Implementation of Duties and Powers of the National Preventive Mechanism in 2010
DPM, it would be the most appropriate to use multiple-bed rooms for occupants who want to
be in them, or for whom expert personnel establish the positive effect of such accommodation
on their health. However, all other residents should be accommodated in rooms with fewer
beds (single- or double-bed room). Overcrowding is especially evident when the institution
installs additional (auxiliary) beds after an urgent admission to the ward. In terms of quality,
they are as not good as other beds, and residents have nowhere to put their personal items.
There is no space for a night-stand table, no possibility of installing a reading light, and no
wardrobe or cabinet for other personal items of the new residents. An additional bed or even
more beds in a room reduces the quality of life of other residents. This should therefore be
an extreme measure when all other options have been exhausted (e.g. accommodation in
another home, transfer of a less demented occupant to another ward and similar). This issue
is also noted in the chapter on persons with mental disorders and persons in social care
institutions – Skipping the Line to the Secure Ward.
In certain visited institutions, we still observed that not all residents are provided with the
basic utensils for maintaining personal hygiene (soap, towels, toilet paper). These utensils
must be provided, as this enables residents to take care of their hygiene without having to
ask the personnel for the most basic items. We agreed that some accessories might be
dangerous for demented residents, but a different choice of accessories (e.g. liquid natural
soap instead of hard soap) would eliminate the danger. We specifically emphasised that all
such accessories should also be available to incontinent residents.
We also frequently observed that rooms in secure wards (bedrooms and common rooms)
were bleak and with no decoration, residents’ pictures, creations made in occupational
therapy, or personal items. Certain institutions were informed of good experiences from
other visited institutions, which made the secure ward much more pleasant at only minimum
cost and effort by the personnel and residents. The DPM encourages the rearrangement of
residents‘ rooms, so that almost sterile hospital rooms are turned into homely places. We
still observe problems in providing sufficient staff in individual secure wards. Particularly in
some visited nursing homes, we had to point out the obvious lack of personnel, also during
the day (e.g. in one of the homes, a single employee was responsible in the afternoon for 50
residents; in another home, two employees were responsible for the full care of 27 residents
for the whole day), and the problem is even more serious at night. At night, usually only
two persons in the nursing homes are responsible for the entire institution, so there is no
constant presence of personnel in the secure ward. The homes try to resolve this issue
(only) with more frequent rounds to these wards and video-surveillance. In some nursing
homes, an employee is present throughout the night, which we specifically welcomed, and
we encourage other institutions to do the same. In one of the nursing homes, we drew
attention to the insufficient psychiatric care; the home provided a psychiatrist for only six
hours twice per month, which in the judgement of the DPM is not enough, considering the
total number of residents (158) and the number of residents in the secure ward (48). In
another home, we suggested that written records of persons waiting for a general practitioner
or a psychiatrist should be established. With appropriate records, the possibility of forgetting
the residents’ wishes or a medical condition established by personnel could be prevented.
Regular records of consultation would also provide regular examinations by the psychiatrist
for all residents diagnosed as demented. We also recalled that the examinations performed
by the psychiatrist should be frequent enough. If the psychiatrist comes to the secure ward
only rarely, the condition of a resident who does not receive therapy in due time might
be aggravated, so that hospital treatment is required or (rarely, but possibly) the condition
improves to the extent that detention in the secure ward would not be necessary.
National Preventive Mechanism in the Republic of Slovenia under the Optional Protocol to
the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment
57
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