This Report was commissioned by the HSE in late 2007 and identifies that approximately 4,000 (based on 2008 census) people with disabilities in the Republic of Ireland live in congregated settings, a residential setting where they live with ten or more people. Notwithstanding the commitment and initiative of dedicated staff and management, the picture that emerged in the course of preparing this Report is one of a group of people who live isolated lives apart from any community and from families; many experience institutional living conditions where they lack basic privacy and dignity. Most have multiple disabilities and complex needs.

Community living is no more expensive than institutional care once the comparison is made on the basis of comparable needs and comparable quality of care. Accommodation will primarily be in ordinary houses and made available for local (public or private) housing stock.

The significant challenge that implementing the Report poses to the many stakeholders, including clients, families, service providers, the HSE and the various Departments; will require the need for a major change programme. Furthermore, everyone currently living in congregated settings should have the opportunity and right to move to a home of their choice in the community and therefore engaging with clients and families' will take time and it is difficult to predict how clients will choose to live in the future.