9.4. Social care institutions The management could not report about any other cases of the use of restrictive measures recently. Nevertheless, one of the staff members and some residents unanimously affirmed that the week before the visit, a female resident – having become aggressive – was administered a sedative injection, and one of her arms was tied down. Another nurse admitted that if someone needs to be strapped down, the event is usually not documented. In light of the accounts of the above case, the scarce documentation (the Institution provided the delegation with documentation for only one case of the use of restrictive measures) was an indication of the fact that physical restrictions must not have been documented in each and every case. Medications involving chemical restriction, given to the residents from time to time, were supplied to the residents “at their own request”. One of the nurses reported that such medication is registered as an action carried out at the residents’ own request because in that case, it does not qualify as a restrictive measure. I asked the head of the Institution to make sure that in the case of the use of chemical restrictive measures, the documentation prescribed by law is properly filled in. In March, April and May (up to the time of the visit), there had been 4, 3 and 2 cases of death at the Institution, respectively. The causes of death were mostly cancer, stroke, pneumonia and old age. One of the residents reported about having had several suicidal attempts. A psychologist could provide substantial help to high risk residents in coping with their psychological burdens. It is reasonable to assume that access to psychological care would reduce the doses of medication and the proportion of combined treatments. The physical well-being of the residents could be improved by regular sessions of corrective-gymnastic therapy conducted by a physiotherapist (in addition to medical treatment). Catering for the residents was provided by the Institution’s own kitchen: residents received breakfast, a morning snack, lunch, an afternoon snack and dinner. In addition to a regular diet, dietetic meals and pureed diets were also available on the physician’s prescription. The dietetic menu was composed by a dietitian, and the dishes of the menu were prepared by a dietetic cook in accordance with the menu and the nutrition portions. The pureed diet was not specifically designed: the dishes of the regular menu were pureed with the help of a blender. In the fluid menu, soup was added to the purees prepared in the above manner in order to turn them into a liquid. The residents were served tea or some dairy liquid (and additional quantities of tea if they were suffering from a febrile illness), as well as occasionally fruit juice for the afternoon snack. In hot weather, lemonade was also available for them to ensure proper rehydration. The residents, including those on dietetic meals, were generally satisfied with the catering. Concerning the preparation technology of the pureed and fluid dishes (i.e. the blending of regular dishes), the only reason the investigation did not reveal 91