Poročilo Varuha človekovih pravic Republike Slovenije o izvajanju nalog državnega preventivnega mehanizma za leto 2011 Obiski posebnih socialnovarstvenih zavodov V letu 2011 smo obiskali tri posebne socialnovarstvene zavode (zavod): Dom Lukavci (4. 5. 2011), Socialnovarstveni zavod Hrastovec (SVZ Hrastovec) (28. 7. 2011 in pozneje še 19.10.2011), Dom Prizma Ponikve (27. 10. 2011) in kombinirani zavod Doma upokojencev Podbrdo, Enoto Petrovo Brdo (Enota) (24. 11. 2011). Vsi obiski zavodov so bili nenapovedani, razen prvega obiska SVZ Hrastovec. Pri vseh so sodelovali predstavniki izbranih nevladnih organizacij. Obiski so vključevali pogovor z vodstvom, ogled varovanih in drugih oddelkov ter drugih prostorov Zavoda ter pogovore z naključno izbranimi stanovalci. O vsakem obisku smo pripravili predhodno poročilo, ki smo ga posredovali obiskanemu zavodu s predlogom, da ga obravnava ter nas obvesti o svojih stališčih do ugotovitev in predlogov DPM. S končnim poročilom, ki je vključevalo tudi odziv Zavoda, pa smo seznanili Ministrstvo za delo, družino in socialne zadeve. Vse navedene zavode je Varuh obiskal že v letih od 2007 do 2009. Za obisk Zavoda Hrastovec in Lukavci v vlogi DPM smo se odločili, ker smo bili seznanjeni, da stanovalci bivajo tudi na varovanih oddelkih, za druga dva pa smo se odločili za obisk, zato da bi ugotovili, ali so od našega zadnjega obiska morda vzpostavili varovani oddelek oziroma ali se osebam na drug način omejuje svoboda gibanja. V Domu Prizma Ponikve nismo ugotovili, da bi imeli prostore ali izvajali dejavnosti, s katerimi bi bila posameznim stanovalcem omejena svoboda gibanja, zato nadzora v vlogi DPM nismo nadaljevali. V Enoti Petrovo Brdo pa smo ugotovili, da Zavod sicer nima klasičnega varovanega oddelka, vendar po navedbah vodstva nekateri stanovalci Enote ne morejo samostojno zapustiti. Predlagali smo, da bi bilo te stanovalce zato treba ali premestiti na varovani oddelek druge enote Zavoda ali pa o njihovem omejevanju svobode gibanja obvestiti sodišče, skladno z določbami Zakona o duševnem zdravju (ZDZdr). Zavod je v odzivnem poročilu zapisal, da so se o našem predlogu pogovorili z lečečo psihiatrinjo in skupaj z njo ugotovili, da trenutno nihče od stanovalcev ne potrebuje pridržanja na varovanem oddelku. Ob morebitnem poslabšanju duševnih stanj pa nameravajo stanovalcem pojasniti razloge za omejitve gibanja, in če bodo sposobni pojasnila razumeti, pridobiti njihovo soglasje. V nasprotnem primeru pa bodo obveščali sodišče, kakor smo predlagali. Problematika, ki smo jo zaznali ob obiskih navedenih zavodov V enem izmed obiskanih zavodov je vodstvo izpostavilo pereče vprašanje nameščanja stanovalcev na varovani oddelek brez privolitve na podlagi sklepa sodišča, čeprav zavod nima prostih zmogljivosti. Varuh je v zvezi s tem že podal mnenje, da je takšna ureditev sprejemov na varovani oddelek pomanjkljiva. Na neprimerno zakonsko ureditev je opozoril tudi Ministrstvo za zdravje in Ministrstvo za delo, družino in socialne zadeve. Zadnje nas je maja 2011 seznanilo, da naj bi bila v pripravi rešitev omenjene problematike z vzpostavitvijo mreže varovanih oddelkov v posebnih socialnovarstvenih zavodih, ki bo enakomerno pokrila celotno območje države in zagotovila zadostno število zmogljivosti za tovrstne namestitve. Zavodi so nas ob obiskih nadalje seznanili s tem, da se v zadnjih letih povečujejo potrebe po nastanitvi vse starejših ljudi s številnimi zdravstvenimi težavami, na drugi strani pa je čedalje več mlajših stanovalcev s težavami z zasvojenostjo. Nastanitev starejših zahteva več zdravstvenonegovalnega kadra, pri mlajših pa pogosteje nastajajo konfliktne situacije zaradi agresivnega vedenja in verbalnega nasilja do zaposlenih. Kjer so slabše še bivalne razmere, je zaradi generacijskih razlik problematika še bolj pereča. Zavodi poskušajo navedene težave reševati tako, da o tem dodatno izobražujejo zaposlene, zanje organizirajo supervizijo in intervizijo. 44 Državni preventivni mehanizem v Republiki Sloveniji po Opcijskem protokolu h Konvenciji OZN proti mučenju in drugim krutim, nečloveškim ali poniževalnim kaznim ali ravnanju Implementation of the Duties and Powers of the National Preventive Mechanism in 2011 Visits to special social care institutions Three special social care institutions were visited in 2011: Dom Lukavci institution (4 May 2011), Hrastovec Social Care Institution (SVZ Hrastovec) (28 July 2011 and again on 19 October 2011), Dom Prizma Ponikve institution (27 October 10. 2011) and the combined institution of Podbrdo Nursing Home, the Petrovo Brdo Unit (the Unit) (24 November 2011). All visits to the institutions were unannounced, except the first one to SVZ Hrastovec. Representatives of the selected non-governmental organisations participated in all visits. The visits included an interview with the management, the inspection of secure and other wards and other rooms of the institution, and interviews with randomly chosen residents. A preliminary report was prepared after each visit and submitted to the visited institution; we suggested they consider it and notify us on their views of the findings and proposals of the DPM. The final report, including the institution’s report, was then submitted to the Ministry of Labour, Family and Social Affairs. The Ombudsman had already visited all of the above institutions in the period from 2007 to 2009. We decided to visit Hrastovec and Lukavci in the capacity of the DPM because we were informed that the residents were also accommodated in secure wards; and we decided to visit the latter two to learn whether they had established a secure ward since our last visit, or whether there was another method of restricting freedom of movement. In Prizma Ponikve Home, we did not observe rooms or activities aimed at restricting the residents’ freedom of movement and therefore did not continue monitoring in the capacity of the DPM. In the Petrovo Brdo Unit, we found that the institution does not have a secure ward in the usual sense, but the management, state that some residents may not leave the Unit unaccompanied. We suggested either moving these residents to a secure ward of another unit of the institution or notifying the court of their restricted freedom of movement, in accordance with the provisions of the Mental Health Act (ZDZdr). In its response report, the institution stated that they had discussed our proposal with the treating psychiatrist, and it had been agreed that none of the residents needed detention in a secure ward. If the mental conditions of a resident deteriorate, they intend to explain to them the reasons for their restricted freedom of movement and, if they are able to understand, obtain their consent. Otherwise, they would notify the court as proposed. Problems found during visits to the institutions The management of one of the institutions raised the grave issue of accommodating residents in the secure ward without consent based on a court order, despite the lack of vacancies. The Ombudsman has already given an opinion on this matter, stating that such regulation of admissions to the secure ward is deficient. The Ministry of Health and the Ministry of Labour, Family and Social Affairs have also been notified of the inadequate regulation. In May 2011, the latter informed us that a solution to this problem was being prepared in order to establish a network of secure wards in special social care institutions which would uniformly cover the country and provide sufficient capacity for such accommodation. During our visits, the institutions informed us of the growing need for the accommodation of increasingly older people with numerous health problems and, on the other hand, of the growing number of younger residents with addiction problems. The accommodation of elderly people requires more health care personnel, while conflict situations arise in regard to younger people due to aggressive behaviour and verbal violence towards personnel. Where the accommodation situation is poor, generational differences exacerbate the problems. The institutions try to resolve these issues by providing additional training for employees, and organise supervision and intervision for them. 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 45