Dr. Aideen Hartney:

On speeding up the process, that is another one where the access to housing is a barrier, for example suitable housing in suitable locations for people to move out of institutional settings. In moving from a model where it is a large institution at some remove from the local community to a house within that community, those houses are not readily available or there is competition for them. Consideration must also be given to providing staff and support as they transition to this new model, new ways of working, and new skills and competencies they might need to build on. A lot of it is about communication. Sometimes there is resistance from the individuals or from family members because they do not know what the change is going to look like. Again, robust communication is needed about what to expect and how it will work out. What the HSE and some of the service providers have done with people who successfully transition is to spend some intensive time on that process. People have been very successfully decongregated who perhaps would have felt a little bit apprehensive about that. We did an analysis of the cost and benefits of living in institutional settings versus homes within the community. Our finding was very clear on the quality of life outcomes for people living within the community with support staff so it is not completely being cast out and within a home of their choosing and with people of their choosing. The quality of life outcomes were vastly improved compared to the institutional settings.