Mr. Finbarr Colfer:

I will start by addressing one of Senator Dolan's questions. It certainly rang true and it has been part of the discussions I have been engaged in of late, that is, looking at whether focusing on residential services stymies a person's opportunity to develop a full life. The provider community recognises that increasingly and we are certainly having discussions with providers who are coming up with quite innovative approaches and proposals to meet the needs of people as opposed to placing them in the traditional residential service. The concerns are about the current requirements around regulation. Some providers are very cautious about having services outside of regulation because they are concerned that people will not have the protection of regulation. Some of the innovative services are being developed as residential services. Other providers are anxious because they are worried they are moving people out of the regulatory process and the protections that affords people.

That goes back to the paper we submitted, looking at services as opposed to buildings, and what is happening within buildings. I am sure the providers will be able to talk further about that themselves when they appear before the committee.

As regards Deputy Durkan's comments, having engaged with families both prior to and in my current role, I completely understand the point about family anxieties arising from moving people from congregated settings. There is a concern that people will no longer receive adequate care and support and will not have access if they move into a smaller setting. There is a challenge to services, as they are provided in the community, to ensure that arrangements are in place for people to receive services based on their assessed needs.

While I acknowledge the concerns of families and those who are moving out of those services, the other aspect is that in the vast majority of congregated settings we have inspected we have found startling issues including the safeguarding of residents, their quality of life, and ongoing institutionalised practices that are based on organisational needs as opposed to the needs of people in those services.

We have also had to require providers to take immediate measures to keep people safe in historically accepted situations whereby residents cause injury to other residents, which are not responded to appropriately. Some of the more significant findings we have made in the last three to four years have been in congregated settings.

Our discussions with providers and the HSE have increasingly been about acknowledging the concerns of people who are proposed to be moved to other services, as well as the concerns of families. That process needs to happen in a managed way that engages with people and involves them in the process. We have seen good examples of where that has happened, but we have also seen poor examples where that engagement has not been effective and it has caused further anxiety to families.

As regards people's rights, Senator Dolan referred to respite and the examples I gave. Currently our discussions are based on requirements in the regulations and reaching compliance with them. The provider is required to demonstrate a high level of evidence that it is looking after the needs of people.

The Senator is correct to say that it does not assert the rights of people in their own home. We have discussions with providers on that, but we do not currently have a regulation we can enforce. However, the introduction of those measures will allow us to ratify the UN convention, along with a review of regulations in that light. It would certainly be helpful to inspectors in that review of regulations if those rights were to be asserted more clearly in our regulatory requirements. That is for discussion as we move forward. Meanwhile, we are focusing on issues like dignity, respect and how the person is supported in that environment to live a good quality of life.