One of the positive trends, noted by the team of NPM is that in all HMSCCs the capacity of the offered residential care for children aged 0 - 3 years has been reduced by 20 percent. The stay of the children has been also reduced by one year and the process of adoption has been accelerated. However, the capacity of HMSCC - city of Varna, city of Burgas and city of Stara Zagora continue to be large - of 200 children. The National Preventive Mechanism believes that such children's institutions could not apply an individual approach to each child, which is important for their development. Another very alarming fact is that in HMSCC - city of Varna and in HMSCC - city of Burgas, about 140 inmates are healthy. This means that the admittance to these institutions is still not closed for healthy children and that the provision of alternative social services such as taking care of a child by a foster care family or return to the biological family are not implemented. Another important finding, which was identified by the NPM is that after the closure of 8 HMSCCs and the creation of new integrated health and social services, no medical standard to cover the treatment of children aged 0 - 3 years with disabilities has been developed. The team of the NPM believes that the principal supplying residential service of family type for children with disabilities with a substitute care aged 0 - 3 years, should be the Ministry of Health. A positive trend is that a large part of multidisciplinary teams of HMSCCs have passed trainings for working with children aged 0 - 3 years and with children with disabilities (over 50% of the children accommodated in these homes have medium and heavy disabilities). To meet the needs of children in all HMSCCs visited specialised staff such as psychologists, speech therapists, educators and therapists has been appointed. The right to education and training of children is impaired because of the lack of infrastructure for children with disabilities in municipal kindergartens, as well as the lack of vacancies in the kindergartens. In none of the HMSCCs visited children do not attend public childcare facilities. Most children accommodated in HMSCCs are handicapped, but again the MH has not provided funds for the purchase of specialized transport. Another problem associated with medical care is that children's wards in hospitals continue to set conditions for admission of children from these homes: food and children's clothes to be provided by the home, and the child to be accompanied by an assistant - representative of the home. Due to the limited number of specialized personnel, the administration of the homes is not able to provide additional staff during the stay of children in the hospital. The main recommendation the NPM sent to the Ministry of Health was to provide plans for deinstitutionalisation of all remaining HMSCCs in order for the NPM's team to examine the next steps in the process of deinstitutionalisation of children aged 0 - 3 years. IX. SOCIAL INSTITUTIONS FOR ADULTS During the visits carried out in 2014 in homes for adults with mental disorders (HAMD), homes for adults with mental retardation (HAMR) and homes for the elderly with dementia (HEPD) the NPM found negative resistance of the system to provide long-term social services. The problems identified by the inspecting team in the past years (2012-2013) continue to apply in varying degrees to all institutions visited: 1. The large number of people waiting for accommodation in homes for the elderly, demonstrates the importance of these institutions. However, there is an increased degree of control over the quality of services provided. 40

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