29 Selected topics from 2020 being strictly necessary. In some cases, significant physical coercion was applied to carry out the force-feeding. One of the visits gave particular grounds for concern. The concern was in relation to the sum of intrusive measures as part of treatment for eating disorders.17 The Ombudsman pointed out the fact that staff did not feel they had adequate compe­ tence in the methods on which the treatment measures were based. The institute’s methods also included other treatment measures with a ques­ tionable or absent statutory basis. Among other things, some activities were made reliant on patients completing meals without this having any medical foundation. It is problematic if the course of treatment is organised in a way that undermines children and adolescents’ right to activities.18 In some cases, adolescents’ bathrooms were locked and they had to ask staff for permission to go to the toilet. Both the professional grounds and statutory basis for this practice were unclear. Children have the right to protection against serious abuse such as violence, neglect and sexual abuse.19 Places where children are admitted against their consent have the responsibility to protect children against such violations.20 Our find­ ings from visits indicate that there is a need to do more to protect children and adolescents against such incidents whilst they are admitted to a ward. The Ombudsman has requested clear routines to prevent violence and abuse. We have highlighted the need to ensure that staff feel free to speak to one another regarding how they should act in relation to vulnerable children and adolescents. Good practices for safeguarding the needs of children The Ombudsman’s findings this year have also shown examples of institutions that have been successful in offering treatment to children and adolescents that safeguards fundamental rights. During one visit, we found that the ward had creat­ ed safe and caring frameworks for children.21 The ward’s decision not to be approved for enforced admissions had had several positive consequences for how children and adolescents were safeguard­ ed. Major emphasis was placed on creating a situation in which the children themselves would wish to accept treatment. Activities organised by the ward were good and varied. The ward organ­ ised regular activities such as gym sessions and various voluntary activities – the adolescents were given the opportunity to influence in these. The exit doors were unlocked. The ward had made a The common area at the children and youth ward, Levanger Hospital. 17 The Parliamentary Ombudsman’s report after the visit to St. Olav’s Hospital, Children and adolescent psychiatric clinic, Lian, 25–27 February 2020, chapter 12. 18 UN Convention on the Rights of the Child article 31. 19 See report by UN independent expert Manfred Nowak on children who are deprived of their liberty, A/74/136, Report to UN General Assembly 11 June 2019, section 102. 20 UN Havana Rules, rule 87 (c) and (e), Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse, adopted October 2007 (Norway became a signatory to the convention on 1 October 2018). See also Specialist Health Service Act Section 2–1 (f), which stipulates that “Regional health services shall ensure that specialist health services are capable of precluding, uncovering and preventing violence and sexual abuse”. 21 The Parliamentary Ombudsman’s report after the visit to the children and youth ward, Levanger hospital, 10–12 February 2020.