A study commissioned by the State's disability authority has revealed that just a quarter of services for people with physical and mental handicaps, which were surveyed, are meeting the Department of Health's standards.
The confidential draft report, obtained by The Irish Times, indicates for the first time that there are significant failures in areas such as providing needs assessments, respecting rights of patients and consulting family members over the care of relatives.
While more than €1 billion in State funding is provided annually to voluntary organisations and health boards to provide the services, these are not subject to inspection.
However, a pilot project, involving the assessment of care for more than 300 people in almost 20 services across the State, says just 26 per cent of services met standards for the sector proposed by the Department of Health.
The report states: "This data would imply that the services in this study had significant failings on the criteria chosen by the National Disability Authority and the Department of Health in the pilot exercise . . . This could have major political consequences."
The pilot project is seen as a precursor to setting proper national standards for disability services and providing for independent inspections.
However, an evaluation of the independent assessment of disability services concedes that much work remains to be done in finalising agreed standards.
In spite of the findings, voluntary organisations, which provide around 80 per cent of the services, point out that many of them have received excellence awards and international recognition.
Mr Brian O'Donnell of the National Federation of Voluntary Bodies said members supported the idea of standards but emphasised they should also be people-centred and address issues of importance in an individual's quality of life.
Disability groups, meanwhile, have expressed support for the process, which they say is vital to raising standards and ensuring greater accountability among service providers.
Ms Deirdre Carroll of the National Association of the Mentally Handicapped of Ireland said the disability sector needed to catch up with the residential childcare sector which already had national standards and is subject to independent inspection.
Ms Mary Keogh, director of the Forum of People with Disabilities, said: "The absence of standards leaves the State vulnerable because, ultimately, regardless of what kind of service is provided, the State has a fundamental duty to ensure highest standards are adhered to. Otherwise, the State is culpable."
The pilot project notes there were significant differences in the results of assessments by employees in the disability services and by external consultants.
It also says that a basic set of mandatory standards could be agreed which all services would be required to meet before they would be considered a "recognised service provider".
A working group, including Department, health board and National Disability Authority representatives, is to work together to develop the proposed standards.
