The role of accommodation
with disability in the community
The problem in providing individualised accommodation for people with
high support needs is that the resources (funding, available land,
building infrastructure etc) are diverted from other areas.
The housing crisis in Australia is getting worse, and the dream of
everyone living in their own house is looking more like a nightmare.
Interest rates are increasing, land is getting more scarce, skilled
builders are leaving the industry to look for work in other areas.
As the demand for individualised housing increases the resources
available to meet those needs will become less and less.
Who is going to miss out?
How will we meet the needs of an aging population in the future?
The trend in most urbanised societies is for group living, where people
live in communities in apartment towers, blocks of flats or units that
have all the necessary facilities to support those communities.
Why should people with high support needs (aged, physical /
intellectual disability etc) be segregated from the normal social
activities of the society in which they live?
The role of the building
in the community:
Within society we see all sorts of communities that provide for our
needs. We see the community of the family, where the members share a
home with each other. They interact and socialise with each other
within the home. There are various customs, rules and regulations that
allow the members of the family function as a community. There is a
hierarchy that provides leadership, order and stability within the
A hotel provides accomodation for a group of people that need a place
to stay. A
community center provides a ficility that can be used by various
within the wider community for different activities. A sports facility
is used by various groups within a sporting community. A school or
university provides knowledge, skills and resources to various groups
within the wider community. A factory is a place with a number of
groups that work towards the production of goods. While each building
or facility has a distinct role within society, they also heve a role
within each community that makes use of the building or facility.
Community groups make use of a community centre, The recreational
community makes use of the recreational facilities, the educational
community makes use of schools and universities.
The community of the
A building is not just a building (unless it is empty). It is a
Each building is a community in its own right. At a shopping centre for
example we see a group of people that interact with each other. They
have a purpose. They act within a set of conventions and cultures that
allow the shopping centre to fulfil its role within society. While the
members of the community of the shopping centre have no other
relationships with each other, they still need to organise themselves
so that their individual needs can be fulfilled.
People with intellectual disabilities were historically (and to some
still are today), housed in hospitals, refuges, nursing homes (and in
cases prisons) etc that were referred to as institutions. These
horrible places, many were crowded, unsanitary places that were highly
and structured along military lines. To cope with the large numbers of
a culture evolved that allowed a small number of staff look after the
basic needs. There was no room for other needs such as privacy and
we take for granted these days.
Today, we see that hospitals, refuges, nursing homes and prisons etc
generally different places (although there are still some examples of
homes and prisons that are not desirable places) and they fulfill an
in our community. Even today these buildings share the some of the
characteristics as described by Wolfensberger in his paper "The
and Nature of Our Institutional Models
". This does not mean
have to pull down these buildings for the sake of progress. It does
institutions and the buildings are an important part of our community.
refuges for the poor and destitute, hospitals for the sick and injured,
for education, large boarding houses for students, nursing homes and
villages for the frail and aged, even churches for worship, factories
workers, and prisons for criminals etc. These buildings are designed to
large numbers of people in the most efficient and cost effective way,
by their very nature will involve some sort of process of
Within a community (cities, towns, suburbs etc) we see a variety of
buildings and settings that are used for accommodation. We see large
high-rises, apartment blocks, villages, estates, units etc that are
communities within the wider community. These are all designed for
purposes and fulfil specific needs within the wider community. To a
degree people choose the setting that most suits their life style, and
sometimes there is no choice in the matter. Each style of living has
advantages and disadvantages.
only spend a
short amount of time in institutional care (school, or hospital etc),
have our own families and lives to return to.
needs of people
that have a physical or intellectual disability are as varied as the
always be people with disability that need part / full time care,
Some need only a small amount
of care and
need full time support, and spend their whole lives in
institutionalised care. Let’s
be realistic in providing the most appropriate care, in supporting
have a physical or intellectual disability. Of course there will always
facilities that support groups of people (group homes, nursing homes,
centres, boarding houses etc), but that does not mean that these
not a part of a community.
developed, interesting questions emerged, for
Are community facilities valued locally?
they serve a broader community benefit?
Do multi-purpose facilities or the co-location of services contribute
positive community outcomes more so than individual facilities?
Is the building of community facilities the only or best way to promote
possible to identify an approach to the building, design and management
community facilities such that community outcomes are not only
PLACE AND BUILDINGS - The Role of Community Facilities in Developing
Spirit - Introduction)
The building and the institution:
An institution is generally referred to as a large building where
in groups (50 or more). These were divided into large areas where all
of the group participated in the same activities, were dressed the
expected to behave the same and were all treated the same. There was no
for individual needs as staff ratios were 1/20 or more.
People with low support needs were grouped with high support needs and
treated the same. They were treated in terms of dollars and cents,
individuals. There was very little contact with the outside world. They
most of their lives in isolation. Government policy contributed to
people to be deemed as not able to look after themselves where placed
facilities, they were institutionalised.
While institutions (the buildings) are often thought of as horrible,
that disadvantaged people are locked up in, these buildings had
1) to provide for
the needs of
2) to protect it's members from society
3) to protect society from it's members.
Through the influence of normalisation and SRV we see that the
generally different places and the members have different roles within
buildings. However these buildings essentially fulfil the same roles
society. People with high support needs will always need more support
people with low support needs.
While the wider community and the institution (the building) may be
from each other, this does not invalidate the fact that the members of
institution communicate with each other, participate in activities
institution, and generally share the same characteristics as a
fact, these institutions that Goffman and others wrote about are
there own right, just as any other community, in that the members are
inter-dependent on each other, have a hierarchical structure, are
within a set of formal/informal beliefs, values, roles, expectations
The building and the community: (Top)
Just as a carpenter may blame the tools for the poor workmanship,
blame the tools that are used in supporting disadvantaged members in
community. The building is an inanimate object, what we do with it is
up to us.
Just because a building is designed a certain way, and there are all
support mechanisms in place, does it mean that the building is any
some other form of reasonable accommodation (The reference is
living spaces that accommodate groups of people, large dormitories of
or more are rare these days but may exist - probably a youth hostel),
that members of the community of the building are automatically members
supported within, the wider community ?
I think not ! In some circumstances a person may be worse off, where
has lost the connections, networks and valued relationships within the
community of the facility that he/she was once a part of.
A person that is living in a single person dwelling, for example, would
some basic skills in maintaining the dwelling as well as personal
The person would also need to be able to access various facilities
work, recreational, education etc) in the local community in which
living. Any assistance would need to be provided by family, volunteer
professional help. Either way, the person has to arrange the assistance
(depending on the persons needs) with others that are providing the
the service is provided by a service provider, the person also has to
the service provider. The staff of the service provider provide the
which means that the various formal / informal cultures, objectives,
hierarchies, goals, policies, constitutions, unwritten laws or codes of
behaviour etc, become a part of the normal routine of the dwelling.
reports, care plans, medical charts, drug sheets, time sheets etc.
provide 24 hour support which means that there may not be a consistency
care. Alternatively, the person may be only supported a few hours a day
means that the person may be left by him/her self with no company for
of the day (which does happen).
People with high support needs (aged, severe disability, drug
etc) will need more intensive care and more structured settings. They
restricted in what they can and can’t do and are dependent on others.
the building is that they live in, because of their condition, they
be able to live independently.
Rather than build better individual housing, supported accommodation
we need to build better communities that are more able to fulfill the
provide valued roles to its members. By promoting institutions as an
part of the community, we can develop a more appropriate (and holistic)
approach to balancing the needs of people that have a physical or
disability with the needs of the community that they live in, i.e.
placed in accommodation that is most appropriate for their needs, as
the needs of the community in which they live.
"On the one
critics have argued that deinstitutionalisation has resulted in at best
reformist housing models and at worst exclusionary housing processes
‘transposed the same structures, routines and cultures of institutions
community settings’ (Chenoweth 2000: 85). By contrast, other groups
deinstitutionalisation has been too transformative. In particular, some
relative/advocate associations have sought to counter community care
with an alternative construction of ‘reform’ that centres on the
not closure, of institutions through systematic improvements to
and services’ (Gleeson & Kearns 2001: 66). As we have noted,
countercurrents have successfully (re)conditioned the course of human
and, in some states, reopened a policy-political ‘space’ for congregate
phases of deinstitutionalisation are certain to be contested by
socio-political interests. As a consequence, the housing futures of
institutional residents are likely to be contested and – for some
– may not involve significant change to the place and form of their
Moreover, the rehousing of some institutional residents may be delayed
multiplicity of interests and support claims that will confront policy
and service agencies in the future. Whilst we do not support the
of orthodox forms of institutional care, the contest over housing
is increasingly apparent in Australian policy realms may not in itself
be a bad
thing for service users.
participation by all stakeholders in decision-making is a cornerstone
inclusion and essential to ensure that everyone can gain access to the
and support services they need to achieve their own potential in life.
means that a contested rehousing process will be constructive if it
reflective rather than conflictual service reform. Much will depend on
service agencies manage discussions and consultations about policy
(see Gleeson & Kearns 2001 on this). A more reflective mode of
in our opinion, more likely to produce heterogeneous not formulaic
support options for people in care. A diverse and flexible community
housing landscape will be better equipped to meet the individual
needs and desires of service users and thereby enhance social
Housing Landscapes? Social Inclusion, Deinstitutionalisation and
Think of the facility you are living in:
Is it a single dwelling, shared accommodation, a town house, a boarding
an apartment or in a block of flats?
Where is the facility located?
Do you enjoy living in the facility?
What networks and valued relationships do you have within the facility?
What networks and valued relationships do you have in the wider
When providing the most
care for people with high support
1) The community is not
person is living, but where the
person participates, shares experiences and has valued relationships
2) People with high support needs (severe disability, aged etc.)
will always need support structures as a part of their lives.
3) The amount of participation in a community (living, education,
employment or recreation) is directly related to the skills and
resources of the person, and, the skills and resources of the
community that the person wishes to participate in.
4) Institutions are going to be around in one form or another
whether we like it or not, It is the way that they are used that is the
5) The institutions of a society towards a particular group
determine the way the group participates in society.
6) The institutions of a particular government department,
profession or service define the way the person is supported within
7) Facilities that support people with high support needs do not
need to be the nursing homes or prisons in the
that they are today, but can become warm inviting community places that
offer a range of services to the community, as well as be a part of the
wider community within that society.
8) People with high support needs are a minority group in our
society, and will have the same problems as other minority groups in
being a part of society.