Developing Community Care

“We will find the way” is the guiding principle of the team at the VyššiHradek in the Central Bohemian Region of the Czech Republic. Determined to close the doors of the large institution inherited from the Communist era, the young director and his team are building community care alternatives and are slowly dismantling the existing system.

When Ivan Semecky became director of Vyšši Hradek, he thought it was one of those places where time hadstood still. Located in the classical baroque building of a former seminary, this institution for persons with intellectual disabilities is tucked away in a small town near Prague and used to be a home for over 100 people.

Unable to accept such a model of care, Semecky built around him a team of like-minded individuals who felt that in the 21st century no-one should live in a large institution. Together they established the first day-care centre in the municipality and laid the ground for a transition to community living by acquiring or renting suitable accommodation.

“We had to start from scratch”, recalls Semecky, “as most of the users had outdated or incomplete care plans, which were definitely not centred around their needs.” The team of professionals reviewed each user’s plan and together they designed a new person-centred plan. Not long after, users started leaving the institution and moving into the community.

“At first we worried about the reaction of the local community, but we actually had no problems”, laughs Semecky. The neighbours quickly got used to the residents who are seen regularly taking walks or going shopping. The rule is that there are never more than two flats (each occupied by 2-4 people) in one neighbourhood to avoid creating ‘horizontal institutions’. “Our residents can choose their flatmates, just as anyone of us can pick with whom we want to live”, explains Semecky. “Given local housing shortages, we are unable to ensure individual housing at this stage, but moving from a 100-bed institution to a new flat with just 3 colleagues is a step in right direction”.

Today more than 30 people live in the community and 15 have returned to their families and use day-care centres. Another 58 users are waiting to be transferred. Those who want to have the opportunity to try how it feels to be more independent by moving to one of the three ‘training flats’ (located within the main institution’s building), where they learn basic skills, such as cleaning, cooking or doing laundry.

By the end of 2013, the last remaining users should leave the premises and settle into the community. Perhaps then the regional government will turn this historical building into a hotel or a conference centre it should always have been.