Thursday, 1 December 2016
Ceisteanna - Questions - Priority Questions
Disability Support Services Provision
3. To ask the Minister for Health the status of the implementation of the congregated settings report; the number of persons that have left congregated settings to date in 2016; the measures in place to support persons when they leave residential institutions; if his attention has been drawn to the concern among the relations of many of those persons that leave residential institutions that the support levels are insufficient; and if he will make a statement on the matter. [38166/16]
What is the status of the implementation of the congregated settings report, the number of persons that have left congregated settings to date in 2016, the measures in place to support persons when they leave the residential institutions? Has the Minister’s attention been drawn to the concerns among the relatives of many of those persons who leave those institutions that the support levels are insufficient and will he make a statement on the matter?
I thank the Deputy for his very important question. The programme for partnership Government commits to moving people with disabilities out of congregated settings, to facilitate them in living more independently and to be included in their community. Currently, 2,649 people live in congregated settings and the objective is to reduce this figure by one third by 2021 and ultimately, to eliminate all congregated settings. It is anticipated that 97 people will have completed their move to the community during 2016, with a further 63 ready to move early in 2017. A similar additional number of people will be supported to move throughout 2017.
A sub-group under the Transforming Lives programme is developing an implementation plan for moving people from institutions in accordance with the recommendations of the Time to Move on from Congregated Settings report. The needs and wishes of people moving from congregated settings will be prioritised during this process with a model of support based on a person-centred plan.
I wish to emphasise that appropriate plans and resources are being put in place to ensure that people are properly supported as they move out of institutional care. This is very important because a lot of people do not know this. Earlier this year, I announced the provision of €100 million in capital funding between now and 2021 to provide more appropriate homes for people currently living in a number of institutions. Further supports are provided by a service reform fund involving the Department of Health, Atlantic Philanthropies, the HSE and Genio.
Separately, the Department of Housing, Planning, Community and Local Government has provided €10 million under the capital assistance scheme for people transitioning from institutions in 2016, benefiting an estimated further 100 people. A sum of €1 million in ring-fenced funding is also being made available by that Department in 2016 to support people moving from institutions into suitable social housing. This demonstrates the joined up commitment of both Departments to support the decongregation programme.
There is not a Deputy in this House who has not met families and individuals who are being decongregated from institutions. That is a broad policy and it is supported. The difficulty is that when a policy becomes a target-setting exercise, very quickly the individuals get left behind. I would be concerned that the focus on targets the whole time and the pressure on the HSE to achieve the target of moving so many people into a community setting means that we will end up not having person-centred plans. They will become statistically-focused plans. That is something I am beginning to detect in this context.
The chairperson of St. Mary of the Angels Parents and Relatives Association told Kerry County Council recently about the conditions one former care resident is living in since moving out under the HSE's Time to Move on from Congregated Settings policy. These are the words of the chairperson of this organisation:
I saw the outside of the house where one of them is living. There is an eight to ten-foot wooden fence around the back garden. The sides and front of the house are guarded by a six-foot mesh fence and there's a big heavy metal gate. That person is living like a prisoner.
It is an indication that we need to put the supports in place in the community and go back to person-centred plans as opposed to statistically-focused plans.
I say very strongly that, as far as I am concerned in my job as Minister of State with responsibility for the disabled, individuals will never be left behind. My focus is always on the person with the disability. I have heard people's opinions on the row about decongregated settings. I have heard staff and people with a different view to my own. However, I hope the Deputy is not going to tell me that keeping people in institutions in 2016 is the way forward. My objective is to put every single person with a mental and intellectual disability who wants to go, with their permission and with their families' agreement, into smaller community housing with supports in place. The budget of €100 million over the next five years is for that.
I would be very interested to hear about that particular case the Deputy has spoken about. Every single case that I have dealt with over the last six months in which a person has moved from an institution to a community house has had the services in place first. In fact, I was down in Áras Attracta last week. There were young men with intellectual disabilities coming into the office of Ms Suzanne Keenan, the director of services, to ask when they were moving into their new house. The smile and glee on their faces is often not represented, by the way, in this debate. Supports will be in place and if there are any issues or bad practices I will definitely track them down and sort them out.
The Minister is quite right and nobody on this side of the House is suggesting that we should abandon the decongregated settings policy that has been in place for a period of time. The issue here is to ensure that there are full assessments carried out on the individuals, that there are supports in place when the individuals move out to the communities and that those supports are committed to and maintained for a long period of time. When families are consistently saying that there is not enough support for the individuals when they move into the community setting, the issue has to be addressed. In the context of the plans that are in place with the HSE in terms of the Time to Move on from Congregated Settings policy, each individual's demands and needs must be assessed and supports put in place in advance of the decongregation. When a target is set and an organisation that does not necessarily have the budget in place all the time is forced to meet it, corners start to be frayed or cut.
I give Deputy Billy Kelleher a final commitment that every single person involved in the planned movement from congregated settings into the wider community will be monitored by the people who work in that sector and by my own office. I give the commitment that we will put the services in place where these people are moving to. We will ensure that that is happening. As I said before, I visited some of those places recently. I saw examples of very good practice. I saw examples of the staff changing its own mindset in that they had worked in an institution for 20 years and were now working in a smaller community house with better facilities. They saw the change in the individuals, particularly those with intellectual disabilities. They saw the change of mindset, the change in health and the change in happiness. It is very beneficial. Of course, I agree with Deputy Kelleher that the supports have to be there. People cannot just be left in the community without the supports because that has been a failed policy of the past. That is something that I have to prioritise.