We believe in the right of all persons with disabilities to live in the community, to choose their place of residence and where and with whom they live, on an equal basis with others.
Many people with intellectual disabilities and their family members are trying to plan in advance in order to avoid crisis situations, but at present there is no clear process to follow to apply for housing with supports and no declared priority system or declared timeframes you should expect. This makes it very difficult for people with disabilities – and in particular people with intellectual disabilities – to apply for and to avail of housing.
If you need social housing, if you have additional support needs, do not wait until you are in a crisis.
- Contact your local authority. Find out about your housing options. Apply for the housing or social housing supports you need.
- Contact your local HSE Disability Manager. Find out about the models of housing support available in your locality for people with an intellectual disability. Apply for the supports you need.
Table of Contents
- Independent Living and Intellectual Disability
- Care and Support Service Models
- Provision and Funding of Housing and Supports
- Demand for Residential Services/ Housing with Supports
- Starting the Search for a Residential Service or Housing with Supports
- Who are the residential service providers in my county?
- Housing – Additional Resources
Independent Living and Intellectual Disability
What do we mean when we say, “Independent Living”?
Independent living is about having choice and control over your life and having the same range of opportunities as a non-disabled person. Independent living is a broad idea and a human right.
Independent and Community Living – View of People with Disabilities
“People with intellectual disabilities who participated in the review lived in a variety of homes and circumstances, with most living at home and others living either in community residential homes or in a home of their own with support or assistance. The consultation found that everyone needed some form of support to live as they would wish.” Weafer 2010
“Living independently does not mean doing everything yourself or living alone without support. People with intellectual disabilities may need support, adjustments or more time to access information, think about things or make decisions, but with the right support and recognition, those with intellectual disabilities can exercise choice and control in their lives. Even people with complex needs and people with responsive behaviour communicate and demonstrate preferences, but often non-verbal and non-direct communication is ignored. A person may not have the capacity to sign a legally binding contract, for example, but that does not mean they are not able to choose where and with whom they like to live.” (ENIL 2018)
“Independent living” is not a model of residential service or housing support. Where you live is not what makes you an independent person. But all models of residential service and housing support service should support independent living.
Residential services and housing supports should meet the needs of each person, so they have as much choice and control as possible and enjoy the basic human rights and opportunities we all expect as an independent and individual human being. (ENIL 2018)
The right housing with the right support is a key part of independent living. Support with communication and decision-making are also essential to independent living so that the person’s will and preference are understood and respected and their rights as an individual are protected.
What does independent living look like?
“What independent living looks like depends on the needs of the individual person. For example, one person may need someone to come in once a week to do budgeting another person may need support workers /personal assistants working with them all the time. Someone else may just need support to access employment or work out how to do something new.” (ENIL 2018). There are many different approaches to support independent living for those with intellectual disabilities. These include:
- Community/Residential Services
- Supported or Assisted Living
- Personal Assistance
- Home Care
- Home Sharing
People with an intellectual disability may also reside in Nursing Homes or Secure Units.
The accommodation and support provided should be in accordance with the person’s will and preference, or the best interpretation of their will and preference. Housing and support must be appropriate to and capable of fully meeting the support needs of the person.
Note: Residential support also continues to be provided in Congregated Settings, institutional or campus style accommodation. It is Government policy that congregated settings be phased out in favour of people being accommodated in the community.
Care and Support Service Models
What is a community based residential service?
Referred to in other countries as ‘group homes’, community-based services typically take the form of a house in a residential area that provides a service to people in a house-share arrangement. Community residential service houses must be dispersed – this means ordinary apartments and houses of the same types and sizes as the majority of the population live in, scattered throughout residential neighbourhoods among the rest of the population, not clustered or in very close proximity to each other.
The service users are supported by staff who are present in the house on a 24-hour basis. This is a social model of care where service users are supported to partake in activities similar to those of their peers. (HIQA 2017)
While older group homes may have up to nine residents sharing, it is now policy that no more than four disabled people would share a home in any new housing and support packages. Those sharing accommodation should have, as far as possible, chosen to live with the other three people. (HSE (Health Service Executive) TTMO 2012)
In shared housing with residential supports, the estimated capital(building) cost per head is around €130,000. This is based on the cost of building or purchasing/upgrading to provide premises that accommodate people’s needs, provide privacy for individual adults sharing a home, and meet regulatory standards, including the higher fire safety standards required for a group home. Generous space standards are required to provide for additional bathrooms, to address mobility needs, and to ensure accommodation for staff. As a result, the cost of housing provision is generally higher than for social housing. (NAAS 2020) Total annual per resident running costs for those with low levels of support need average €81,000 per annum in the community housing context. These costs increase according to residents’ level of support need, reaching €278,000 per annum for those residents with ‘Intensive’ support needs. (NDA 2021)
All such houses are currently regarded as designated centres and registered with HIQA accordingly. (HIQA 2017). A full list of registered providers in each county is provided below.
What is meant by supported or assisted living?
This model is provided in the community with a view to facilitating people to live lives with the minimum support needed to live independently. Services such as these are often purpose-built facilities and are largely provided in the voluntary sector.
Some providers of this type of housing provide a care service to their tenants with access to on-site support staff, if necessary. Some providers have no role in providing care, they simply provide the housing, and their staff may assist tenants to access care from third parties.
There is a degree of uncertainty around whether these types of services fall within the definition of a designated centre, and thereby whether they are regulated by HIQA. (HIQA 2017)
How does a Personal Assistant provide support for living independently?
This model of care usually involves a single dedicated person to provide one-to-one support to a person to live independently. A personal assistant (PA) provides support at the direction of the service user and this arrangement is most found where the person has a physical or sensory disability.
The level of service provided differs on a case-by-case basis, but there is no accommodation component as the person is usually provided with this support in their own home. The Health and Social Care Professionals Council (CORU) is responsible for registering certain health and social care professionals. One of the categories required to register is social care workers. As such, if a personal assistant is a social care worker, they would be registered with CORU.
However, there is currently no requirement for personal assistants to be qualified as social care workers. The level of training or qualification required is at the discretion of the employer. (HIQA 2017)
What is the “Home care” model of support?
This model of care is provided in the person’s own home, sometimes referred to as domiciliary care. It is normally for a set number of hours during the day and is concerned with assisting the person with activities of daily living and with community engagement.
This service is provided by the HSE or contracted privately and is not currently considered to meet the definition of a designated centre. HIQA currently has no remit to regulate this sector, but it has been identified by the Government as an area that is under consideration for regulation. (HIQA 2017)
Why are people with an intellectual disability sometimes offered accommodation in Nursing Homes?
While the majority of nursing homes cater for older persons, there are some residents who are accommodated in these services as a consequence of needs arising out of their disability, rather than infirmity due to old age. This setting may not be the person’s choice of accommodation and may not be most appropriate, particularly in the context of the person’s social care needs. (HIQA 2017)
A recent investigation was conducted by the Office of the Ombudsman into the situation of some 1,300 people aged under 65 who are described as being ‘inappropriately placed in nursing home care (MIMO 2021) (Ombudsman 2021)
What is the “Home Sharing” model of care?
Home Sharing (sometimes referred to as adult placement) is a catch-all term which refers to arrangements whereby a person with a disability stays with a host family. Other terms include ‘shared living’, ‘family-based respite’ or ‘home-sharing short breaks”.
Such arrangements are short-term and facilitated by a voluntary organisation that matches a person with a disability to a host family. An example of such an organisation in Ireland is the National Home Sharing and Short Breaks Network (NHSN) which provides services for both adults and children.
Organisations facilitating home-sharing services are regulated in other jurisdictions (such as in Northern Ireland and England). (HIQA 2017)
What is a secure unit?
HIQA reports a small number of applications have been received in the recent past to register designated centres for people with highly specialised care needs. In many instances, the service users proposed to be accommodated in these centres have very complex presentations which require significant support interventions and can include a mental health condition along with a learning or intellectual disability — a dual diagnosis.
HIQA reports that there is evidence to suggest that there is extensive use of environmental restraints such as locked doors and high fences surrounding the centres. Providers have advised that these measures are necessary for the safety of the residents and the general public. these units require a level of service and expertise well in excess of the average designated centre for people with disabilities.
There are significant challenges in applying the current regulations to these kinds of environments. This is primarily due to the complex, high-level support needs of residents who often have dual diagnosis which may include psychiatric care needs. These centres fall within the definition of a designated centre requiring registration by HIQA. (HIQA 2017)
What is a Congregated Setting?
Congregated settings are living arrangements where ten or more people share a single living unit or where the living arrangements are campus‐based. Congregated settings also include clustered housing, or housing associated with an institution which may be on the grounds of or near the institution.
This model of service is a legacy of how people with a disability (primarily an intellectual disability) were accommodated and cared for in Ireland in the 20th century. Often in purpose-built, campus-style settings, large numbers of people were accommodated in groups and received care which was traditionally based on a medical model.
The average total costs per resident at the congregated settings which participated in the NDA Moving In Moving On survey (2021) ranged from €98,000 p.a. up to €185,000 p.a. (NDA 2021)
What is government policy in relation to people with an intellectual disability living in congregated or institutional settings?
Congregated or institutional settings remain a feature of the Irish system, but it is Government policy that they be phased out in favour of people being accommodated in the community. All congregated settings are currently registered as designated centres.
There are no new admissions to congregated settings. (HIQA 2017).
What is government policy in relation to housing arrangements for people with an intellectual disability?
All housing arrangements for people moving from congregated settings should be in ordinary neighbourhoods (dispersed housing) in the community, with individualised supports (supported living) designed to meet their individual needs and wishes.
Dispersed housing means apartments and houses of the same types and sizes as the majority of the population live in, scattered throughout residential neighbourhoods among the rest of the population. All those moving from congregated settings should be provided with dispersed housing in the community, where they may:
- Choose to live on their own
- Share with others who do not have a disability
- Share their home with other people with a disability (to a maximum of four people with a disability)
- Opt for a long‐term placement with a family (HSE Time to Move On 2012)
Provision and Funding of Housing and Supports
How is housing and support for people with an intellectual disability funded?
The provision of services within the disability sector is largely by not-for-profit providers. Disability service providers rely largely or wholly on funding from the Health Service Executive (HSE) and other State bodies. The State, through the HSE, directly provides around one in eight residential care places.
However, HSE provision is not evenly distributed across regions. The organisation and structure of service provision vary by region and by disability type. Providers differ by size, geographical sphere of services, type of contractual arrangement with the HSE, culture and ethos, and the type of disability support offered. Regional tiers of management and contracting within the HSE and within larger disability providers add to the complexity of the sector. Many organisations, particularly larger organisations, deliver support via a variety of service models. While private for-profit providers play a minor but growing role in the delivery of disability support. NDA 2021 (1)
The accommodation needs of people with an intellectual disability, moving to their own home for the first time or moving from congregated settings, are generally met through a combination of purchased housing, new‐build housing, leased housing or rented housing.
Housing can be provided by standard local authority housing, housing rented on a long‐term arrangement from a private landlord with support as needed from your local authority as needed, or it may be a family home or housing provided by a housing association. Most community/residential service providers are housing associations. (TTMO 2012)
Meeting capital costs of new housing stock. There will be instances where purpose-built new housing in the community to meet particular individual needs will need to be built or purchased and made accessible. (TTMO 2012)
What is an approved housing body?
Many Residential Service Providers may also be referred to as an Approved Housing Body. AHBs are also known as housing associations. Approved Housing Bodies are independent, not-for-profit organisations. They provide affordable rented housing for people who cannot afford to pay private sector rent or buy their own homes.
Some AHBs were established by existing caring organisations to provide services to specific groups, such as older people, people with disabilities or homeless people. Some offer non-housing services, such as group meals, social activities and welfare advice.
Approved Housing Bodies vary in size and in the services that they provide. As well as providing affordable rented housing, AHBs aim to encourage and promote community engagement and development. AHBs are known as approved housing bodies because they are approved under the Housing (Miscellaneous Provisions) Act 1992. This allows them to access assistance from local authorities to provide housing. They use this funding to, build new homes, buy existing homes, and lease private homes.
If you want to be housed by an AHB, you need to be on the local authority housing waiting list in your area. To get on the waiting list you need to apply for and be approved for social housing support.
Demand for Residential Services/ Housing with Supports
How many people with an intellectual disability are living in Residential Services?
The Health Research Board 2020 reports there are 7,600 people availing of full-time residential support, and 93% report intellectual disability as their primary disability.
There are 2136 people on a waiting list to move into the community from congregated settings. There are approximately 1,500 younger people inappropriately placed in nursing homes. These people require appropriate community-based housing and support.
The 2020 Disability Capacity Review reports about 8,300 people with disabilities, 90% being people with an intellectual disability (ID), live in residential care.
How many people with an intellectual disability are living with family members?
The Health Research Board 2020 reports that 16,000 individuals have a primary carer.
84% report intellectual disability neurological disability or autism as their primary disability.
96% live with their primary caregiver, and
84% of primary carers are parents.
20% of those parents are aged 60 years and over. (HRB 2020)
These numbers indicate a demographic of people reliant on family members for both their housing and support needs. This is a group who are not adequately housed in their own right, and for which there seems to be no forward planning of accommodation as family members grow older. (Inclusion Ireland 2018).
Many people with disabilities and their family members are trying to plan in advance to avoid crisis situations, but at present there is no clear process to follow to apply for housing with support and no declared priority system or declared timeframes you should expect. This makes it very difficult for people with disabilities – and in particular people with intellectual disabilities – to apply for and avail of housing.
If you need social housing, if you have additional support needs, do not wait until you are in a crisis to find out about your housing options or to apply for social housing support.
Starting the Search for a Residential Service or Housing with Supports
How do you apply to your Local Authority for housing supports?
Contact your local authority to find out about your housing and housing support options and find out how to apply for housing and /or social housing support and what supporting information and documents they will need.
Visit the additional resources listed below for more information and guidance.
Apply in Writing: Apply in writing to your local authority for housing or housing support. Include medical and other professional reports which identify or confirm the disability and the support needs of the person. Include medical and other reports that identify or confirm why the person’s care and support needs may no longer be met at home.
Important: Current housing guidelines clearly say that people with a disability “shall not be deemed adequately housed when their current address is a congregated setting, institution, hospital/nursing home, community-based group home, or when they, although an adult, remain in the family home due to their personal circumstances and/or support needs”.
For information on applying for social housing visit The Housing Agency website.
To help you complete your form Inclusion Ireland has developed an Easy to Read Guide for the Housing Agency – Easy-to-Read Guide to Filling in the Social Housing Support Application Form
Why it is important to make clear if support needs are the reason for your housing application to the Local Authority?
The local authority, in practise, may not ask about or consider a person’s support needs in their evaluation of housing needs. They may assess an adult currently living in their family home as adequately housed even though the person may need more support than can be provided at home. The Local Authority may not take into consideration the situation arising where family members currently provide the support that enables the person to stay at home but cannot continue to provide the level of support needed due to old age or declining health.
Where support needs are the main reason for applying for housing, it is important, as part of the application or in a supporting letter, to state clearly –
- that the application is not based on the standard of current accommodation but on the grounds that the person as an adult is living/remains in the family home due to their support needs and
- that due to changing support needs or changed family circumstances, they require supported housing or a residential service so that those support needs can be met.
For information on applying for social housing visit The Housing Agency website.
To help you complete your form Inclusion Ireland has developed an Easy-to-Read Guide for the Housing Agency – Easy-to-Read Guide to Filling in the Social Housing Support Application Form
How do you apply to HSE Disability Services for Housing Supports and Residential Services?
Contact and arrange to meet your local HSE Disability Manager to find out about the housing support and residential services options in your locality for people with a disability.
You may also wish to meet local housing support or residential service providers. It is always advisable to phone in advance, to make an appointment for meetings, at a time that suits you and the disability manager or service provider.
What to ask when meeting the HSE or Residential Service Provider?
Ask what support they currently provide and what additional support they could provide, to meet your housing needs
- Explore different models of support
- Find out how to apply for housing support or a residential service and what information they might need to support that application
- Ask about the criteria they use to assess and prioritise applications for housing or housing support. At present offers of accommodation are commonly only made to people deemed to be in a crisis.
- Find out if there is a likelihood of accommodation in the short or medium term and the expected time you may wait for housing.
- Ask about interim supports such as respite services and community outreach services.
Apply in writing (letter or email) for housing and the necessary support to the HSE Disability Manager. Also, apply in writing to the residential and housing support service providers that may have suitable housing accommodation or support.
You may include medical and other professional reports which identify or confirm the disability and the support needs of the person. You may include medical and other reports that identify or confirm why the person’s care and support needs may no longer be met at home.
Why it is important to state clearly if you are looking for housing and supports in your own local community?
It is important to the person to stay living in a particular area, typically to maintain contact with family, friends, community, services and support or for the reason that it would be very difficult or distressing to have to adapt to a new or unfamiliar location, that should be made clear in correspondence or meetings, when applying for housing or when discussing housing options.
Again, letters to support the need for housing options in the persons’ own locality, from their day service etc. can be included with correspondence to the HSE.
What can I do to progress the application for housing and supports?
Unfortunately, HSE Disability Services do not have a clear system, pathway or timelines for processing and managing these applications for housing and support. This makes it very difficult for the applicant and people supporting them, often family members, to know how long to allow at each stage, what the next step to take and how to best progress the application.
The person applying and the people who support them need to be organised, decide how they will proceed, how soon and how often they wish to follow up on a meeting or any correspondence and when they may need to speak to higher management or seek other advice or support. Having met or spoken with the HSE Disability Manager and made a written application for the housing support needed we would advise:
- Keep a record of all meetings and correspondence.
- Follow-up meetings and phone calls with a short email or letter to confirm what was discussed, the agreed actions, how they will be followed up and the timeline.
- Keep in regular contact by phone or email with the Disability Manager or their office, for updates regarding your application and to keep them advised and up to date with your situation.
If the Disability Manager says that decision-making regarding housing and support is at a level above their grade you may decide to include those higher grades in your correspondence (write directly to or cc higher management in letters and emails) or you may seek a meeting with them. The local Disability Manager reports to the Head of Disability Services in your region. The Head of Disability Services reports to the Chief Officer in your region.
What can I do if the application for housing and supports is failing to progress?
Where there are difficulties with the process or significant delays sometimes these matters can often be resolved by discussion or informally. If not, you may need to take further action. If making a complaint, follow the HSE’s own complaints procedure.
Always send a written complaint by email or recorded delivery, or ask for a receipt if delivered by hand, and make sure you keep a copy for your own records. If you are not happy with the result of the complaint, you can contact the Office of the Ombudsman.
Where can I go for supports and advocacy resources when applying for housing and supports?
Connect with support as needed. Family members or friends, local family support groups, disability and advocacy organisations, your local citizen’s information office and local elected representatives may all be useful supports and resources.
The National Advocacy Service provides a representative advocacy service to people with a disability. As part of their role, they work directly with the individual, to assist and support those with disabilities, in identifying and understanding their needs and options and in accessing their entitlements to social services. For more information visit www.advocacy.ie
The Australian Family Advocacy organisation have produced a short guide called Advocacy Tips and Tools which is very useful. The guide sets out how to plan and organise meetings, write emails and letters etc. when advocating for a family member with a disability.
Who are the residential service providers in my county?
Download List of Residental Services Providers in my County (PDF)
Housing – Additional Resources
Apply for Local Authority or Social Housing
To apply for social housing support, you must fill in and submit an application form to your local authority. You can only apply to one Local Authority.
This Local Authority must be in the area where you and your household usually live. You can apply to another area if someone living in the house has a local connection to that area.
How Local Authorities Allocate Houses
Each local authority draws up its own rules for deciding the order of priority on its housing list. These are called allocation schemes and are generally published on the local authority’s website, or you can ask staff at the housing department to explain how they organise or order the housing waiting list.
Housing Assistance Payment
The Housing Assistance Payment (HAP) is a form of social housing support provided by local authorities. HAP allows a person who qualifies for social housing support to rent in the private sector, subject to certain limits. The local authority pays the market rent to the landlord and the tenant pays an affordable rent to the local authority.
There is the concern that availing of HAP as a tenant results in the person being removed from the social housing waiting list. However, people can apply to be placed on the transfer list and, if they do it within two weeks of receiving the letter confirming the HAP payment, will still have their time on the waiting list counted, which means that if a regular social housing unit becomes available, they would be considered for a transfer across.
Rental Accommodation Scheme (RAS)
With the Rental Accommodation Scheme RAS Landlords can put their properties forward for a period of 4 to 10 years and the local authority will nominate a household to that property. The tenant pays an affordable rent to the local authority and the local authority makes payments to the landlord on behalf of the tenant.
The scheme is available to all people who qualify for social housing support, including those moving from congregated settings and those residing in the community requiring housing on disability/medical grounds.
Videos and Easy to Read Documents
This is a guidance series to social housing called Rights and Pathways for Housing and Supported Independent Living for People with an Intellectual Disability. This series is for people with an intellectual disability and/or their supporters (parents, key workers, friends etc).
There are 3 videos to be watched preferably in this order:
The First Steps (rights and choices).
The Checklist (things to gather before you fill the form).
Filling the Form (this includes the application form and the HDM1 Form 1 which is the Health/Disability/Medical form).
You can also access Easy to Read Documents here: