”.

The Tusla spokesperson says “a transition plan was implemented to ensure a safe transfer of allocation, as is normal practice when there is a change in social worker”.

But Farrelly, the Social Democrats TD, says social workers have told him there was no proper handover process. Some couldn’t even work out who the new social worker was for some children, he said. 

Tusla still needs to answer questions on the restructuring, he said. “Can they guarantee that all of those children now have a new social worker?”

Said the Tusla spokesperson: “We are confident that the implementation of these reforms will ensure more timely and equitable access to services and promote better outcomes for young people and families availing of our services.”

Strong says some social workers now have heavier caseloads.  

She is worried about potential burnout, she says. “We are concerned about the number of social workers either leaving or planning to leave Tusla thus exacerbating the crisis.” 

Even before the restructuring, there was a lot of turnover, says Bruen, and burnout in child protection teams was already high. “It’s an exceptionally heavy experience for any individual to shoulder.”

Continuity of care

The Tusla statement doesn’t mention continuity of care as a concern, as such. 

“A change can occur at any time," says the Tusla spokesperson. For example, the social worker may get a new job, or they could be reassigned to another child with greater need, or Tusla could change the social worker at the request of a child, parent or carer, she says. 

But children usually don’t like it when their social worker changes, says Strong. “It means they have to re-tell their story to new people, and build the trust, and wonder how long this person will be around.”

For many young people, this won’t be the first time they get assigned a new social worker. But for some who have had the same social worker for years, they could be devastated by losing them, says Bruen. 

Farrelly says continuity of care is vital for children in care. “It is that trust piece,” he says. “For young people who have experienced trauma, we cannot just assume they will be willing and able to enter into a relationship with a new social worker.”

Families too have built up trust with a social worker and allowed them into their homes and their lives, he said. Changing social workers undermines that engagement and could affect outcomes too, he says. 

Bruen says she struggles to understand why senior management in Tusla don’t appear to understand the value of relationships.  

“It's just mind-boggling that they would move away from such a foundational aspect of their social care provision,” she says.