Tusla inspectors found problems with the use of physical restraint in seven children’s homes

Tusla inspectors found problems with how staff used physical restraint at seven children’s homes, according to its inspection reports.

These problems included unsafe restraint practices and staff attempting to use restraint to manage children’s behaviour, while restraint should only be used in cases where there are serious and immediate risks to safety.

This is according to a review of 107 Tusla inspection reports for privately-run and charity-run children’s homes across Ireland, from October 2024 to July 2025. 

Children in care “are often coming from highly traumatic situations”, says a spokesperson for the Ombudsman for Children’s Office. 

“This means that any use of physical restraint may be extremely disturbing and may also be re-traumatising by triggering symptoms of previous experiences,” they said.

On the other hand, John Byrne, a psychotherapist and a lecturer in social care at South East Technological University, says sometimes restraint is necessary to keep others safe.

“There are circumstances where a failure to physically restrain a young person could lead to accusations of professional negligence, because the failure to intervene contributed to, or caused actual (foreseeable) harm to a child,” Byrne says.

But when it’s necessary, it should be done by staff who know how to do it safely, he says.

Asked about the use of physical restraint in children’s homes in Ireland, a Tusla spokesperson said that, “The restraint of a young person is only used in exceptional circumstances and in cases of violent physical assault.” 

There are around 600 children in mainstream children’s homes in Ireland, according to Tusla figures. Last year there were 1,077 restraints recorded, up from 2024 (1,022), which was up from 2023 (983), which was up from 2022 (736) – but lower than 2021 (1,270), according to records released under the Freedom of Information Act.  

“Staff members who are not trained in physical interventions are not permitted to engage in physical interventions with children and young people,” the Tusla spokesperson said.

But, in practice, that is not always the case Tusla’s inspection reports show. 

In one facility, a young person was restrained 78 times, with staff failing to build a relationship with the child. 

In another facility, the medical histories of children were not taken into account in deciding whether they could be restrained. 

Three reports noted inexperienced or untrained staff attempting to restrain children, and in one case, a staff member was hurt. 

Yet Tusla, which is responsible for inspecting and regulating most of the children’s homes it funds, failed to attach conditions to the registrations of any of these seven homes based on the restraint-related issues documented in these reports.  

Attaching conditions to a home’s registration is one of the tools Tusla can use to ensure the provider corrects the problems flagged. If the organisation doesn’t meet the conditions by a deadline, Tusla can cancel its registration, effectively shutting it down.

Instead, Tusla addressed these issues through its corrective actions and preventative actions process. 

A spokesperson for Tusla didn’t respond to a query sent on 13 January asking how Tusla responds to concerns that children's homes are using restraint in ways that are unsafe or using it as behaviour management. 

Nor did they respond to a query on 26 January asking whether the agency stands by its decision not to attach conditions to the registration of homes when it found issues with the use of physical restraint. 

The Ombudsman for Children has previously flagged concerns that Tusla has oversight of private children’s homes – which it also commissions and funds – rather than HIQA, says a spokesperson for the Ombudsman for Children’s Office.

“The process of inspecting, registering and monitoring these centres is an important safeguard for some of our most vulnerable children,” the spokesperson said. 

A spokesperson for the Department for Children defended the system now in place. “A robust regulatory framework exists for residential care services for children,” he said.

This is to ensure that the vulnerable children placed in these settings receive safe and high-quality care and all children’s homes are inspected against the HIQA National Standards for Children's Residential Centres 2018, he said. 

Tusla inspections process

Unlike healthcare settings or nursing homes, most children’s homes are not inspected by the HIQA – only those that provide medical services such as disability care, or are run directly by Tusla. 

Instead, when Tusla contracts charities and private companies to run children’s homes, it also inspects those homes. 

Tusla’s Alternative Care Inspection and Monitoring Service (ACIMS) is responsible for the registration of children’s homes run by private companies and charities, which it inspects against the national standards.

If there are issues in a home, inspectors put in place a corrective and preventative action plan. It then re-inspects to see if the action plans have been implemented.

If the home doesn’t comply with the standards, Tusla can attach conditions to the registration as a way of escalating the issue, putting the home’s continuing operation at risk if it doesn’t fix the problem. 

It has been doing that a lot less lately. 

In 2021, Tusla attached conditions to the registration of 15 facilities and closed one. In 2022, it attached conditions to the registration of 21 facilities and closed one, according to a Tusla spokesperson.

In the 10-month period from October 2024 to July 2025, Tusla attached conditions to one registration, run by Daffodil Care Services, because of staffing issues, according to a review of the reports for that period. 

Tusla closed one children’s home run by Terra Glen Residential Care Services following March 2024 inspections, because “The efforts of the centre management to maintain appropriate oversight and quality of care had been insufficient.”

But when Tusla inspectors found issues with the use of physical restraint at seven homes during this period, it didn’t attach conditions to any of their registrations for that reason.

In one of those cases, Tusla attached conditions for staffing in 2023 but not for safeguarding, following issues with a staff member not being trained in how to use physical restraint. 

In 2025, inspectors found problems with the plans for the use of restraint at the same home and Tusla still didn’t attach conditions to the registration. 

Tusla didn’t respond to a query as to why the follow-up inspection was a year and a half later and whether its failure to add conditions contributed to the issue persisting in the home.

By contrast, in Limerick, in March 2024, HIQA found issues with the use of physical restraint in a Tusla-run special care facility, which are facilities where high-risk children are detained for safety reasons. 

HIQA reported the incidents to the Gardaí, saying it “may constitute physical abuse”. HIQA attached a condition to the registration of the facility, formally instructing Tusla to review restraints within seven days and report any issues to HIQA if necessary, among other things. 

In response to a question about when it attaches conditions, a Tusla spokesperson said its inspectorate “adds conditions as part of a regulatory escalation process to direct a provider to take actions or implement a specific action that cannot be addressed through other regulatory interventions”. 

Restraint is rarely used, she said. “Where it is absolutely necessary to restrain a young person, it is done in line with specialised training,” says the Tusla spokesperson.

Teach Nua Care Services

In February 2025, a Tusla inspector visited a home for three kids run by Teach Nua Care Services, following up on a previous inspection in September 2023. 

The 2025 inspection report, published two months later, found issues with staff training and plans on file for the use of physical restraint.  

In the 2023 report, the inspectors found that the staff were not trained in behaviour management and were unable to restrain a child when they needed to in order to protect another child in the centre. 

The inspectors found there “was a deficit in the oversight and governance of behaviour management and care filing systems”.

The centre “had gone through a significant period of change”, the report says. Sixteen staff members had left. 

“It is imperative that increased staffing must be worked towards as a matter of priority for the safety of both young people,” says the report. 

Tusla briefly attached conditions to the registration of the home due to the staffing issues in September 2023, according to the April 2025 report.

Tusla’s follow-up inspection took place in February 2025, a year and a half later. It hasn’t responded to a query as to why it waited so long before reviewing the situation.

The 2025 inspection report says that the issue with management of violence continued after the first inspection until the young person was discharged by the service six months later in April 2024. 

The issue with short staffing also persisted throughout 2024, according to the 2025 report.

Inspectors did not find the same issue with staff not being trained to use restraint, but found a different restraint-related issue.

“One young person had a medical issue that was a contraindication to the use of physical restraint,” the report found. But “Their ICSP [individual crisis support plan] noted the use of restraint was permitted and noted there were no contraindications.” 

It also found that some staff went through periods without having up-to-date training certificates for behaviour management courses, and that they were employing behaviour management techniques that were not part of the training. 

However, Tusla did not attach conditions to the home’s registration. The report says it held a meeting with management in March 2025 and “the outcome determined that progress had been made in relation to the implementation of the CAPA since the review occurred in February 2025.”

It re-registered the home, without attached conditions. It is not clear whether the home was brought into compliance through this process. Tusla has not responded to queries as to whether it stands over how its inspectors dealt with the issues in this facility. 

Teach Nua didn’t respond to three emails, sent on 18 December, 13 January and 23 January, and a text message asking to explain these issues and the action taken afterwards. 

Ashdale Care Ireland

Ashdale Care Ireland says on its website that it provides enhanced therapeutic support for children in its care, including those with complex needs. 

A November 2023 report on a two-child centre it was running found an issue with physical restraint.

“It was clearly stated in one child’s [individual crisis support plan] ICSP that restraints were to be used as a last resort yet, they had experienced a high number, 78 physical restraints since their admission,” the report said.

“It was clear that the child had not developed positive relationships with staff,” the 2023 report said. 

“Which had resulted in the staff team not being able to manage their behaviours effectively and, in the child, not developing strategies to manage their own behaviour,” it said.

Staff were inexperienced, there was high staff turnover, and staff said they had no one to learn from, according to the report. 

The facility needed to strengthen its practice and focus on learning how to de-escalate the child’s behaviour in other ways, the report said. “The stabilisation of an experienced staff team is crucial for all of this to occur,” it said. 

Tusla did not attach any conditions to the registration of the facility. 

But it did require Ashdale to take a series of actions to check that staff understood the policies and procedures for behaviour management, that they ensured staff learned from incidents and review restrictive practices.

“Senior management must review the incidents and numbers of physical restraints in line with the lack of stable, inexperienced, and ongoing changes within the staff team and the requirements of the behaviour management programme in operation in the centre,” it says. 

The next year, Tusla inspectors returned, and issued another report, in November 2024. 

This time, inspectors found staff had reduced the use of physical restraint, it found. “In terms of physical restraint, there had been a significant reduction in the use of this, and when it had been used it was proportionate to the risk present,” it said. 

But there were outstanding issues around short staffing. “The centre is continuing to operate below the minimum requirements in terms of staffing,” the report found.

Daffodil Care Services

Inspection reports from October 2024 to July 2025 show that Tusla inspectors found issues with physical restraint in two of 12 Daffodil Care Services facilities inspected. 

In one case, at a centre with two kids living there, staff didn’t have the necessary expertise but still attempted to restrain a child, according to a May 2025 inspection report. 

“Physical intervention was used by staff on duty during the incident; however, they were not experienced in the techniques of the model,” the report says.

There was no review of the use of physical restraint by the staff team completed from that incident, it says. 

In a different children’s home run by Daffodil Care Services, which was home to one child, an inspection report published in October 2024, followed up on previous issues with physical restraint.

That previous report had “highlighted that at times there was difficulty maintaining physical holds and staff members were hurt as a result”.  

A “physical restraint review” was conducted, and the person’s ICSP was updated, although when the Tusla inspectors interviewed two staff members, “neither were able to communicate any learnings or changes made to practice following the review”.  

Still, “It was noted that the young person had only been involved in one physical hold in 2024 which is significant progress for them.”

Tusla attached (and then removed) conditions to the registration of the facility, due to staffing issues – not because of the issue with restraint. 

Daffodil Care Services didn’t respond to queries by phone, or by email, on 24 November and 1 December and 16 February about these issues.

Compass

A Tusla inspection report names Compass CFS Ltd as the company behind a home it inspected in March 2025.

However, Derek Byrne, CEO of Clare-based Compass Child and Family Services CLG says this naming is a mistake that he’s flagged with Tusla  – which hasn’t responded to queries about this.

Compass Child and Family Services CLG is a registered charity. Together with another non-profit entity based in Germany, it owns Compass Children's Residential Services DAC.

The home is being operated through the DAC since September 2025, Byrne said by email.

The report on the 2025 inspection of a Compass-run home with two kids in it found issues with physical restraint. 

“At times it appeared to inspectors that during events, physical restraint was relied upon to manage a behaviour for one young person, rather than this being implemented as the last resort in maintaining safety,” the report says.

There were also issues with how incidents were reviewed and reported, the inspectors found. 

“On two occasions over the preceding twelve months, one young person had been placed in a similar non-routine physical restraint which was deemed to be unsafe by management,” says the report. 

“Following the first incident in April 2024, it was clearly communicated to the team that this approach to managing a situation should not be used, however a similar incident arose again in December 2024,” it said.

This was escalated to Tusla’s Alternative Care Inspection and Monitoring Service (ACIMS) “due to the serious nature of the incident”, it says. 

“On review of the centre response to the incident it was clear that the organisation had responded in a proportionate manner and had followed their policies and procedures in relation to the management of this,” the report says.

On foot of this inspection report, Tusla did not attach conditions to the home’s registration.

Compass did not respond to a request for its internal policy and procedures on restraint. 

However, a spokesperson for Compass said that, “The inspection report you reference is in the public domain, and the findings, actions, and preventative strategies arising from it are formally recorded within the oversight and regulatory processes of the organisation and TUSLA, Child and Family Agency.”

Odyssey Social Care Services

In a January 2024 report on a home to three children that was operated by Odyssey Social Care Services, Tusla inspectors flagged issues with its plans for using restraint.

The children’s individual crisis support plans “did not identify the specific physical restraint interventions that were permitted or the contra-indicators to undertaking physical restraint for one of the children”, the report says. 

It also flagged issues with management of complaints: “inspectors found in two instances allegations made against staff members were not managed appropriately in line with the policy or Childrens First guidelines”.

“Following a review of the centre's child protection records the inspectors noted that staff who received the disclosures of alleged harm/abuse did not respond to the children in line with the centre policy or best practice guidance relating to disclosures of abuse,” it says.

“Additionally, records of follow-up meetings with the staff members concerned were either not evidenced on file or were not sufficiently robust,” it says. 

A spokesperson for Odyssey said that the two allegations referred to two instances of staff members physically intervening to ensure the safety of one young person, who made a complaint afterwards.

“These complaints were investigated by Tusla in accordance with standard practice and determined that the complaints were unfounded,” says the spokesperson. 

A Tusla inspection report issued in February 2025 refers to the issues with ICSPs and complaints procedures, and finds that they had been addressed. 

“The inspector reviewed the individual crisis support plan for each young person and found it clearly outlined the type of physical intervention that was permitted and prohibited,” the report says. 

And, “The inspector reviewed the complaint records and found that they had been managed appropriately through the centre’s complaint procedure and none submitted constituted a child protection or safeguarding concern.” 

The report concluded that the centre was “continuing to operate in adherence with regulatory frameworks and standards in line with its registration”, and registered it without attached conditions. 

A spokesperson for Odyssey said: “Internal and external inspections will inevitably identify areas for improvement, and these are used to strengthen our service arrangements.” 

“It is evident that no serious concern regarding the safety or quality of the care we provide has been identified or is the subject of any ongoing concerns to Tusla,” they said.

Ann’s Children’s Care Ireland

An inspection report issued in May 2025 on a facility run by Ann’s Children’s Care Ireland, with four kids living there, found a lack of consistency in how restraint was practised in the home.

As well as a lack of clarity among staff on how to intervene during physical incidents, due to conflicting guidance on safety plans.  

“Inspectors found the care team were unclear about how they would intervene during incidents,” it says. 

“From reviewing the Significant Event Notifications (SENs), inspectors observed disparities in how staff physically intervened for the different young people when required,” it said.

Management acknowledged the deficits and committed to carrying out a full review and issuing clearer, more robust guidance for staff, says the report. 

The report said the centre was deemed to be “continuing to operate in adherence with regulatory frameworks and standards in line with its registration”. And so it was registered without conditions attached. 

Ann’s Children’s Care didn’t respond to queries by phone and email on 18 December, 13 January and 15 January, and 23 January requesting a copy of its internal policy on physical restraint and what action it is taking to prevent issues arising in the future. 

Restraint is “a treatment failure”?

Performing physical restraint can be dangerous, for staff and for the person being restrained. 

Staff in children’s homes are trained on crisis-prevention and de-escalation to avoid requiring restraint, the spokesperson said.

This should be a priority, according to HIQA guidelines for the use of restrictive practices, including restraint, in special care facilities. 

“Providers should use this guidance to assess the use of restrictive practices in their centres with a view to reducing or eliminating their use, the guidelines say.

Centres should be sufficiently staffed, and staff should be sufficiently trained, “and have adequate opportunities to build positive, trusting and supportive relationships with children”, the guidelines say.

Restrictive practices, including restraint, risk physical injury, psychological consequences, and “are often ineffective and counter-therapeutic”, they say.

“The use of restrictive practices should be viewed as a treatment failure and preventing their use should be a priority for those involved in the care of children,” the HIQA guidelines say. 

Terry Dignan, who is a spokesperson for the Children’s Residential and Aftercare Voluntary Association (CRAVA), which represents most of the charities that run children’s homes, says his members very rarely use physical restraint.

“Physical restraint, even when carried out by trained and experienced professionals, carries significant risk of physical, psychological and emotional harm, including re-traumatisation of the child or young person involved and of other children or young people who may witness it, as well as staff involved,” he said. 

Research shows that positive, therapeutic care models built on strong relationships with children can reduce and almost eliminate the need for staff to use physical restraint, he says. 

Tusla doesn’t issue guidelines on the use of restraint, but each company has its own policy and procedures, which Tusla inspectors check on inspection, a Tusla spokesperson said. 

In the UK, the independent regulator, Ofsted, spoke to young people living in children’s homes in 2012 to find out their views on physical restraint. 

“Overall, children in our discussion groups agreed that restraint should usually be used as a last resort,” says the report. “Every group said that staff should always try to calm things down before things get so bad that restraint is needed.”

Here in Ireland, Tara Ćirić, a PhD researcher at Maynooth University, who previously worked as an educator in children’s homes in Canada, is interviewing young people living in children’s homes for her research. 

"Fortunately, none of the young people I worked with had experienced restraint themselves," Ćirić says. But “they had witnessed it happening to other young people, and they would describe it as upsetting, traumatic or intimidating".

Still, it is necessary to restrain children at times for their own safety and the safety of others, says Byrne, the psychotherapist and a lecturer in social care at South East Technological University. 

Young people in the care of the state have often experienced varying degrees of emotional and physical abuse, neglect and maltreatment, says Byrne. The trauma caused by these experiences can manifest in emotional and/or behavioural difficulties, he says.

“These can range from minor struggles when identifying and expressing emotions, right up to chaotic (explosively violent) outbursts or self-injurious behaviours,” Byrne says. 

“In these instances, the role of a social care worker is to endeavour to keep everybody safe, while supporting the young person to identify, understand and express what they are trying to say, in a socially acceptable way,” he says,

It is difficult to learn to be calm “when all you have ever known in life is chaos and violent expression,” he says. 

Indeed, the kids Ofsted interviewed in the UK said that the children said that in very dangerous situations, staff should intervene straight away. 

“For example, if a child is carrying a weapon or to break up a very serious fight, or if a child is in danger of immediate injury (as in the example of going to jump from a window),” the report says.

So Byrne, at South East Technological University, says that “it is crucially important that all staff in residential child care are highly trained (not just educated) and experienced in 'the craft of care'”.

Many staff working in children’s homes are not social care qualified, and Byrne says that the degree doesn’t teach practical skills like restraint. 

“In many services, the practice advice in these situations is to go to the office and call the Gardaí, who will come and use their pain-compliant interventions, supported with mechanical restraints (handcuffs) to restore order to the situation,” he says. 

By then, it could be too late to prevent harm coming to a child, he says, so in his view, staff in children’s homes should learn the same restraint techniques as the Gardaí to use in emergencies. 

“It is our job to have a system in place which can keep everybody safe when that happens, so that positive relationships can be formed in which children learn the skills to become the best versions of themselves,” says Byrne. 

But the 107 inspection reports show that many Tusla-regulated children’s homes have high staff turnover, short staffing and management-level problems, including deficits in core training.