Homes with a maximum of five residents, individual rooms, and neighbourhood life for people with significant support needs. This is the Casa Meva model, which the Fundació Privada Ilersis has been implementing since 2022 across four homes in Lleida. We spoke to Marc Prat, the project manager.
How did the Casa Meva project come to the Fundació Ilersis?
Plena Inclusión promoted some pilot programs just before the pandemic. We signed up, but everything stopped. Later, Plena Inclusión designed the Mi Casa project on a national scale, which in Catalonia is known as Casa Meva, with the aim of opening up new opportunities for people with disabilities and great support needs. Dincat, which coordinated it in Catalonia, proposed that we participate.
What led you to say yes?
We jumped in blindfolded, because we didn't know what we were committing to. But we did know that it was a project to transform housing services and offer opportunities in the community to people with great support needs. And that fit very well with the values of Ilersis, which has always worked with a focus on person-centered care.
How has the project evolved since then?
The Casa Meva pilot project comenced in 2022 in seven autonomous communities and ended in 2024. In Catalonia, the participating entities, with the support of Dincat, valued it very positively and reached an agreement with the Generalitat to continue it through a grant for the years 2025 and 2026. During these years, we have been working to consolidate it as a service within the social services portfolio, and we have recorded a documentary so that people with disabilities themselves explain in their own words what Casa Meva is.
How does Casa Meva differ from a traditional residential home?
The homes of Casa Meva are located within a residential community, and the people who live in them actively participate in neighborhood life. In addition, the cohabitation units have a maximum of five people, with individual rooms. That is what sets it apart from a conventional residential home.
What profile do the participating people have and how is it decided who can access the project?
60% must have great support needs, that is, a degree III of dependency or a degree of disability greater than 75%.
In two of our homes we support people in a process of deinstitutionalization. They were people who had been living in residential homes for a long time and wanted to change homes. Some have behavioral disorders or autism spectrum disorder, and needed a more intimate space, more integrated into the community, more cared for and with more individualized attention. They asked for it and were prepared to take the step.
In the other two homes, we proposed to people from Ilersis and their families a process of prevention of institutionalization.
What does that mean?
These are people who lived in their home and had told us that, in the medium or long term, they would need support at home. Instead of going through a residential home with cohabitation units of 12 or 24 people, we offered them a Casa Meva home.
As a curiosity, in one of the homes, located on the Paseo de Ronda, we have been able to provide service to five people who already lived in the neighborhood. They have great support needs, but since they already knew the neighborhood, the pharmacy, the bakery, etc., they have been able to get along very well from the first day. With our support, they have been able to stay in their natural environment, but living an independent life from their family members.
How do you know if the people in a cohabitation unit will be compatible?
We work hand in hand with the other services of Ilersis: the occupational therapy service, the occupational insertion service and the multidisciplinary support team of the special work center. We know the people very well and coordinate with the referents of their individual program to assess if they can work.
How were the beginnings? How did you find the apartments?
We had a rental apartment where very autonomous people lived, with intermittent support, but they did not fit the profile of the project. These people were prepared to take another step towards independent living and moved to homes with another type of support. In that apartment we supported people with great support needs in a deinstitutionalization process. Then we opened the rest of the homes gradually.
At first, we looked for rental apartments, without leaving aside social rental through the Municipal Urbanism Company or the Catalan Housing Agency. Of the four current apartments, one is owned, two are privately rented and one is socially rented through the EMAU.
Those who have made it easier are the people with disabilities; who has made it harder, the bureaucracy.
Was it easy to set up the homes?
No. Those who have made it easier are the people with disabilities; who has made it harder, the bureaucracy. The project sets some conditions: individual rooms for everyone and practical homes, with accessible bathrooms: wide doors, walk-in showers, adapted sinks, etc.
We had to find a home large enough, in a building with an elevator, and that you would let you adapt the bathroom. The project already provided a grant to adapt the homes, but not all owners allow it nor can you do a renovation with a two-year rental contract. That requires everyone to agree and have a longer-term vision, and the project was initially for three years.
Many constraints…
In the end, it is a decision of the entity: to bet on this model. We have three years, but will Ilersis be able to continue it? How do we make it sustainable after the project? That is the key.
One of the principles is that the person makes decisions about their own life, but, to what extent can they decide?
They can decide everything, as long as they comply with the rules that we all must comply with in society. In principle, they should be able to decide everything. The direct care professionals are here to guide them on what is right and what is not. If you want to eat ready-made meals every day, it cannot be because you will have a health problem, and I have to make you understand it so that you end up deciding yourself not to eat badly every day. This pedagogy also has to be transferred to the families, because some are not fully prepared for the person to make all the decisions.
One of the innovations of the project are two new figures of care for people: the facilitator and the community connector.
How do you do it?
One of the innovations of the project are two new figures of care for people: the facilitator and the community connector. From the bond, the conversations and the daily observation with the direct care professionals, we detect the interests, needs and desires of each person.
I am not talking about "I would like to travel to Punta Cana", because that I would also like and it is not feasible. I am talking about things like "I would like to go for a coffee on my own". It is a person with great support needs who has never gone alone to have a coffee at a bar, but it is a desire they have. Well, we accompany them so that it is possible.
The professionals have stopped doing purely assistance work and now accompany people so that they make better decisions.
So, what role do the professionals have and what has changed in their way of working?
The professionals have stopped doing purely assistance work and now accompany people so that they make better decisions. For example, at the medical consultation, the user is the one who has to express themselves, not the person who accompanies them. On the bus, it is the person with disabilities who has to press the button and be aware that they get off at the next stop. It may seem insignificant, but for them it has a lot of meaning. The professional is there, but not to replace them in what they can do.
Have you encountered fears or initial resistances on the part of the community or the families?
Families, because of the affection they feel for their relative, want them to gain autonomy, but at the same time they are afraid that something happens to them. The neighborhood asks who will come to live in the block: "Let's see if someone will be aggressive or do something they shouldn't". But, when you show up at the first neighborhood meeting with the people who are going to live there, people change. And, as we share moments, things change. There are people with disabilities who comply with the rules of coexistence much better than many people without disabilities. We have turned the tables by being there. When you are there, people lose the stigma along the way.
How do you work the relationship with the neighborhood, the shops, the cultural activities, leisure and the neighborhood networks?
We try to do the shopping in the neighborhood shops, to which we can go walking. If we always buy bread at the same bakery, we establish a relationship of trust with the shop assistant, and maybe one day a person can go alone.
We don't want to be treated in a patronizing way; we want to be just another citizen.
Sometimes we do encounter patronizing attitudes: "I'll serve the boy or girl from Ilersis first because they have a disability." No, they can wait to buy bread like any other citizen. We don't want to be treated in a patronizing way; we want to be just another citizen. We want the relationship to be natural, based on healthy coexistence.
After all these years of experience, are the people living in the Casa Meva homes happier?
Yes, everyone agrees that their quality of life has improved. During the national pilot project, INICO, the University Institute for Community Integration at the University of Salamanca, which researches disability, compared people in the project with people who were not participating in it. In 90% of cases, positive changes were observed: greater participation in household chores, leisure activities, and shopping, a greater ability to make decisions, and far fewer behavioral problems.
Ultimately, the person-centered, more community-based model improves quality of life.
Is it economically sustainable?
A place in Casa Meva may be slightly more expensive, but indirectly it saves more resources than it spends. If you help you acquire good habits and integrate into the community, you will have better physical and mental health, which means less use of public resources. For example, if behavioral disorders decrease, money is saved in the healthcare system. Everything is connected.
What should change in public policy so that Casa Meva stops being an exceptional model?
The project should be incorporated into the social services portfolio, and people should be able to choose the lifestyle they want. We need to move from a service-centered system to a person-centered system: the supports should be adapted to each person, not the other way around. The reform of the Disability and Dependency Law is moving in this direction, but the bureaucracy should be more supportive. We hope that the Administration consolidates the service and that many other organizations join the model.
