⸻ The Journey from Institutional Care to True Integration

   



       You may often hear Sidney express dissatisfaction about the Czechia, but sometimes there are efforts here to improve life for its more vulnerable residents. One of these efforts I see the transformation of social services.

For many years, I have been trying to help people through direct care, having worked in many homes for people with disabilities, including those with intellectual disabilities and autism, as well as I worked in a hospital.

I consider it valuable that I had the opportunity to experience the Transformation of Social Services firsthand. In the Czechia, transformed social services are still far from common, but I do have this experience. Here are some examples of how I was trained for the Transformation and how I contributed to its implementation.

In my opinion, even my social interests as Sidney SN are connected to causes such as the Transformation of Social Services. Much of the criticism expressed by Sidney SN stems precisely from these social concerns.



       Transformation of Social Services by the Ministry of Labour and Social Affairs (MPSV)



 Inclusion – The Journey from Institutional Care to True Integration


  Isolation and Stigmatization


1. Care for people with disabilities is often provided in large institutional facilities, frequently accommodating dozens or even hundreds of residents, in buildings with multiple households.

2. These buildings are located away from mainstream society, isolated, and often feared by the surrounding community.

3. Residents are visibly distinguished – for example, by marked clothing – and their lives are far removed from normal conditions.


  Making the Invisible Visible: Inclusion and Individualization Instead of Isolation and Stigmatization


4. A fundamental change is the shift towards a model of ordinary households within a single regular house or apartment. In regular apartments or family houses, no more than five clients live together. In sheltered housing (CHB), there are usually two to three people per apartment, often with only a few hours of daily support, or just occasional visits from an assistant or social care worker.

5. The house or apartment bears no visible stigmatizing signs indicating that it is a DOZP (Home for People with Disabilities). Neither do the vehicles used for transport. They must look like regular houses, apartments, and cars, blending into the environment—this is inclusion.

6. Importantly, clients themselves are not marked in any way. Clothing and personal items are not labeled, because staff know the clients and their needs as naturally as in a family. This eliminates stigmatization, which is still a common feature of institutional practice in many non-transformed DOZPs.

7. There is a rule that when moving outside the household, no more than two clients may accompany a single staff member. This prevents groups from standing out—thus avoiding stigmatization. It also helps prevent fear in the community, which often arose during mass transfers.


  Part of the Ordinary Community: Inclusion


8. Households are located directly in regular streets—ranging from standard single-story houses to typical apartment buildings.

9. Local residents often do not even realize that a DOZP operates in their neighborhood.

10. The presence of a few clients does not burden the community; on the contrary, it helps to break down prejudices and fosters inclusion.

11. Another great advantage is the requirement for access to essential services—shops, hairdressers, medical and social facilities, and public transportation.

12. Clients thus naturally interact with other people, use regular infrastructure, and gain experiences they could never have in an isolated institution.


  A Healthier Environment, Better Control


13. A smaller number of people in one household also means a lower risk of disease transmission and easier health monitoring. In an environment where large groups do not mix, illnesses are detected more quickly and do not spread as widely as in large institutions, or in buildings with multiple households.


  The Outcome of Transformation


14. Instead of anonymous institutions and facilities that provoked fear or isolated their residents, small households have emerged—naturally integrated into the life of the town, city or village.

15. Clients are not visibly different, they are not “frightening” to the surroundings, and society benefits from an environment without large facilities that would unsettle the community.

      16. Especially for individuals who can live in sheltered housing, the transformation has become liberating. In a way, they can go where they are able to go without the barriers that previously oppressed them, including in choosing their identity. 

17. The transformation is not just formal—it is true inclusion and normalization into the life of society.


         18.  A similar approach can be applied to homes for the elderly. Seniors can also live in regular houses or households with the support of direct care workers, instead of in large facilities with dozens or even hundreds of residents, as is still common practice. This brings benefits both for seniors, who can enjoy the safety and comfort of everyday life instead of isolation, and for social service workers, who are not overwhelmed by having to care for dozens of clients at once. In smaller households, they can provide higher-quality services, as each worker is responsible for far fewer seniors. 


  Conclusion: 


   It remains open to debate how effectively the transformation functions in practice, when it comes to the inner workings of these households because these conditions are not always visible for public itself. Nevertheless, the concept itself is present and represents an important step toward a more inclusive and humane approach to care. 

Perhaps for the best outcome, households of DOZP could be monitored. Moreover, guardians, for instance, could have access to records or even real-time monitoring. This could be complicated for the staff, especially also because they would sometimes have to explain their approaches to the guardian. Yes, the question is whether monitoring is something typical for ordinary households. However, in regular households, people also use monitoring devices to prevent things they do not want to happen or to have evidence if needed. For example, within the framework of the transformation, things such as having a fire extinguisher in a precisely designated location were addressed, as required by standard fire safety measures. This is not a legal requirement for an ordinary household, but even in transformed houses and apartments, the law mandates that a fire extinguisher be placed in an institutionally designated spot.