When a child is in the care of the HSE there are a number of different ways in which care can be provided. Whatever kind of care is chosen the HSE must facilitate reasonable access for the parents or other relatives of the children in its care. Where possible the HSE places the child with foster parents. The Child Care (Placement of Children in Foster Care) Regulations 1995 require that a care plan for the child be drawn up which sets out, among other things, the support to be provided to the child and the foster parents and the arrangements for access to the child in foster care by parents or relatives. If there is a shortage of foster parents however, children may be placed in residential care instead.
Residential care can be in a home run by the HSE, a children's residential centre registered under the 1991 Act, a school or other suitable place of residence. The Child Care (Placement of Children in Residential Care) Regulations 1995 state the requirements for the placing of children in residential care and the standards for residential centres which are registered with the HSE. The centres are subject to inspection by the Health Information and Quality Authority.
These regulations make provision for relatives to receive an allowance for caring for a child placed with them by the HSE. The regulations set out the arrangements for the placement and are broadly similar to the Foster Care Regulations. http://www.irishstatutebook.ie/1995/en/si/0261.html
The Health Information and Quality Authority’s (HIQA) inspection reports have repeatedly found that insufficient or non-existent plans were in place to assist young people in their preparation for leaving care. Inspectors have called for the development of appropriate care planning within the statutory care planning process at least two years prior to a young person leaving care, in order to ensure required supports are in place. 
This Report acknowledges that aftercare provision across the country is inconsistent and recommends that “aftercare services should be provided to give young adults a support structure they can rely on. In a similar way to families, childcare services should continue contact with young people after they have left care as minors”. The report states that the “provision of aftercare by the HSE should form an integral part of care delivery for children who have been in the care of the state....In particular, and in common with all young people, care leavers need the type of flexible support provided by families to young people exploring independence.”
The Ryan Implementation Plan Progress Report addresses issues relating to aftercare in action points 64-67, 69 and 35. Though some progress has been made, including a new National Policy on Aftercare, progress on other issues are behind target including the need to map young people leaving care through a longitudinal study. Another key concern relating to aftercare within this Implementation Plan is young people who are placed in care but who are not legally in the care system and therefore have no right to aftercare (section 5’s).
The Guidelines stress that all efforts should be made to strengthen vulnerable families with a view to keeping the child with his or her family. If such strengthening efforts are not successful or not appropriate then, and only then, should children be placed in alternative care. The Guidelines discuss a range of options including foster care, other family-based environments, or small group residential care, from which the option chosen should meet the best interests of the children in each specific case.
The Council of Europe made a recommendation to member states in March 2005 on the rights of children living in residential institutions, including the principle that children living in care should be entitled to appropriate aftercare support.
In 1998 a working group to review the child abuse guidelines was established to compile guidelines aimed at improving the identification, reporting, investigation and management of child abuse. The revised guidelines; Children First National Guidelines for the Protection and Welfare of Children were introduced in 1999. Children First emphasises that the needs of children and families must be at the centre of child care and child protection and that a partnership approach must inform the delivery of services. The guidelines are intended, in particular, to support and guide health professionals, teachers, members of the Garda Síochána, and the many people who come into regular contact with children. The guidelines highlight the importance of consistency between policies and procedures across the Health Service Executive (HSE) and other statutory and voluntary organisations.
Some of the objectives of the Children First guidelines are to:
National Children’s Strategy 2000-2010
Constitutional Referendum on Children
 These are the standards against which HIQA inspects.
 New policy signed off in Q1 2011.
 Health Information and Quality Authority, National Children in Care Inspection Report 2008 (published November 2009). Available at: http://www.hiqa.ie/media/pdfs/HIQA_National_Children_in_Care_Inspection_Report_2008.pdf (05.01.11).
 Report of the Commission to Inquire into Child Abuse 2009, Implementation Plan; recommendation 16 p47.
 Report of the Commission to Inquire into Child Abuse 2009, Implementation Plan; recommendation 16 p48.
 Recommendation 2005(5) of the Committee of Ministers of the Council of Europe to member states on the rights of children living in residential institutions (16 March 2005); available at: https://wcd.coe.int/wcd/ViewDoc.jsp?id=835953&Site=CM (05.01.11).
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