CHANCELLOR OF JUSTICE AS THE PREVENTIVE MECHANISM Service provider should be aware whether the doctor has excluded the use of seclusion in respect of a particular person. A specialist doctor or a medical specialist of the rehabilitation team in their letter of referral may have prescribed a specific approach to communicating with the person and recommended measures for pacifying the person. For example, if a person has the habit of scratching their hands and arms during a bout of agitation, gloves could be used to prevent them from injuring themselves, or if a person bangs their head against the wall a protective cap could be used, etc. A medical specialist may recommend other measures to handle specific behaviour of a person and prevent self-injuring. A medical specialist may also exclude the possibility of using seclusion if secluding a person alone in a closed room may have a deteriorating effect on their health (agitation increases, a risk of a heart attack or other health damage arises). Physical restraint of service recipients, i.e. the use of mechanical means of restraint (straps, handcuffs, special clothing, restraint bed), to restrict the freedom of activity of a person is prohibited and the application of such means of restraint is inadmissible even if a person has caused a serious danger. Obviously, it is also prohibited to restrain persons for purposes of increased convenience of providing the care and guarding them (e.g. at night; a restless client who wishes to walk around, etc). Means of restraint may not be used as a punishment for behaviour or attitude which the staff find to be inappropriate. In any case, other pacifying activities, first and foremost verbal pacification, should be preferred to physical restraint as a procedure which most strongly restricts a person’s rights and may have a degrading effect. 4. Secluding a client when they pose a danger to the staff of a social welfare institution Workers of social welfare institutions were concerned that they are not protected against clients who pose a danger to the life or physical integrity of the staff, as the current legislation does not allow the use of seclusion in such cases. The health condition of a person receiving the service voluntarily or on the basis of a court ruling may be serious. If due to reasons caused by an illness a person is behaving in a manner which endangers themselves or others, the safety of the person as well as others must be guaranteed. For this, it may be necessary to use seclusion. As was explained above, under § 202(4) of the Social Welfare Act, seclusion in respect of a person receiving 24-hour special care may be used only if: 1) there is immediate danger to the life, physical integrity or physical freedom of the person himself or herself or other persons receiving the service; 2) verbal appeasing of a person or application of other measures known to the service provider and indicated by the doctor with respect to the specific person has been insufficient; 3) to the service provider’s knowledge the doctor has not excluded the use of seclusion with respect to the specific person. This version of the Act entered into force on 13 March 2011. Under the previous version, seclusion of a person could only be used if the person posed an immediate danger to themselves or to other clients, and if other conditions for seclusion (provided for in clauses 2 and 3 of § 202(4) of the Social Welfare Act) are fulfilled. Thus, the law provides for the right of a service provider to seclude a person from other service recipients if an immediate danger to the person himself or herself or to the life, integrity or physical freedom of others exists (§ 202(4) clause 1 of the Social Welfare Act). In other words, since 13 March 2011, it is possible to use seclusion in respect of a person if a danger to other natural persons not mentioned under the previous version of the Act exists, for example a staff of the social welfare institution or a person visiting a client. 14 Each worker of a social welfare institution should be competent and responsible and have completed training prior to assuming the work duties as well as subsequent regular in-service training. The importance of special training for the staff who are entitled to implement measures of restraint in a social welfare institution should be emphasised. Inter alia, the staff should be trained to restrain agitated or violent clients. Such skills enable the staff to choose the best suitable course of action in complicated situations and significantly reduce the risk of ill-treatment, injury and other damage to the client himself or herself and to the staff.