Teresa Costello (Fianna Fail)
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I welcome the Minister of State. Day services for adults with disabilities provide a vital network of support for more than 25,000 people across this State, individuals whose personal circumstances, interests and aspirations are widely diverse. There are people with physical, sensory and learning disabilities. They range from young adults beginning their journey into adult life to older people of retirement age. They live in small communities in isolated rural areas and in towns and cities in every part of our country.

In 2007, a comprehensive review of HSE-funded adult day services was initiated to modernise and reconfigure the services we were providing. The purpose was clear: to bring these services into alignment with the principles of person-centredness, quality and accountability, and to ensure that every adult with a disability had access to supports that enabled them to live a life of their choosing. The review culminated in the publication of the New Directions report in 2012, which marked a radical shift from provider-led programmes towards user-led supports.Under New Directions, services are designed so that adults with disabilities can participate as equal citizens in their communities and contribute meaningfully to those communities. Crucially, the report also states that the new approach must be underpinned by nationally agreed standards. However, work remains to be completed. As part of that review, a census was conducted which highlighted a significant absence of nationally agreed or clear definitions about what constitutes a day service. The report describes services that have developed without the benefit of a coherent national guidance framework or robust quality assurance systems. A consultation engaged more than 1,500 people, including service users, families, service providers and the public, on what is working well and what is not.

In regard to what people want to see in future service provision, the consultation highlighted the striking differences in people's experiences of services and underlined the need for quality assurance systems and support for providers to achieve common standards. Providers themselves argued for quality standards grounded in person-centred principles alongside systems for monitoring services and support to provide them. The New Directions framework established that all service providers must work with the HSE to prepare plans for delivering New Directions within a quality assurance framework that the HSE will develop. That commitment to quality is to be expressed in service standards and in the arrangements made for monitoring and evaluating services. Yet, almost 14 years after New Directions was published, we still do not have a permanent national standard for community hubs and service locations used for day services.

Interim standards were developed by the HSE to check how well adult day services are following New Directions but providers are not yet being inspected against these interim standards. Instead, the HSE has asked all adult day services to self-evaluate their services against the interim standards, with support and training on how to do so. Managers must now start self-evaluations which must include asking stakeholders to rate how their service is doing. Providers must set actions for areas where stakeholders agree there is room for improvement. This process is intended to promote continuous improvement in service quality. Despite this progress, very few positive comments have been made about the buildings or locations used by day services. Many people benefit from their day services but others describe unhelpful or negative experiences. These differences highlight the need for reform, quality assurance systems and support for providers to meet common standards.

I accidentally walked into a community hub and was surprised at how basic it looked, given that the people using the hub had originally been availing of the day services in Stewarts Care, which was providing a high standard of amenities. I asked the Minister when she would instruct her Department to instruct the HSE to establish and publish clear national standards for community hubs and buildings used for day services for adults with disabilities and when those standards would be subject to independent inspection, for example, by HIQA, rather than self-evaluation? We know the interim standards exist. We know self-evaluation is under way. We do not yet have clarity on when nationally agreed permanent standards and an independent inspection regime will be in place.

Adults with disabilities deserve day services that reflect dignity, quality and consistency, as set out in New Directions. It is time to bring this long-promised reform to completion by setting out a firm timeline for standards that ensure quality, safety and inclusion in every community hub used for day services.

Neale Richmond (Dublin Rathdown, Fine Gael)
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I am grateful to Senator Costello for raising this important issue and offering me an opportunity to respond on behalf of the Minister, who, as per Senator Tully, finds herself in the Dáil answering oral questions. As a heads-up to Senator Scahill, the next Minister due in will also be in the Dáil in about ten minutes' time. I am sorry to say I have been entrusted with responding on behalf of both of them.

Day services, as the Senator laid out, are part of a suite of support services that enable people with specialist disability services needs to live within the community. As outlined by the Senator, the New Directions policy, published in 2013, lays out the manner in which adults with disabilities receive disability day services. This policy is underpinned by the values of person-centredness, community inclusion, active citizenship and equality. Each person should have access to flexible and outcome-driven supports to enable them to live a life of their choosing that meets their own wishes, aspirations and needs.

In 2025, the HSE projects it will provide day services to 20,600 individuals with a disability, up from just over 19,500 in 2024, together with a further 2,000 or more in rehabilitative training services. These services are provided at almost 1,300 locations around the country by 97 service provider agencies. Adult day services and rehabilitative training programmes are delivered by a combination of the HSE section 38 and section 39 organisations, as well as private providers.

The New Directions policy is implemented using a continuous quality improvement approach under the guidance of the New Directions implementation group and in line with New Directions standards published in 2025, which were referred to as interim standards at the time. These interim standards, or standards, continue to underpin the delivery of New Directions day services. They require service providers and key stakeholders to involve people with disabilities in the design, delivery, monitoring and evaluation of the services and supports provided.

The implementation plan for these standards was developed in conjunction with the disability sector and in consultation with HIQA. The first phase of the implementation plan for standards focused on developing a process of continuous quality improvement for day services in line with these standards, while the second phase is the development of a monitoring system that will provide a mechanism for assurance quality and safety update services. The HSE, working in partnership with the National Disability Authority, persons using adult day services and the disability umbrella bodies, is developing an outcomes-focused monitoring system for adult day services in support of implementing standards.

In preparation for a formal monitoring structure, all day service locations are required, as the Senator alluded to, to self-evaluate under the evaluation action service improvement process for continuous quality improvement, which features as part of their service agreements with HSE. The consultation on the proposed outcomes-focused monitoring framework for adult day services concluded in the third quarter of 2024 and included 1,800 family responses, separate consultations with 80 service users and 96 direct support staff, and nine focus groups with standard leads across all community health organisations. A series of trial monitoring visits has taken place in 2025 and these visits are due to continue into 2026. The aim of the trials is to test the monitoring approach in a range of adult day service locations, continuing consultation with stakeholders throughout, including having people with a disability as part of the assessment team carrying out the monitoring visits.

In regard to the Senator's more pertinent final question on laying out a hard timeline, there is extreme difficulty in this because the priority for the Minister is to make sure this is done right, is fit for purpose and reflects the true needs. Placing an arbitrary hard timeline is probably not the appropriate thing to do at this stage. However, I agree that this could perhaps move at a faster pace.

Teresa Costello (Fianna Fail)
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I thank the Minister of State for his response. I am concerned about the self-evaluation. An independent evaluation is needed. If we want to do things right, renting a room in a community centre is not the correct standard for the people in question.

I have a few questions. What is the current budget for day services? How much was secured in budget 2026? What was last year's day services capital budget allocation? What was secured for 2026? The Minister of State may not have those answers to hand but I would appreciate it if he could forward the questions to the Minister. I would be glad to get that information. I have a concern about community centre rooms being rented. Independent evaluation should be carried out. A primary care setting would be more appropriate for that.

Neale Richmond (Dublin Rathdown, Fine Gael)
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I thank the Senator again for raising this issue and for her clear questions. Before I get into the detail, and thankfully I have some of those numbers to hand, I will state that the ambition of this Government is to bring about a real step change in services for people with a disability in Ireland. It is committed to the expansion and reform of the disability service in order to maximise people's independence and help to support them. This is reflected in the significant investment made in specialist disability services in recent years, with a record investment of €3.8 billion in 2026 alone. This includes funding for a new cohort of 1,400 school leavers and 53 day service places for non-school leavers. Some €44.3 million was secured in budget 2026 for day services. These services are provided in 1,091 locations by 97 different providers. As I said, there are in total 19,591 people in receipt of day services and 2,132 in rehabilitative training.

I will make sure the Minister forwards further details to the Senator in a timely manner.