TD: Residential care for children with disabilities ‘should be a last resort’

Child welfare advocates say earlier and better interventions could allow more of the 300 children with disabilities stay in their own homes. Stock picture

The number of children as young as three with disabilities who have to live in State residential places has doubled in just over two years.

Advocates say the use of such accommodation should be a last resort, adding that they can be avoided if earlier and more consistent treatment is given to allow the children stay in their own homes.

At the end of 2023, there were 155 residential places for children with disabilities in Ireland.

As of the end of April 2026, that figure had risen to 300 — a 93% increase in less than two and a half years.

Inclusion Ireland says the age of children in such residential care can be as low as three.

However, when asked, the HSE would say only that “the granular detail regarding the breakdown of the children’s ages is not reported on, tracked, or collated”, meaning the number of children of preschool, primary school, and secondary school age can not be discerned.

Residential care sees a scenario where a child will live away from their family home, often in full-time care, and frequently at great distances from their community and support systems.

Reasons for such a placement can vary from a person requiring 24-hour support and supervision — potentially due to complex behavioural needs — to them needing a level of constant medical monitoring which cannot be delivered at home or via community care. Crisis pressures such as family-related or other safeguarding concerns may also lead to an emergency placement.

HSE 'does not collate' data on reasons children are in residential care

In replies to parliamentary queries from Cork East Social Democrats TD Liam Quaide, the HSE said it “does not collate” data regarding the reasons why children are placed in residential care.

It did say that the figures from 2023 to 2025 indicate that between 45% and 60% of new children’s residential places each year arise from cases co-funded with Tusla.

“This appears to be a contributing factor in the increase in children’s residential placements,” the service said.

However, the lack of such data behind the placements means it cannot be determined how many have resulted for reasons ranging from crisis situations to those involving safeguarding concerns.

The costs of the care provided for the children in question have also surged.

The average cost of a new or planned child residential placement was €472,512 per year in 2022.

By 2025, that had risen to €571,205, while the highest-cost child placement last year was over €1m.

Mr Quaide criticised the lack of data being held by the HSE.

He said it means that establishing how many of those children might have stayed at home — had earlier and more consistent support been provided to the family — cannot be effectively estimated.

'Residential care should be last resort'

“Sometimes, residential care may be necessary. But it should be an absolute last resort, used only when every effort has been made to support that child at home,” he said.

“Some of these placements could be averted if families were not left waiting until crisis point for properly joined-up services, including regular respite, therapy, behavioural support, and school-based assistance.

“The HSE cannot tell us the ages of the children in these placements or why they entered residential care in the first place.

“That is indefensible.”

Asked why the ages of such children are not recorded centrally, a HSE spokesperson said its residential capacity database “does not hold this level of detail”, adding that given the file in question is “Excel-based ... its practical reporting functionalities are limited”.

They added that updating the data set to reflect the circumstances of the 300 children in residential placements, out of the overall cohort of 9,000 people with disabilities living in such circumstances, “would require a substantial additional effort and resources”.

Asked how the placements are funded, the HSE said between 45% and 60% of them are co-funded with Tusla, with a further small number of places jointly funded with mental health services.