In the past, people with intellectual disability in residential care often had no choice in where they lived. For decades many people resided in large medical congregate settings (including psychiatric hospitals). The Midland Health Board has recognised the merits of inclusion in community housing opportunities for people with intellectual disability by establishing the ‘Transfer Programme’. By 2006, over 200 people with intellectual disability will transfer from the Midland Health Board’s three large residential centres to a community setting.
The transfer programme draws its inspiration from the Midland Health Board’s mission statement for people with disabilities: ‘People with intellectual disability should receive a quality service delivered locally and responsive to their individual needs.’ (Midland Health Board 2003).
As part of its 1999 service plan, the Midland Health Board undertook to establish a project team to advise on the future direction of residential service provision in relation to its three main centres for people with intellectual disability. These are St Peter’s Centre in Castlepollard, Co. Westmeath, with 85 residents; Lough Sheever Centre, Mullingar, Co. Westmeath, where 73 residents live; and Alvernia House, Portlaoise, Co. Laois, with 48 residents. Thus a total of 206 people are to be involved in the transfer programme. The programme is informed by the changing climate for service provision, as described below:
Changing Models of Service Provision and Best Practice
- In society, a focus on equality, human rights and inclusion is replacing congregate medical care.
- In education, special schools and special education are moving towards the mainstream model.
- Vocational sheltered workshops are being replaced with on-the-job training and supported employment.
- Institutional/residential care is being replaced with community living.
- In healthcare, emphasis has moved from the treatment of a person, to person-centred planning, health promotion and healthy lifestyles.
Methodology of transferring people to a community setting
A process of person-centred planning is undertaken, by means of an individual needs assessment:
- The person’s chooses where to live and who they want to live with.
- The care support that they need is provided.
- The new setting is a nice place to live.
- Something meaningful and relevant to do during the day accompanies the residential move.
- The person’s standard of living is improved.
- The person and their family must be happy with the move.
- The person is happy living with other residents in the house.
- The structure and facilities of the house are suitable for the individual.
The range of housing options on offer to people with intellectual disability includes:
- Individual ownership
- Shared ownership
- Supported/assisted living
- Supporting the person in their own home
- Community residence
- Room-to-share arrangements
- Tenancy agreements.
The Transfer Programme has succeeded in providing a home for life in the community for 54 people to date. An objective of the programme has been to acquire single-storey accommodation, with no physical barriers to access, ensuring a home for life, especially as people grow older.
This move will have the advantage of providing person centred care while at the same time it will provide local employment, community integration and a wealth of new opportunities for all concerned.
Quality of Life
The transfer programme draws inspiration from international policies with a human rights focus, ie, the United Nations Standard Rules and the draft National Disability Authority Standards (2003). In order to measure and ensure an enhanced quality of life of people transferring to the community, a longitudinal study has been commissioned by the Midland Health Board, in partnership with the Health Research Board (HRB). Preliminary findings give a clear indication that people are now much better off in terms of: –
- Community participation
- Domestic participation
- Health and well-being
- Family and social relationships.
As one resident said:
I really love it here. I have my own room. I do the shopping for dinner. My family comes to visit me more now and I really like having my own front door key. It’s great.