Ms Anne O'Connor:

I am glad the Deputy raised that. We often focus on assessments of needs and often do not focus on the other end of disabilities, which can be serious. We have seen a significant increase in demand for residential placements. Critically from our perspective, post pandemic we see that some families have just had enough. Many people are coming forward, having gone through potentially two years of day services being closed and struggling with challenging behaviours at home. We know that it is often a severe challenge for ageing parents. We see some difficult situations for people with high complexity cases. We are struggling to get residential places. It is easier in some areas than others. We are completely reliant on all those funded agencies that the Deputy referred to. Regarding the cost of placements, we know we have to provide for many people. If I think back to many years ago, if a placement cost more than €100,000, it was a big news story. Many of our placements now cost between €500,000 and €1 million. We are challenged to find places that have sufficient staffing. Like the HSE, those voluntary providers and funded agencies are equally as challenged.

One challenge and discussion we have had with the Minister is about developing houses. We are looking at how to do that better as part of decongregation and as part of respite. In theory, the HSE should be building houses. We are looking at how we can work with local authorities. It is working well where we provide them with support. It is a mixed bag, to be honest. We are very challenged in Dublin, especially in south Dublin, with regard to anything to do with property, even for providing accommodation for staff to attract them. It is a different picture around the country.