Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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1970. To ask the Minister for Children, Disability and Equality the action she is taking to ensure that no person under 65 years is living in residential care; and if she will make a statement on the matter. [46144/25]

Norma Foley (Kerry, Fianna Fail)
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I want to thank you for raising this question. This Department, along with the HSE, is working together to find solutions to the practice of placing individuals with disabilities under the age of 65 in nursing homes, including examining why people end up in nursing homes in the first place, and establishing preventive measures.

The Programme for Government sets out specific commitments to advance the rights and improve the lives of people with disabilities. This includes an increase in disability home support and personal assistance hours, the development of a multi-year capital plan for investment in residential and independent living options for both adults and children and continuing to work to end the practice of placing young people with disabilities in nursing homes.

Additionally, the Action Plan for Disability Services 2024-2026 sets out ambitious targets to increase the provision of residential services, including 260 transitions for those under 65 in nursing homes between 2024 and 2026.

As identified in the Ombudsman Report 'Wasted Lives', for some people under the age of 65 nursing homes are not an appropriate placement and alternative, more sustainable supported living solutions are needed to give them greater independence and choice in their daily lives.

Data from the HSE indicates that as of May 2025, there are 1,227 people under 65s in Nursing Homes. 86% of these residents are over the age of 50.

As of June 2025, A total of 106 people have transitioned to homes of their choosing in the community since 2021 (the start of the programme). There are 16 further new transfers, with reserved funding, expected to move before end 2025. As of end of 2025, estimated total of transitions is expected to be 122. In addition to this, the HSE is engaging with a cohort of 656 individuals for review and assessment for transition into the community or continued nursing home placements.

A further 154 individuals have received additional enhanced quality of life supports while they are currently continuing their placement in a nursing home. Enhanced Quality of Life Supports (EQLS) are aimed at improving an individual’s quality of daily life in a nursing home, and where appropriate, to support the pre-transition work, and to help individuals prepare for a move back into the community. These supports ranged from personal assistance hours, specialist and therapeutic supports, as well as the provision of personal devices such as iPads, laptops, audio books and headphones, and motorised wheelchairs etc.

HSE data consistently shows that the reason given for the majority of those continuing in nursing Home placement is due to their current will and preference. This is followed by a cohort of people who remain due to assessment of need requirements. This includes a number of people who have complex medical and social care needs, that require intensive nursing and medical care that cannot be provided in a home setting or by family members.

Following the publication of the Ombudsman’s “Wasted Lives: Time for a better future for younger people in nursing homes” report in 2021, the HSE is co-ordinating a programme at the Health Regions operational and national levels, to progressively address the review and implement the report’s recommendations for which the HSE has accountability.

The implementation programme has been divided into five work streams which include:

1. Quality of life and model of service development – “A Place to Call Home”

2. Funding and personal finances

3. Services access and navigation

4. Informed consent policy and human rights

5. Nursing Home (NH) U65 (under 65) survey

The majority of individuals under the age of 65 who are in nursing homes come from an acute setting (in particular due to the Winter Discharge Programme) due to a lack of more appropriate step-down facilities before hospital discharge. The HSE reports that due to the work of their Integrated Steering Committee and U65 project team, there is a greater awareness across acute settings, older persons and disability services of the need to prevent people under 65 being placed in nursing homes. Other reasons for nursing home entry include family circumstances, referral from community operations and no primary carer being available.

It is acknowledged that a key component to implementing the report’s recommendations is to prevent admissions to nursing homes. Preventing entry to nursing home facilities requires a model of service that supports the changing needs of individuals and allows them to continue to live a life of their choosing in the community.

Therefore, the HSE along with voluntary and private organisations are providing a variety of supports to people with disabilities including personal assistants, peer supports, respite, day services, home supports, advocacy and digital and assistive technology. These supports are governed by a diverse range of health and social care policies and ongoing programmes.