The systemic changes described in the provision of social services took place in the whole territory of the Moravian-Silesian Region in 2003Ð2019. In the whole of the following text the term ÒclientÓ is used for people with a mental or combined disability, who are the target group for all the systemic change described.
In the Moravian-Silesian Region in 2003 social services clients were isolated, where they lived in large institutions situated in quite remote locations and in completely unsuitable buildings, for example historical chateaux and monasteries in which there were poor material and technical conditions. In the Moravian-Silesian Region clients were concentrated in 15 institutions in 15 places. The total capacity of such historical buildings ranged from approx. 100 to more than 200 clients. In these buildings the rooms were for 20 or more clients, with one common bathroom or toilet on the corridor for more than 20 clients. They were institutions in which care was provided either for only men or for only women, children were placed together with adults. The ordinary practice in such institutions was that clients were stripped of their ability to perform acts in law. Overall, few specialists worked in the institutions, the medical model of care predominated and the number of medical personnel was more than the number of personnel in direct care.
The clients lived in the institutions in a quite unnatural, separated environment and had to adapt to a large group of people and rules for the operation of specific workplaces (public catering, mass accommodation, mass hygiene) and an unnatural regime quite different to ordinary life (this means having space for themselves, privacy, getting an education, and certainly not in an ordinary school, going to work, having partnership relations, etc.). In the past clients were placed in the institutions regardless of the degree of their disability (light, heavy, deep) and with regard to the political situation before 1989 it was not unique for people who were perfectly mentally healthy, but troublesome for the political system of the day to be placed behind the walls of institutions. Photographs of the original institutions are attached in Annex No. 1 Ð Original Services.
In such environment there was a fundamental denial of basic human rights, the weakening of competences and responsibilities for oneÕs own life, a reduction in self-sufficiency, limitations on privacy, personal freedom and the foundations of human dignity, i.e. what makes a person a human being.
This state required a correction and necessary settling of wrongs from the past that concerned clients in such facilities. At the level of the Moravian-Silesian Region significant strategic decisions were taken and the necessary funding was secured for investment and non-investment events (projects). Uniform, comprehensive and organised project management was set up.
The reason for all the systemic changes described in the region was that clients are citizens who have the right to live in ordinary society and make use of public resources. Moving towards inclusion, i.e. a common life and co-operation with municipalities, a wide spectrum of providers of social services and the general public, in particular during the return of clients to their natural environment. Great emphasis was placed on an assessment of the degree of the necessary support (in accordance with the degree of a disabilityÑlight, heavy, deep) for a client and in accordance with this individual approach and an assessment the appropriate type of social service was selected.
The Moravian-Silesian Region was the first region that responded to trends abroad in the Czech Republic and it started the transformation project in 2003. In the first years there were pilot projects verifying the option of realising an overall systemic change in the region, which included the adoption of the strategic document Concept for Social Services in the Moravian-Silesian Region in 2004, whose aim was to determine the direction in the provision of social services in the region with regard to the specifics resulting from the regionÕs characteristics and the opening of several community services. The climax of the pilot verification was the abandoning of Ho__‡lkovy chateau, whose capacity (in 2003 it was approx. 100 clients) was replaced by community services.
The project for a complete systemic change was commenced in 2008, first of all in all 13 regional organisations that provided year-round residential social services to more than 1,100 clients. Partial steps in the transformation in all regional organisations led to the clear idea of improving the life of clients and providing them with human rights and freedoms.
Five self-governing authorities (City of Ostrava, Kop_ivnice, Komorn’ Lhotka, _esk_ T__’n, Bohum’n) and two non-governmental non-profit organisations (Slezsk‡ diakonie, Charita Opava) gradually got involved in this project managed by the region.