Controversy has recently arisen over the increasing number of complaints of mistreatment, abuse or lapses in care for people with disabilities in residential settings. Hundreds of complaints over the past two years have centred on poor accommodation standards[1].

It has been reported that currently, more than 8,000 adults and 400 children with intellectual disabilities, are in full-time residential accommodation. These settings range from large institutions to group homes. Of the people with intellectual disabilities living in institutional care, it is claimed some 300 are inappropriately residing in psychiatric hospitals, even though they may not have a mental illness. A further 350 live in de-designated units, parts of psychiatric hospitals that were reclassified as community units about 20 years ago[2].

National Quality Standards ‘Residential Services for People with Disabilities in Ireland’ was published by the Health Information and Quality Authority (HIQA) in May 2009. These Standards are aimed to assist service providers to assess the quality of the service they provide in advance of inspection, and also act as a guide to individuals and families as to what they can reasonably expect of a residential service. However, due to pressures on the public finances, the Government rejected plans to put these measures in place on a statutory basis.

If the standards were statutorily implemented, service providers would have to prove their fitness to manage the residential services. Each residential service would then be registered for up to three years. HIQA’s Social Services Inspectorate would inspect residential services on an ongoing basis to ensure they were adhering to the new standards and that everyone living there is getting the quality of support they deserve. A list of all inspection reports would then be published on HIQA’s website.

The Minister of State with responsibility for Equality, Disability and Mental Health, John Moloney, TD, acknowledged that progressive implementation of the standards would be commenced on a non-statutory basis in all publicly funded facilities. It is argued the sheer volume of recent controversy and complaints shows the clear need for urgent mandatory inspection and care standards. The Minister hopes to bring fresh proposals on the issue to the Government shortly. Compliance with a formal statutory framework will obviously lead to greater costs. It is critical that any legislative changes are accompanied with appropriate financial provision so owners and operators can comply.