The pace of moving people with disabilities from institutional-style settings to more community based premises has “stalled” which has a significant impact on residents’ quality of life, a new report by the health watchdog has found.
On Tuesday, the Health Information and Quality Authority (Hiqa) published a 10-year overview report of regulating disability centres.
The report said there has been “much progress” in improving the quality of services over the past decade, but there are “significant challenges facing the sector now and into the future”.
The report says there continues to be gaps in the legislation, such as the need to make provision for situations where providers need to accommodate people with disabilities in an emergency.
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There is also a need for regulatory reform, to update the regulations to reflect current circumstances, such as the ratification of the United Nations Convention on the Rights of Persons with Disabilities, to strengthen the human rights-based approach within the regulations.
Furthermore, service providers have told Hiqa about a number of difficulties it has encountered in delivering services, such as the recruitment and retention of staff being “a barrier to the adequate resourcing of services”.
Efforts to “decongregate” – the process of providers moving residents out of such institutions to live in a house in the community – have stalled in recent years.
There were an estimated 4,000 placements in congregated settings in 2011, but Hiqa’s most recent number of registered residential places in congregated settings (2,256) suggests the number has reduced by less than half since the publication of the strategy in 2011 up to 2023.
“If this pace of change continues, it will be a considerable period of time before congregated settings are phased out of the system for supporting people with disabilities in Ireland,” the report said.
“With congregated settings, residents experience poorer outcomes due to settings that are outmoded and reminiscent of institutions rather than homes.”
According to Hiqa, there are many reasons for this slow pace, including the housing crisis which as “limited the options available to providers”.
“Tied to this point is the level of funding available to acquire new premises and staff them according to residents’ assessed needs,” the report said.
“There is also a reluctance on the part of some providers to decongregate due to the complexity of care required by some residents.”
Hiqa, however, acknowledged there is some resistance to the closure of some of the congregated settings across the country from providers and residents and their families.
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