Implementation of the Duties and Powers of the National Preventive Mechanism in 2012
At the time of the visit to Črnomelj RH, there were 54 residents diagnosed with dementia
(all of them categorised with 4th degree care). Residents with dementia reside among other
residents all over the nursing home and those who are mobile are included in activities taking
place in groups in individual wards. In addition to these activities, they take part in daily
activities which give them practice of independence in daily activities (for example, dressing,
washing, making tea, and similar). Since an integrated model for the institutionalized
treatment of persons suffering from dementia is established within Črnomelj EH, there is
no secure ward. The management believes that the staff of the establishment are effective
and that tasks relating to personal care, health care and safety of persons with dementia
scattered in all department of the nursing home can be handled without any problems.
According to the statements by the management, there are usually five to ten dementia
sufferers (not oriented in time and space) in their care for whom individual plans of health
care and individual risk assessment have been made. If a resident suffering from dementia
wishes to leave the nursing home, he/she is not restrained. The staff first try to discuss this
with a resident, when this is possible, and if this is not possible, there is a well established
method of looking for stray residents. This happens two to three times a year. In this case,
the nursing home informs the police and relatives of a missing person.
The NPM was interested, in the light of these statements, how safety and supervision was
provided for persons classified within the category of 4th degree care who need partial or full
personal assistance and supervision owing to long-term issues in mental health, old-age
dementia or related conditions. It was explained by the nursing home that instructions on
employees’ conduct had been developed which also related to the procedures involving
dementia sufferers. In accordance with such instructions, not later than every two hours,
medical caregivers personally check the presence of residents in the nursing home. If
residents were absent and their absence had not been announced, the staff proceeded in
accordance with the above mentioned instruction (for example, inquiring with relatives and
the family of a missing resident). In spite of explanations received, a question has been
raised by the NPM, whether such supervision is sufficient, which is why a request for an
explanation of this issue was submitted to the Ministry of Labour, Family and Social Affairs.
The NPM was particularly interested in the position of the above mentioned Ministry in regard
to the appropriateness of protection given to residents treated in accordance with 4th degree
care. The instruction by Črnomelj RH, that medical caregivers physically check the presence
of residents in the nursing home no later than every second hour may be questionable, in
the NPM’s assessment, when it is a matter of a person in need of personal assistance and
supervision. If such persons may in fact be without supervision for even two hours, they
may obviously be exposed to various risks during that period of time. It is emphasized that
in that case, Črnomelj RH is also fully responsible for the protection of such a person as that
responsibility has been taken over upon the admission of such person.
National Preventive Mechanism in the Republic of Slovenia under the Optional Protocol to
the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment
81
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