četrtek, 7. december 2017

Roadmap for Deinstitutionalisation – Common European Guidelines




“Though governments increasingly recognise the inevitability of deinstitutionalisation, there is less clarity with regard to the mechanisms that replace institutionalisation and what would constitute a human rights-based response.” [1]  This led to the development of The Common European Guidelines on the Transition from Institutional to Community-based Care[2] at commonly referred to as the “Common European Guidelines” brought together European and international best practices to “provide practical advice about how to make a sustained transition from institutional care to family-based and community-based alternatives.”

Common European guidelines are the only European document that is explicitly devoted only to deinstitutionalisation. The guidelines are a form of recommendations for member states and pre-accession states on how to implement the transition to community services. At the same time, they are a practical toolkit for stakeholders and practitioners on how to plan the process and how to implement it on an everyday level.

As the guidelines state deinstitutionalisation should base on a deep respect for human rights of people with disabilities, minimisation of risk and effectiveness for all stakeholders and actors of the process. Together with the institutional closure quality community services should be established. A good vision, community involvement, decision makers’ involvement and good leadership are key features of deinstitutionalisation. 

The document sets guidelines on how to create a good strategy and action plan based on dialogue and practical data, which legislation should be changed to enable community care, how to develop a range of community services, how to develop the workforce and steer the founding from institutions towards community, how to develop person centred care, how to plan institutional transformation and how to steer, monitor and evaluate the process.

Together with the Toolkit on the Use of European Union Funds for the Transition from Institutional to Community Based Care, they enable states to carry out deinstitutionalisation effectively and consistently without unnecessary investments in institutions.

Since the UNCRPD, a paradigm shift is occurring away from a medical model of care, towards a social rights model where individuals are supported to become active citizens making a contribution to their own communities. This has been accompanied by a wider understanding of the adaptations which society must make in order to ensure that the rights of people with disabilities are vindicated.[3]

A re-shaping of how services are provided is needed and the development of new services not currently available to meet new and changing needs and/or the integration in the services of a person centred, inclusive, participative and individualised approach, adopting the new social rights model of disability. One of the areas requiring improvements and/or changes is the way provision of long term and/or intense care is provided to persons with disabilities.

Common European Guidelines see it as an imperative that in managing the transition process people with significant disabilities and complex needs are not left behind. As this only generates additional needs. Promoting a person-centred approach will inevitably require innovative solutions, providing greater choice and control throughout life.

Regarding community based services; the guidelines refer to the spectrum of services that enable individuals to live in the community and, in the case of children, to grow up in a family environment as opposed to an institution. This encompasses the use of mainstream services, such as housing, healthcare, education, employment, culture and leisure, which should be accessible to everyone –regardless of the nature of their impairment or the required level of support. It also refers to specialised services, such as personal assistance for persons with disabilities, respite care and others. In addition, the term ‘community based services’ includes family-based and family-like care for children, including substitute family care and preventative measures for early intervention and family support.

Claimer: This blog is intended as a part of Situation Analysis and Assessment/ Evaluation Report of Implementation of National Strategy on Deinstitutionalisation 2008-2018 which will be soon presented to the public within the EU framework project Technical assistance support for the deinstitutionalization process in social sector. For this blog Andreja Rafaelič is considered to be co-author.



[1] COE Human Rights Commissioner, 2012.
[2] www.deinstittutionalisationguide.eu  The Common European Guidelines on the Transition from Institutional to Community-based Care, published in November 2012
[3] EASPD MAKING COMMUNITY-BASED SERVICES A REALITY - Roadmap on deinstitutionalisation

1 komentar:

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