Mr. Finbarr Colfer:

When we started regulation, there were a number of centres where, if there was a vacant bed and a child in the community needed a residential service, the first vacant bed tended to be used. We have looked at that and challenged providers on it. That is no longer an issue. Where we now see mixed centres with children and adults living together, it is because of one of a number of things. The first is that there is a small number of legacy centres where children, usually in their late teens, have been living for quite a long time. They are settled there and are transitioning into adulthood. There are services where children have lived together for quite a period of time and are now transitioning into adulthood. We recognise they want to continue living together. In terms of our conditions of registration we will allow children and adults to live together so they can transition into adulthood and continue living in their own home. The other type is respite services. Our conditions of registration do not permit providers to accommodate children and adults at the same time. There might be one week of respite dedicated to children and another week to adults. I will make another comment about congregated settings, and follow up on some comments made earlier with a specific example. I was on an inspection of a centre in a small bungalow. It was an old, worn and poor home environment. When we went in, there were 12 young men in their 20s and 30s living in that environment. The only way the staff and services could manage that situation was through brute control of residents. There were high levels of medication. What struck me was that as one person became agitated, others became agitated and it was an intense experience to go into that service.

We held that provider to account and required it to address the situation. The house still exists but there are now six people living in it. It has been refurbished and other people have moved to smaller centres elsewhere. The provider has told us the number of behavioural issues in the service has reduced, as has the requirement for medication. This goes back to the point that the environment in which people live has such an impact on them.

I have a final comment on congregated settings. Last year in our overview report, we reported there had been a reduction of 140 residential places across congregated settings in Ireland. That is a very small number considering that 2,279 people continue to live in congregated settings. Our indication from data from this year to date is that there will be fewer moved from congregated settings this year. That is a concern. With congregated settings, there is more of a risk that medication will have to be used to control a situation and make it safe for people to live in large group settings.