B. Recommendations to address challenges

1. Increase hourly rates for service provision

In 2021 and increasingly in the context of the war in Ukraine, energy prices along with access to certain materials have seriously affected social services provision. Fuel prices have risen, leading to higher food and other commodities prices, all of which impacts the provision of social services. State and municipal budget planners have to bear that in mind.

2. Develop suitable service provision

The Civitta Ltd. study on the cost effectiveness of accessible service provision is one side of the coin, while the use of modern tools, involvement of educated staff and maintenance of staff morale may be able to bring services to a higher, more adequate level. This is a challenge needing attention.

3. Avoid burn-out

Many NGOs and Foundations were established in the early 1990s, followed by another wave around year 2000, when the needs and possibilities for civil society stakeholders were becoming clearer in a young society regaining independence and starting to redevelop as of 1991.

This means most stakeholder organizations have been developing about 20–30 years, often with the same leadership from the very beginning. In the current circumstances where the economic situation has worsened, the war in Ukraine is impacting on people’s mental health and wellbeing, and COVID-19-related measures have led to constant alerts to re-organize work to prevent harm to the users, the burn-out risk is high. The leadership of each service provider should already be looking for next generation leaders to get involved.

4. Train and motivate staff

Interviews with the case study representatives also highlighted that the low level of salaries in the sector along with a high need for flexibility and few incentives to encourage staff pose real challenges to staff motivation. Cases of serious breaches of codes of conduct have taken place, which would have been avoidable with structured updates of mental health and wellbeing assistance. However, general workloads for offering the service tend to be so overwhelming that focus is lost and cases of staff-related dissatisfaction and misuse of trust can arise.

5. Focus on digital literacy

Currently, many people only use digital services with the assistance of a personal helper. The statistical overview of who is able to use the service is hence not accurate, as one digitally literate person is likely to help out several individuals. Training of individuals themselves, where possible, is crucial and is a current focus of the State Office of Estonia Innovation initiative, where the theme of better digital literacy for people with disabilities is among 22 themes for mapping the solutions to a problem in the public sector.

6. Further diversify services and improve accessibility

The need for smart provision of services where digital solutions can be utilized must be reiterated. Diversification of service provision needs to continue with personalized provision of care. Provision of services must also be evaluated for different user groups in the same way, using staff and securing staff full-time employment if needed.

7. Support processes for establishing supported decision-making mechanisms

In the 2020 Estonian State report in relation to the CRPD, it was clearly highlighted by the CRPD Committee and civil society that there was a need to focus on developing a supported decision-making mechanism to enable people with disabilities, who in many circumstances are put under guardianship, to exercise their rights under Article 12 in the CRPD. The present study highlights how in many cases there is a lack of flexibility and ad hoc approaches are used to assisting individuals in their interaction with the State and municipality.

8. Secure independent living based on individual needs

The interval care service is a step towards finding a unit for independent living. Currently, the support offered by the State and municipality depends on existing financial capabilities, services and earmarked support agreed by legislators. Tailor-made solutions are often not financially supported. The fulfilment of Article 19 of the CRPD also faces challenges due to the lack of assistants and attitudinal barriers still existing in the society. Social innovation should be increasingly used in the development of independent living solutions.