Introduction

One of the most important, but probably least recognised, services for adults with a disability is the Day Service for Adults with a Disability provided by the Ministry for the Family and Social Solidarity.

Short description

This service consists primarily of a number of centres spread all over the Maltese islands. In fact there are four large centres, in Mtarfa, Marsascala, Sta Venera and Hal Far. There are also six small centres, one in Ghajnsielem, Gozo (run by the Ministry for Gozo) and five in Malta: in Mtarfa, Pembroke, Cottonera, Swatar and Sta Venera. All these centres, except for another small centre in Sta Venera which focuses exclusively on the needs of a group of blind people, cater for persons with an intellectual disability. However, one needs to bear in mind that a relatively high percentage of clients of day services have other, mostly physical, disabilities.

Mission

The mission of this service can be summarized into two broad aims:

(a) to provide meaningful and enjoyable activities, such that the persons receiving these services can enjoy the best quality of life possible;

(b) to provide the carers of these persons with the necessary support, so that they themselves can continue to care for the persons with disability, as far as possible, within a family and community environment.

History

The first centre opened in Sta Venera in 1976. This was followed by the centres in Mtarfa and Hal Far in 1979 and in Ghajnsielem in 1981. In 1997 the Marsascala Centre was opened. Following that, a decision was taken to open small centres in the community. Between 1997 to date, small Day Resource Centres were opened in the other localities.

Another important development was the signing of two partnership agreements which the Ministry for the Family and Social Solidarity signed in order to complement this service. The ministry is also funding a day service provided for a small number of disabled adults by the Eden Foundation and Equal Partners Foundation. These agreements provide these clients with an opportunity to have the possibility – albeit very limited – to choose between different service providers.

Activities

Persons attending these centres are encouraged to participate in various activities that can be divided into:

(a) Activities for Self-Development

Persons attending these centres are supported to develop and practise their self-help skills according to their capabilities. These include activities of daily living such as personal hygiene, grooming, housework, cooking, use of money and telling the time, traveling and other social skills which help the individual to live as independently as possible.

(b) Work activities

Many of these centres provide their clients with the opportunity to participate in work-related activities, such as: packaging, assembly, sorting, book-binding and mailing. Any income generated is used by the centre to meet the costs of major activities that the centres themselves may organise from time to time.

(c) Crafts Activities

Crafts activities occupy the greater part of the day of most of these adults. Craft activities include: fretwork, macramé, knitting, cooking, cane-work, pottery, painting and similar crafts. These activities, besides being enjoyable, offer the disabled persons the opportunity to keep themselves active. Very often, they also provide them with an important opportunity to create something themselves.

(d) Different forms of therapy

Different forms of therapy are also provided to a small number of persons who need the service. Unfortunately, the number of therapists working in these centres is rather limited, and only speech and language therapists are present in nearly all centres. These therapists organise individualised programmes for those needing their support. Furthermore, they carry out group activities, especially activities related to self-advocacy. Persons attending these centres are given the opportunity to develop self-assertion skills and other skills which enable them to participate, as far as possible, in the running of their own centres.

(e) Leisure and Other Activities

These centres organize various other activities which are mainly intended to serve as leisure activities. These include outings and sports activities. Other activities are generally of a religious nature. Furthermore these adults are provided with a light mid-day meal. They are also provided with transport directly from their homes.

Staff

These centres are administered by a central unit headed by Mr. Vincent Tonna, Assistant Director. The large centres each have a staff complement consisting of: a Head, an Assistant Head, or a Senior Support Worker and a number of other Support Workers. The small resource centres are headed by an Assistant Head, or a Senior Support Worker and a number of support workers. The larger centres have a population of between 80 and 100 adults, while the smaller centres’ population averages around 20 adults.

The ratio between the Support Workers and other staff who care for these adults stands at around 1:4. The larger centres enjoy the services of a nurse. The centres are also serviced by the Speech and Language Department of the Health Division and a few other professionals. However, the centres badly need the services of many other professionals, such as: occupational therapists, psychologists, social workers and physiotherapists.

Funding

The Day Centres are completely funded by the government. For the year 2005, the government is planning to spend Lm1,350,000 on Day Centres. This is an increase of around Lm82,000 (6.7 per cent) over the last year. While appreciating any addition in funding for this sector, the Commission is, nevertheless, of the opinion that this increase is not adequate.

The funds are allocated as follows:

Item Funds %

Salaries 1,039,000 77

Transport 168,000 12

Mid-day Meals 35,000 3

Capital 40,000 3

Others 68,000 5

Total 1,350,000 100

Strengths

The centres are providing our society with a sterling service which is largely community-based. The Commission believes that, although understaffed, these centres are also giving value for money. Most of the support workers are very dedicated to their jobs and, given the right support, they are capable of producing even more. In general, the physical environment of these centres is very welcoming, although, it has to be said that in certain areas there is some overcrowding.

Weaknesses

The greatest weakness of this service is its under-funding. This is affecting their overall performance. More professionals are needed in order to support the front-line workers to develop an individualized plan for each adult attending these centres.

Another great problem is the fact that this service is in constant demand. It caters for persons with disability from the ages of 20 years and even provides a service for those in their seventies and eighties. This constant demand creates the need for constant development, and this in turn requires more funding, which, at present, is not forthcoming. In the short term it is likely that the demand for this service will continue to increase, until a natural plateau is reached.

Personal experience

The best way to describe this service is to let one of its clients speak for herself. During a ceremony where President Edward Fenech Adami awarded certificates of attendance to participants who successfully completed a course organised by the Kummissjoni Nazzjonali Persuni b’Dizabilità, Ms Marthese Deguara, a client from the Mtarfa Day Centre shared her experiences with all those present:

“… At the Mtarfa Day Centre I take part in many different activities like: swimming [at the Razzett tal-Hbiberija], drama, shopping expeditions and needlework. I also go out with my friends and with the care-workers.

“Each day I attend a different activity unit. Every morning I’m told which unit I can join. I like changing units and taking part in varied activities. But it would be nice if they [the care-workers] let us choose the activities we want to do.

“I would like a part-time job with the postal service and when I’m not working I’d like to attend Day Services activities. I attended an ETC course and tried to look for a job, but I didn’t find one.

“Many of my friends who attend the Centre would like to work, some full-time and some part-time.

“Going to the Centre is good. I meet my friends there and I learn how to be more independent and I also take part in leisure activities. We carry out a lot of interesting activities with the support of the care-workers.

“But we would like to do a lot of other things, if we have the chance to. When we were asked what we’d like to do in our Centre, a lot of us said that they would like to work and that they would like to learn about different subjects, including sexuality.

“Others would like to try out different activities, such as: sports, sewing and drama. Many would also like to see more outings organised for us. Outings are organised in all the centres, but not everyone organises them. It would be a good idea if we were asked whether we want them organised, or not.

“I’m also very active at home. I help with the housework, I go shopping and in my spare time I like listening to the radio.

“We feel it’s very important for us to become as independent as possible so that we will not need too much help. I am very proud to be able to look after my own needs when I’m at home.

“Perhaps not everyone can go out to work, or to look after themselves without support. But it’s certainly important that we, disabled persons, who attend Day Centres are given the opportunity to make our voices heard and that someone is there to really listen to what we have to say for ourselves.” *

Mr Bezzina is executive director of the Kummissjoni Nazzjonali Persuni b’Dizabilità

* translated from the Maltese original.

Day Centre inaugurated

no. of clients

1. Sta. Venera (Blind) 1979 28

2. Hal Far 1987 88

3. Mtarfa 1987 90

4. Fleur de Lys 1994 62

5. Marsascala 1998 66

6. Mtarfa Resource 2001 16

7. Pembroke Resource 2002 9

8. Cottonera Resource 2002 23

9. Swatar Resource 2003 16

TOTAL 398