CHANCELLOR OF JUSTICE AS THE PREVENTIVE MECHANISM According to this, patients should be entitled to attach comments to the register, and should be informed of this; at their request, they should also receive a copy of the full entry. According to the Chancellor’s assessment, the register for recording incidents of seclusion has an important role in preventing the risk of ill-treatment. The purpose of the register is to provide an overview of cases of seclusion of persons and thus ensure transparency of the practice of resorting to the use of seclusion as a measure which severely restricts the fundamental rights of persons. Besides causing problems with protecting the rights of service recipients, the absence or insufficient maintenance of a register of cases of seclusion also limits the ability of supervisory authorities to verify effectively the services provided and restrictions imposed by an institution. With regard to these circumstances, the Chancellor has recommended to the Management Board of Viljandi Hospital Foundation to establish a register for recording incidents of seclusion conforming to the above requirement, and to the head of Võisiku Care Home to ensure proper recording of the incidents in the register. Chairman of the Board of Viljandi Hospital Foundation replied that a register for recording incidents of seclusion had been introduced in the nursing care and social welfare department. Chairman of the Board of the company AS Hoolekandeteenused replied that the staff of Võisiku Care Home had been informed of the requirements for maintaining the register, and the head of the care home would carry out a follow-up verification of the proper maintenance of the register. The following part contains brief overview of other shortcomings not mentioned above but found during inspection visits to the respective special care providers, as well as an overview of the good practice of ensuring the fundamental rights and freedoms of service recipients. Valkla Care Home can be definitely highlighted as a positive example, as the Chancellor found no violations of the fundamental rights and freedoms of service recipients in this institution. Therefore, the overview below does not include Valkla Care Home. 2. Nursing care and social welfare department of Viljandi Hospital Foundation On 4 May 2010, advisers to the Chancellor of Justice carried out an inspection visit to the nursing care and social welfare department of Viljandi Hospital Foundation. Viljandi Hospital Foundation has been founded by the Republic of Estonia. It has five clinics, one of them the nursing care and social welfare department (hereinafter the department). The department has two units: nursing care unit and social welfare unit. The latter also provides special care services. At the time of the visit, the social welfare unit of the department of Viljandi Hospital Foundation (hereinafter the hospital) provided the assisted living service to 13 persons, daily life assistance service to 7 persons, 24-hour special care service to 12 persons with a profound multiple disability or severe, profound or permanent mental disorder with unstable remission, 24-hour special care service to 13 persons placed in the institution upon a court ruling. The department had 73 staff (35 of them in the social welfare unit). In addition to the problem of absence of a register for recording incidents of seclusion described above, the inspection revealed that the department did not have information for service recipients about external complaint mechanisms and the possibilities for their use. The CPT in paragraph 123 of its report on a visit to Estonia has stated that “specific arrangements should exist enabling patients/residents to lodge formal complaints with a clearly-designated body, and to communicate on a confidential basis with an appropriate authority outside the establishment.” The Chancellor found that it is important to establish in a document, in addition to the rights and duties of service recipients and possible in-house complaint mechanisms, also external complaint mechanisms and the possibilities for their use. This document (or information material) should be made available for each service recipient and, where applicable, to their legal representative, regardless of whether the persons request the information or not. The Chancellor recommended that the Management Board of Viljandi Hospital Foundation should establish in a document the right of service recipients to have recourse to the relevant institutions (the Social Insurance Board, the Health Care Board, the Chancellor of Justice, the court). This document and a list of additional competent bodies (along with their contact details) dealing with complaints from individuals 59