Journal of Policy and Practice in Intellectual Disabilities doi: 10.1111/jppi.12261 Volume 16 Number 1 pp 13–20 March 2019 Changes in the Provision of Day Services in Ireland to Adult Persons With Intellectual Disability Roy McConkey* , Fionnola Kelly † , Sarah Craig ‡ , and Fiona Keogh § *Ulster University, Newtownabbey, Northern Ireland; † The University of Dublin, Dublin, Ireland; ‡ Health Research Board, Dublin, Ireland; and § National University Galway, Galway, Ireland Abstract Internationally, changes are advocated in the support available to persons with intellectual disability. Socially inclusive personalized arrangements are intended to replace congregated and segregated day services. The study examines the changes in the provision of day services within Ireland over a 5-year period when new policies were being promoted but at time of economic stringencies. Sec- ondary analysis was carried out on data extracted from the National Intellectual Disability Database on all persons aged 18 years and above in 2009 and 2014 who received day services, which were grouped into four main types: care centers, sheltered work- shops, employment schemes, and vocational training. Participants in each type of service were profiled by age, level of disability, and living arrangements. Variations in the provision of these services across nine regions were also examined. In 2009, 59% of per- sons attended care centers, but the proportion had increased in 2014 to 69%. There were reductions in the numbers attending shel- tered workshops (down from 23 to 16%) and those receiving employment supports (down from 13 to 11%). By 2014, variations in the numbers attending care centers were evident across the country. The increase in care provision does not accord with national or international policies. Rather, it may reflect ineffective policy implementation strategies and financial cutbacks which services experienced during this period. This study illustrates the value of a national dataset for monitoring policy implementation. Keywords: employment, day care centers, day services, Ireland Introduction Recent years have brought about major changes, nationally and internationally, in the policy landscape and the provision of support services to persons with disabilities. The Convention on the Rights of Persons with Disabilities (United Nations, 2006) has stimulated national governments to review the type of sup- ports provided to their citizens with disabilities and the intended outcomes. Within Ireland, for example, a new policy for day services “envisages that all the supports available in communities will be mobilised so that people have the widest possible choices and options about how they live their lives and how they spend their time” (p. 3) (Health Services Executive, 2012). In particular, increased opportunities for paid employ- ment are to be promoted, which is in line with the aspirations of people with intellectual disability whose views were obtained in a national survey (Garcia Iriarte, O’Brien, McConkey, Wolfe, & O’Doherty, 2014) and confirmed by the self-advocacy of groups throughout Ireland (Government of Ireland, 2015 ). However, these policy shifts have had to be implemented against a background of austerity measures taken by European Governments. In Ireland, government spending was severely constrained from 2008 onward on health and social care ser- vices, with reductions mostly in staffing and associated costs (Hauben, Coucheir, Spooren, McAnaney, & Delfosse, 2012). Moreover, the transformation of long-established service models is not easily achieved particularly for persons with an intellec- tual disability who mostly require daily and life-long support. Thus, the creation of new models of service provision requires an understanding of present arrangements as well as an appreci- ation of national policies, allied with changing economic cir- cumstances. It was against this background that the present investigation was conceived. The focus is on changes in the day services provided to persons with an intellectual disability in Ire- land during a period of economic austerity and when new poli- cies were being developed and implemented. The Evolution of Day Services in Ireland Services to persons with an intellectual disability in the Republic of Ireland were historically provided by voluntary not-for-profit organizations such as religious orders as happened also with educational provision and other health services within the state (Linehan et al., 2014). Up until the 1960s, residential schooling and institutional care dominated, but from then onward local parent and friends associations initiated community-based day services. The form they took was determined by local personnel Received July 7, 2017; accepted May 4, 2018 Correspondence: Roy McConkey, Professor, Ulster University, Newtownabbey, Northern Ireland. Tel: +44 028 90 852537; E-mail: r.mcconkey@ulster.ac.uk Fiona Keogh: Formerly with Genio Trust, Dublin © 2018 International Association for the Scientific Study of Intellectual and Developmental Disabilities and Wiley Periodicals, Inc.