Mr. Joe Meany:

I thank the committee. Delta Centre CLG is a registered charity and has a voluntary board of trustees that ensures the organisation operates in line with its statutory obligations. The organisation is a section 39 agency and is funded by the HSE. The service was established in 1990 by a group of concerned parents who were advocating for people with disabilities in the Carlow area. As the service grew it moved to its current location in Strawhall, County Carlow. Delta Centre currently supports 181 adults with moderate to profound intellectual disability, ASD, mild intellectual disability with associated syndrome and-or physical or sensory disability.

We provide a wide range of care and support services to adults with disabilities from various HSE areas, including CHOs 5, 7, 8 and 9. Our services include day, residential, supported living, and respite services. Delta Centre's entire service has a dedicated staff team of approximately 250 employees with varying skill sets, including social care workers, care assistants, nurses, behaviour therapists, administration, maintenance, catering and horticulture staff.

Delta Centre existing services consist of a regional respite service which receives referrals from five counties across the south east and is delivering scheduled respite breaks to approximately 66 individuals and their families annually since the service opened in June 2022, following a successful tender process run by the HSE. Since its opening the service has also highlighted the need for an expanded service requirement as there are approximately 62 individuals on a waiting list at present.

Delta Centre residential services include 12 HIQA-registered properties which provide a community living setting where residents are provided with care, support, dignity and respect within a caring environment that promotes the health and well-being of each individual resident. Support needs vary across the different residential properties. A total of 40 residents currently avail of residential supports. All residential properties adhere to HIQA regulations and endeavour to not only be compliant with regulatory standards, but also focus on quality improvements across the residential service and foster a rights-based approach to all aspects of care.

The service also supports three individuals from Delta Centre day services to live independently with nominal supports, and we hope to develop this supported living model in the future. Delta Centre day services offer day support services in line with the HSE national service New Directions policy to 137 individuals. The aim of the service is to provide individual outcome-focused supports to allow adults using this service to live a life of their choosing in accordance with their own wishes, needs and aspirations. The programmes are delivered to assist people make their own choices and plans and be active members of the community. The focus is person-centered and on active citizenship as well as high-quality service provision. The programmes offer opportunities to access local employment, local services and facilities and community life. A recently opened new community-based service location supports Delta Centre's commitment to community access for all individuals who avail of its day services.

What are the challenges to the delivery of a rights-based approach in day services? There are ten I have accounted for here and I will mention most of them. In terms of recruitment and retention, individuals accessing day services benefit hugely from consistent appropriately trained employees. The past 24 months have proved to be an extremely challenging time in the context of the recruitment and retention of staff. Not least of the numerous reasons for this is that people appear to be moving away from social care as a viable career option. The challenge is particularly ominous for section 39 agencies as we must compete with the HSE and section 38 agencies, which generally paying higher salaries. While the 2023 WRC agreement is the first step in the process, it will not resolve the issue and pay parity with HSE employees, including terms and conditions, must be implemented as a matter of urgency.

As regards transport to access day services, current transport supports available for individuals to access their day services are unclear and inconsistent and lack transparency and agreed access criteria across the country. This results in inequitable access to transport supports and is often dependent on where people live and how strongly they are prepared to advocate. To ensure equity of access to day services, transport services need to be funded and provided in an agreed sustainable method on a long-term basis.

On the issue of access to purpose-built designed day service locations, through the past 10 years or so the HSE has allocated lease rental and one-off fit-out funding to service providers to develop new day service locations. While this model has supported the development of locations, it is expensive, does not allow for increased costs of rental properties and often forces services into using less than appropriate accommodation because that is all that is available.

In regards to equal access for new entries to day services, there is an increasing population of individuals requiring access to day services who do not meet the criteria for school leaver funding. An agreed funding mechanism needs to be implemented to resource these individuals' access to appropriate day services. Many of these individuals have limited information regarding their diagnosis and require new assessments to be completed. Language and communication can also be a challenge in accessing services.

On the access to day services based on will and preference, there is an increasing cohort of individuals who do not wish to attend traditional services and want to avail of home-based services. The profile of individuals availing of day services increased during Covid. This is a major challenge for providers as they attempt to deliver a rights-based service in adherence to the will and preference of individuals within a funding structure that does not allow or account for same.

On the school leaver profiling process, the existing profiling process was originally developed in 2014-15 and has offered a standardised approach to school leaver resource allocation. However, it does not allow for the level of supports often required to meet the needs of school leavers, including additional supports required to deliver services. The current resource allocation model needs to be adjusted to account for the higher support needs of individuals who often require increased staffing support in a day service setting to fully participate in their person-centred planning process. The current profiling tool was to be an interim solution until the agreed national resource allocation model was in place. The model needs to be evaluated and updated to support the transition to a rights-based approach to resource day services.

With regard to equal access and supports to day services for individuals with ASD, the numbers of people with disabilities leaving school with a secondary diagnosis of ASD has been increasing year on year for the past ten years. In 2023, more than 50% of school leavers with disabilities also have a diagnosis of ASD. To ensure these students have access to a rights-based day service, the transition from school to adult services needs to be completely person-centred, and appropriately trained staff need to be available to offer support in a specific low-arousal environment.

In terms of changing need, historic funding arrangements in services such as capitation payments do not allow for enhanced and changing needs within service provision. With no mechanism in place to address the changing need and additional resources required, this causes a service deficit for the individual and a challenge for the provider. An agreed assessment and resource allocation model is required to quantify the changing needs of individuals receiving services to ensure a rights-based approach is in place for all individuals availing of day services.

Finally, I will turn to personalised budgets. This model of support is in line with a rights-based approach and the Assisted Decision-Making (Capacity) Act 2015. The task force report was completed in 2018, yet there is only limited access to personalised budget services across the country, with no new funding being allocated to develop this model of support in day services for school leavers in 2024. I thank the committee.