Mr. Finbarr Colfer:

I thank the Senator for her questions. First of all, there is no prohibition in the regulations against the operation of a congregated setting. Our focus has been on the experience of people living there and the outcomes for people living in centres. We all know from international research that people are at much greater risk in terms of their safety, their quality of life and their ability to engage in their local community when they live in congregated settings. Over recent years, we have identified the number of registered places in congregated settings, which is the first time that an independent number has been set out there. We can now see whether there is movement of people out of these settings and we can quantify that movement. The other aspect we have looked at is people’s experience of life. Our inspection reports will detail some of the limitations on people’s quality of life in congregated settings compared to their counterparts living in community-based settings.

As part of our annual engagement with stakeholders, we engage with residents as a fundamental part of our inspection activity. Outside of our inspection activity, we meet with advocacy and residents' groups across the country. Last year, we met with 20 groups, including a significant number of people who had moved out of congregated settings. We have found for the most part that a very positive improvement in people’s safety and quality of life has been reported to us by residents and staff. In one of those groups, we spoke to a person who gave us a very good description of her experience. She said that when she was living in the big house she had a small voice, but now that she is living in a community house she feels she has a big voice. That was a very poignant capturing of people’s experience for me.

We have seen examples of people who had significant behavioural presentations when they were living in congregated settings, but when they moved out into community-based services the intensity and frequency of those behavioural issues significantly reduced. We have seen that pro re nata, PRN, medication has been reduced where people have moved into a different environment. This affects all aspects. We saw another poignant description of a person's experience. We met a resident in a house who had been treated for malnutrition in a congregated setting for many years, was on all sorts of supplements and did not eat very regularly. The staff described how this person came into the kitchen in the new house as meals were being prepared and started to taste food. It was the first time this person had actually seen a raw pepper and started to taste it. The staff found that by allowing the resident to become part of food preparation and purchase - to be part of what we take for granted every day - that person started to eat more and their physical well-being improved. People experience a broad range of improvements when they move from congregated settings. We are seeing those improvements and residents are telling us about them.