Community-based residential services preferable for adults with disabilities, says report

NDA director Dr Aideen Hartney said the report highlighted the importance of progressing the process of deinstitutionalisation.

A new report by National Disability Authority has found that community-based, person-centred residential services cost more money, but are better than congregated settings, due to the substantial improvement in quality of life.

The report is being published today and evaluates the outcomes and costs of living in congregated and community person-centred models of service in the disability sector.

In one phase of the study, 91 adults who had intellectual disabilities and lived in congregated settings were interviewed before and after their transition to ordinary homes in the community. It found that participants and staff reported families visiting more often, residents having more opportunities to go out and about, to exercise, more choice and control over their daily lives, and an improvement in their daily living skills.

The second phase involved 280 adults with a variety of disabilities, who used a wide range of disability services. It found that quality of life was better for people who received person-centred services, and worse for people who lived in congregated settings, as they could not choose who they lived with, did not like who they lived with or were experiencing pain.

The preferred model costs more money, driven mainly by the level of support needed by residents.

To capture the full cost of transitioning the approximately 1,800 individuals who still live in congregated settings, and who predominantly have higher support needs, to the community, the study modelled the cost implications for three scenarios, 2030, 2027 and 2025, finding that the faster the rate of deinstitutionalisation, the higher the cost," it said.

NDA director Dr Aideen Hartney said the report highlighted the importance of progressing the process of deinstitutionalisation to meet Ireland’s obligations under Article 19 of the United Nations Convention on the Rights of Persons with Disabilities.

“While considerable progress has been made in relation to transitioning people to the community, the report highlights that there is still much room for improvement," she said. 

The social networks of the participants remain very limited, and very few participants were employed, were in education, or had volunteer roles in the community. 

"We look forward to seeing this improve over time, as people grow more accustomed to more independent living.”