National Housing Strategy for People with a Disability 2011 - 2016

Appendix 10The Evolution of Residential Services for People with DisabilitiesExtract from Chapter 2 of the Report of the Working Group on CongregatedSettings, HSE, published 28 June 20112.1 THE EARLY DEVELOPMENT OF CONGREGATED PROVISIONResidential institutions for people with disabilities have a long history in Ireland. 15 In the18th century, workhouses, poorhouses and asylums accommodated people who were sick ordestitute and people with mental health problems. By the end of the 19th century, therewere 22 large residential institutions in Ireland, each with a catchment area of one or twocounties, where staff and residents lived, and where there was no interaction with the worldoutside the institution. During the 1850s, a focus on the special needs of people withintellectual disabilities developed. As a result of lobbying by prominent citizens, the firstinstitution for people with intellectual disabilities, the Stewart Institution, opened in 1869,with four teachers and a programme of instruction.More than 50 years passed before a second special residential institution was opened. In thelate 1920s, the Daughters of Charity agreed to turn an existing home for children into ahome and school for children with learning disabilities. Over the following 30 years, severalreligious orders opened special centres around the country. The development of specialcentres marked the start of a process of specialisation, and this approach was stronglyembedded in the 1960s, with the development of a range of new professions specialising intherapies and services for people with learning disabilities.2.2 DEVELOPMENTS IN THE 1950S AND 1960SThe 1950s saw the development of Parents and Friends Groups, a movement that grewstrongly in the 1960s, with the setting up of local groups in counties around Ireland and thedevelopment of services and facilities in communities. The Commission on Mental Handicap(1965) 16 recognised that care in the community was generally superior to and ‘moretherapeutic’ than institutional care. The 1970 Health Act and the development of communitycare services in the country’s health boards underpinned the emerging community‐basedapproach to service provision.2.3 DEVELOPMENTS SINCE THE 1980SThe Green Paper ‘Towards a Full Life’ (1984) recognised the slow growth in provision ofresidential services for people with physical disabilities. It noted that the majority of peoplewith physical disabilities who could not live at home were maintained in county homes,psychiatric hospitals and orthopaedic hospitals, geriatric hospitals and centres for peoplewith intellectual disabilities. 17 The review of accommodation carried out at that time foundthat few of the centres reviewed, apart from Cheshire Homes, were equipped to meet theneeds of people with physical disabilities:165165