Changes in the provision of residential care for adults with an intellectual disability: a national longitudinal study

Abstract

PurposeThe move from congregated living arrangements to more homely, community‐based accommodation is a policy objective in many developed countries but its implementation is rarely monitored. This paper aims to address this issue.Design/methodology/approachThe National Intellectual Disability Database in Ireland provided the data to explore the changes in provision that occurred from 1999 to 2009 for nearly 8,000 adults resident in either congregated or community‐based accommodation.FindingsOver the ten years, there was a marked rise in the numbers living in community group homes and by 2009 just under 50 per cent of persons resided in community settings. Although there was a reduction in the number of places in congregated options over the decade, this was not uniform in that increased numbers of persons were living in new forms of congregated provision designated as specialist units. Moreover, the estimated annual turnover of 2.4 per cent vacancies per annum meant that nearly half of the new admissions were to congregated settings. Over the ten years, a few people moved to a different type of accommodation although more people moved from congregated to community settings than vice versa. A few moved to more independent living arrangements. Despite unprecedented increased investment in services in this period, on average only 70 new places were created per annum – a 1 per cent increase on total places.Research limitations/implicationsOutmoded models of residential provision are likely to persist unless there is sustained investment in new forms of provision largely through a planned transfer of resources.Originality/valueThis national study illustrates how policy changes could be monitored in other countries.