npm annual report 2016 / observations and recommendations 3.8 Social welfare / Units for older people The Ombudsman conducts visits to care and residential units for older people in his role as both the NPM and the Parliamentary Ombudsman. When restrictions are placed on older persons in such units, the NPM is competent to pay supervisory visits to them. In many cases, the resident have memory disorders and their freedom of movement is restricted for this reason. The following four sites were visited in 2016: Palvelukeskus Hopeahovi (Kerava), Esperi Hoivakoti (Kerava), Harjukoti (Loppi) and Hoivakoti Salmela (Loppi). All these visits were unannounced. On visits to units for older people, special attention is paid to whether the care and attention received by the residents is respectful of human dignity. Another key theme is how well the municipalities look after the right of their most vulnerable residents to the indispensable subsistence and care necessary for a life of dignity and adequate social and health services enshrined in section 19 of the Constitution. The health care received by older persons and their access to physiotherapy/rehabilitation, oral hygiene and health, nutrition and hydration, personal hygiene and outdoor exercise/recreation are assessed on the visits. The staffing of the unit and the appropriateness of its facilities are also scrutinised. In addition, the NPM always look at how the residents’ right to self-determination and privacy are implemented, what restrictive measures are used, and what decisions are made and records kept on their use. • Based on observations made on the sites, regularly visits to the units by a doctor were considered a positive aspect in general. • The Deputy-Ombudsman concidered as a shortcoming the lack of sufficient individual physiotherapy arranged for the residents. • The Deputy-Ombudsman found the lack of outdoor exercise a problem on all sites – especially in winter and in the case of those residents who would like to go outdoors and who would benefit from it. 51