Overview of institutional services for persons with disabilities (2014) Table 1: Typology of institutions TYPE OF SERVICE SIZE AGE TYPE OF LEVEL OF SUPPORT FUNDER LENGTH OF AGE OF SERVICE Residential home for older people (vanhainkodit) There are institutions of all sizes. However, most of the residential homes have 10-30 residents and approximately 1/3 have 30-100 residents. Older people Older people (mainly) 24 hour support provided Local (some private) Mixed lengths 10-50 years Sheltered housing with 24-hour assistance (tehostettu palveluasuminen) There are institutions of all sizes. However, most of the residential homes have 10-30 residents and approximately 1/3 have 30-100 residents. Older people Older people (mainly) 24 hour support provided Mixed (Local + Private) Mixed lengths 10-50 years Ordinary sheltered housing for older people (Ikääntyneiden tavallinen palveluasuminen) Residential, No information available Older people Older people (mainly) daytime Mixed Mixed lengths 10-50 years
Health centre wards (terveyskeskusten vuodeosastot / Most of the units (approx. 60 %) have 10-30 patients/residents, approximately 35 % have 30-49 residents/patients and the rest over 50. Older people Older people (mainly) 24 hour support provided Local Mixed lengths 10-50 years Long-term care in hospitals (sairaaloiden pitkäaikaishoito) Most of the units (approx. 60 %) have 10-30 patients/residents, approximately 35 % have 30-49 residents/patients and the rest over 50. Older people Older people (mainly) 24 hour support provided Local Mixed lengths Over 50 years Institutions for people with intellectual disabilities Typically 30-100 places (a few over 100 places) Adult Older People disability 24 hour support provided Local (some private) Mixed lengths Over 50 years Housing with assistance for people with intellectual disabilities autettu asuminen) 11-30 (typically 10-15) Adult Older People disability 24 hour support provided Mixed (Local + private) Mixed lengths/ Typical over 2 years 10-50 years adults
Housing with assistance for people with intellectual disabilities ohjattu asuminen) 11-30 (typically 10-15) Adult Older People disability daytime Local (some private) Mixed over 2 years 10-50 years Other sheltered housing for under 65s (24 hours), for example seriously disabled (Muu palveluasuminen alle 65 v., esim. vaikeavammaiset No information available Adults Under 65 Physical disability (mainly) 24 hours Mixed Mixed lengths 10-50 years Other sheltered housing for under 65s (daytime only), for example seriously disabled (Muu palveluasuminen alle 65-v. (ei esim. vaikeavammaiset No information available Adults Under 65 Physical disability (mainly) daytime Mixed Mixed lengths 10-50 years Psychiatric sheltered housing (24 hours) (psykiatrian Typically 10-30 Adult Mental health problem 24 hours Mixed Mixed lengths 10-50 years adults
palveluasuminen) Older People Psychiatric sheltered housing (daytime)( Psykiatrian palveluasuminen Typically 10-30 Adult Older People Mental health problem daytime Mixed Mixed lengths 10-50 years Mielenterveyden häiriöiden laitoshoito (Inpatient mental health care) No information available Adult Older People Mental health problem 24 hours Local Mixed lenghts Over 50 years Supported housing for people with intellectual disabilities tuettu asuminen)* 1-5 (typically 1-2) Adults disability Variable support provided, depending on the resident´s needs Mixed (Local + Private) Mixed lengths/ 2 years 10-50 years Supported housing for people with mental health problems* 1-5 Adults Mental health problem Variable support provided, depending Mixed Mixed lengths 10-50 years typically adults
including full reference with URL if available Type of organisation e.g. government ministry, local authority, national statistical office academia, NGO administrative data state, national intellectual disabilities, services for older people, services for children, large residential homes etc Statistical yearbook on social welfare and health care 2013 (Sosiaali- ja terveysalan tilastollinen vuosikirja 2013 / Statistisk årsbok om social- och hälsovården 2013) National Institute for Health and Welfare (Terveyden ja hyvinvoinnin laitos / Institutet för hälsa och välfärd (THL)) 2013 This report mainly on data from 2012. However, it also presents data over a long period of time (over decades). The report combines various registers, censuses and statistics of the National Institute for Health and Welfare national Among other data: Services for people with mental health problems, services for people with intellectual disabilities, services for older people Institutional care and housing services in social care 2012 (Sosiaalihuollon laitos- ja asumispalvelut 2012 / Institutionsvård och boendeservice inom socialvården 2012) National Institute for Health and Welfare (Terveyden ja hyvinvoinnin laitos / Institutet för hälsa och välfärd (THL)) The report was written and published in 2013. The data was collected from the client census data 31 31.12.2012 client census data national service for older people, people with physical or intellectual disabilities and people with mental health problems
December 2012. Individual Housing for Persons with Disabilities. From long-term residential care to individual housing yksilöllinen asuminen. Pitkäaikaisesta laitosasumisesta kohti yksilöllisempiä asumisratkaisuja / Individuellt boende för utvecklingsstörda personer. Från långvarig institutionsvård till mer individuella boendelösningar) Ministry of Social Affairs and Health (Sosiaali- ja terveysministeriö / Social- och The Ministry assigned Mr. Markku Niemelä to conduct this desk research on 14 February 2006. The report was finished in December 2007. The report was published in 2008. desk research national services for people with intellectual disabilities Round-the-clock social services for the elderly. Results from research and follow-up National Supervisory Authority for Welfare and Health (Sosiaali- ja terveysalan lupa- ja 2010 2010 (answers represent questionnaire, desk research. The questionnaire was sent to all national services for older people
procedures for monitoring. Vanhusten sosiaalihuollon palvelut. Toimintayksiköihin tehdyn kyselyn tulokset ja valvonnan jatkotoimenpiteet. valvontavirasto / Tillstånds- och tillsynsverket för social- och hälsovården, Valvira) the situation in March 2010 when the research was conducted) facilities providing social services for the elderly. 1237 units answer the questionnaire (82 %). Guidelines for sheltered housing (Palveluasumisen opas) (2013) PDF-download available at: The Housing Finance and Development Centre of Finland (ARA) (Asumisen rahoitus- ja kehittämiskeskus / Finansierings- och utveklingscentralen för boendet) guidelines national service for older people, people with physical or intellectual disabilities and people with mental health problems Housing and rehabilitation. Development recommendation regarding housing services for mental health rehabilitees. (Asumista ja kuntoutusta. Ministry of Social Affairs and Health (Sosiaali- ja terveysministeriö / Social- och The report was published in 2007 No data presented: publication contains information on legislation and desk research national services for people with mental health problems
asumispalveluja koskeva kehittämissuositus./ Boende och rehabilitering. om boendetjänster för inom mentalvården.) Hyvönen, Juha: The Finnish Psychiatric Health Services in the 1990’s from the Point of View of Historical Continuity. (Suomen psykiatrinen hoitojärjestelmä 1990-luvulla historian jatkumon näkökulmasta) University of Kuopio, 2008. Mr. Juha Hyvönen The University of Kuopio (Currently The University of Eastern Finland) 1990s doctoral thesis: forensic psychiatry, University of Kuopio, Finland historical material (scientific and statistical data) (national) services of people with mental health problems
Report on housing of neurologically choronically sick and disabled persons. Neurologisesti pitkäaikaissairaiden ja vammaisten ihmisten asumisen selvitys (2013) Aspa Foundation (various writers) 2012 2012 questionnaire and desk research national services of people with neurological impairment Development programme on supported living of the elderly. Vanhusten palveluasumisen kehittämisohjelma, 2004 City of Helsinki: Department of Social Services (Helsingin kaupungin sosiaalivirasto / Helsingfors stad socialverket) 2002 desk research (historical review and development programme) local services for older people Quality recommendation to guarantee a good quality of life and improved services Ministry of Social Affairs and Health (Sosiaali- ja terveysministeriö / Contains and a quality (desk research) national services for older people
asumisen kehittäminen (The development of housing for people with mental health problems) PDF-download available Ministry of the Environment / Miljöministeriet) 2011-2012 2011-2012 desk research, questionnaire national services for people with mental health problems Overview of community-based services for persons with disabilities (2015) Table 3: community-based services for persons with disabilities Type of service Please provide the name of the type of service in the national language and a translation into English Please indicate if the types of services presented below are Yes/ No Please indicate if this type of service is available in your country Profile of the users age (children, or older persons) type of disability (physical disability, intellectual Explanatory information For each type of service, please provide a short description of: the type and level (i.e. 24 hour, daytime, weekends, etc.) of support the service provides; location of the service (i.e. city, town, rural areas); Extent to which support is For each type of service, please provide information about the extent to which users control the support provided. Can individuals using the service: If data are available, please specify number of services operating in the country and the number of users Please provide a full based directed
given a different name in your country disability, disability, deaf or hard of hearing, blind) who is eligible for the service who is the provider and funder of services (i.e. national government, local government, municipality, NGO, private company, etc.)? recruit and manage staff providing support; determine the activities for which support is needed; determine how the budget for services and supports is used; choose types of equipment and adaptations to meet their needs? reference for this data, including information about the period covered by the data. Please indicate, if data is available, if there has been decrease / increase in the last five years Direct payments / personal budgets/individual budget (cash payment enabling service users to employ personal assistants or freely choose using various service providers) Henkilökohtainen budjetointi -No/Not provided for in law -Personal budgets have been piloted in Finland as a part of ’Tiedän mitä tahdon!’ (I know what I want!) project and in a smaller scale in the municipalities -Piloted among young people and with intellectual disabilities -Also piloted in services for elderly -Apart from the temporary pilot project, the service is generally not available, therefore this information is not applicable. - Participants for the pilot project ‘Tiedän mitä tahdon!’ were searched among users of other services for persons with disabilities in the city of Vantaa and South Karelia Social and Health Care District. In the pilot project, the participants were encouraged to gather a support group to help with mapping their personal wishes, goals and needs. The participants expressed which kind of services they would need and how the existing services should be modified. Based on these wishes, the costs of the needed services were calculated for In ‘Tiedän mitä tahdon!’ project, personal budgets were tried out with 30 persons using services for disabled people, after the project, 12 persons had a personal budged. For some participants,
of Helsinki and Tampere. each participant and merged into a personal budget. The employees of disability services in the participating municipalities discussed the size and use of the budget with the clients based on their personal plans. Finnish legislation in its current form does not enable giving the personal budget in the control of the client in a way that the client would independently, supported, or through a third party purchase the needed services. Therefore, the participating municipalities arranged or purchased the requested services for the clients. individual service solutions were developed also without actual personal budgets. Personal assistance (typically purchased through earmarked cash allocations, the purpose of which is to Yes - All age groups - Seriously disabled persons who - Service is provided for tasks that the persons would perform by themselves but are not able to, due to disability or - Assistance is provided for daily routines, work and studies to the extent that is necessarily -In 2013, 15217 and in 2014 17356 persons were receiving
pay for any assistance needed) Henkilökohtainen apu need continuos and long-term assistance to get through daily tasks illness. Its aim is to help disabled persons to make their individual choices both at home and outside home. - No maximum amount of daily hours is established by law and the needs of each person are evaluated individually - All persons who are seriously disabled and whose need for assistance is not primarily related to a disability or illness that is a result of ageing, have a subjective right to personal assistance, meaning that the municipality has the obligation to provide the service regardless of the amount of appropriation available. - Municipality has no obligation to organise personal assistance in case sufficient care of a disabled person cannot be guaranteed with care, that is, the person’s disability or illness requires hospital level care or other expertise that cannot be offered outside of a specialised institution needed. No maximum amount of hours is established by law and the needs of each person are estimated individually - Personal assistance is also provided for hobbies, societal participation and social interaction for minimum of 30 hours per month - The municipality can provide the service by covering the costs for hiring a personal assistant, giving the disabled person vouchers that can be used for buying services, or organising assistant services through a service provider, by itself or together with other municipalities personal assistance provided by the municipalities
In-home (home help, home care service) (home help consists of assistance with household tasks, such as shopping, cleaning, cooking, etc. services include assistance with daily routine tasks such as getting up, dressing, bathing and washing or taking medicines) Palveluasuminen Translation: Housing with services Yes (special housing arrangements combined with one or several types of services) -All age groups -All types of serious disabilities, that require continuous assistance with daily tasks -Home care service includes providing a disabled person with an apartment and services that are necessary for managing the client’s daily life, such as moving, dressing, personal hygiene and cleaning -The apartment needs to have special arrangements enabling as independent daily life as possible, despite of the limitations of the disability -Housing can be arranged in the persons own or rented apartment, or in a sheltered or group accommodation -Housing solutions can be provided by municipalities, non-governmental organisations and private companies -The needed services can be provided as personal assistance (see above), hospital care taking place at home, as subsidies for a family member working as carer, or as a combination of these - The client is responsible for covering costs that are - The municipalities decide how housing with services is to be provided, but special attentions is to be paid to the wishes and ideas of the customer. -In 2013, 5237 person were customers of service housing provided by the municipalities
prerequisite to participate in employment activities required in the Social Welfare Act -Daytime actitivities include outside home activities that support social interaction and the person’s skills to live and indepent life. -Activities might include for instane cooking, doing sports, discussing, hiking and creative activities. Persons who, due to a severe physical or mental disability, cannot participate in employment activities and whose income consist primaly of payments granted based on illness or disability to work, are eligible for daytime actitivies. disabilities. In many centers, the wishes of the customers are highly emphasised. the municipalities. Family support / Respite care (provides supports to carers in their caring role and allows them to have a break, may be formal or informal, and may be provided in the home or out of the home) Omaishoidon tuki Yes -All ages and all kinds of disabilities - Family support is a whole that entails services provided for the client, payment and respite given to a family member or a close relative who is working as carer and supporting services. It is a discretionary social service provided by municipalities in within the framework of their budget. - If the family member only needs small scale daily assistance, the carer does not usually qualify for As a part of family support, a plan for care and services is drawn up together with the person being cared for and the family member working as carer. The plan helps to ensure that family care, together with other social and health services, sufficiently provides services necessary for safety and well-being of the In 2014, 14314 persons between 0-64 years of age were receiving supported care from a family member working as a carer.
all the needed services and assistance adequately. Informal support (help provided by another person close to the user - family members, relatives and friends - without any official forms of support) Tuettu päätöksenteko (tukihenkilö) Eglish translation: Supported decision making (support person) Not provided for in law, but service is available in some forms Persons with mental disabilities - Content and persons eligible for decision making support are not described in law so there is no standard way of producing the service. -According to the description of the National Institute for Health and Welfare, support in decision making can be provided for instance for understanding complicated issues, searching for information, applying for services, finding a job or an apartment and other decisions of every day life. -Support in decision making can be provided by an individual person or a group. The group might consist of advisors for different issues which is to ensure that no single person’s opinions guide the decision making too much. -Right to a support person is established in law only related to certain situations, for example -Basis of supported decision making is that persons with mental disabilities use their and have the right to receive support in making decisions. Supported decision making aims at encourgaging and supporting persons to make decisions and choices concerning their own lives. The support person or group is not to decide on behalf of persons with disabilities or to take away their right to self-determination. - National level numbers are not available
legal assistance. In practice, other kind of supported decision making is provided mainly by civil society associations or volunteer activity and it focuses on freetime activities. It is somewhat overlapping with befriending services. Peer support/counselling (provided by with the counsellor and the client having equal status, and sharing experience and assistance in gaining independence and self-confidence) Vertaistuki Yes, often volunteer based, sometimes offered as a part of the public service system -All ages, all types of disabilities The ways of organising peer-support vary and the service is only in some cases offered as a part of the existing service structure. Often the social authorities planning the individual service entity are not aware of all the available opportunities for peer-support . can be organised as volunteer activity from the initiative of the participants, by organisations gathering together peers, or by professionals. -Information on services is often acquired through other services the person is using. -The ways of organising vary from volunteer activity from the initiative of the participants, by organisations gathering together peers to support organised by professionals. In all cases, peer-support is on experiences, thoughs and emotions shared by the participants. - National level numbers are not available Circles of support (informal group of people close to the Yes (see informal support) See informal support See informal support See informal support - National level numbers