Poročilo Varuha človekovih pravic Republike Slovenije o izvajanju nalog državnega preventivnega mehanizma za leto 2011 Obiski domov za starejše Leta 2011 smo obiskali Dom upokojencev Nova Gorica (17. 2. 2011), Dom starejših Laško (16. 3. 2011), Zavod sv. Martina v Srednji vasi v Bohinju (9. 6. 2011), Dom starejših Lambrechtov dom v Slovenskih Konjicah (8. 9. 2011) in Dom pod Gorco Maribor (13. 12. 2011). Vsi obiski domov za starejše so bili nenapovedani in pri vseh so sodelovali predstavniki izbranih nevladnih organizacij. Obiski so vključevali pogovor z vodstvom, ogled varovanih oddelkov in drugih prostorov zavoda ter pogovore z naključno izbranimi stanovalci, ne glede na to, da je zaradi težav pri izražanju in okrnjenem spominu, ki je značilen za demenco, komunikacija s stanovalci mnogokrat otežena. O vsakem obisku smo pripravili predhodno poročilo, ki smo ga poslali obiskanemu zavodu s predlogom, da ga obravnava in nas obvesti o svojih stališčih do ugotovitev in predlogov DPM. S končnim poročilom, ki je vključevalo tudi odziv zavoda, smo seznanili Ministrstvo za delo, družino in socialne zadeve. Ugotavljamo, da zavodi skrbno in sproti obravnavajo predhodna poročila DPM in se na ugotovitve in predloge DPM v glavnem ustrezno odzivajo. Dva od obiskanih domov sta javna zavoda, trije so zasebni zavodi s koncesijo za opravljanje storitve institucionalnega varstva starejših od 65 let. Obiskani domovi so novejšega datuma gradnje ali pa so bili vsaj delno obnovljeni, tako da so na varovanih oddelkih praviloma dobre bivalne razmere, čeprav smo opazili tudi posebnosti, ki jih omenjamo v nadaljevanju. V enem izmed novejših zavodov smo tako morali kritizirati neprimerne arhitekturne in tehnične rešitve, zaradi katerih je na oddelku v poletnih mesecih nesprejemljivo visoka temperatura prostorov. DPM je zavod podprl pri iskanju rešitev oziroma zavzemanju za odpravo ugotovljenih napak in pri čimprejšnji ureditvi ustreznega hlajenja prostorov. V drugem zavodu, kjer je varovani oddelek organiziran v prostorih, ki so bili prvotno načrtovani in grajeni za potrebe oskrbovanih stanovanj, pa smo ugotovili, da ni neposrednega dostopa na zunanje površine. Še posebej nas je zmotilo, da sta bila ob tem hodnik in večnamenski prostor, kjer se čez dan zadržujejo stanovalci, manjše kvadrature in sta delovala utesnjujoče. Po mnenju DPM pa sta tudi neustrezna za nemirne stanovalce, še posebej, ker je večino dneva gibanje stanovalcev omejeno na oddelek. Ta zavod sicer načrtuje svojo širitev oziroma dograditev prizidka, v pritličje katerega naj bi selil tudi varovani oddelek. Vsi varovani oddelki so bili med našim ogledom čisti in brez neprijetnih vonjav. Zmogljivost varovanih oddelkov v obiskanih zavodih je bila od najmanjšega oddelka z 12 posteljami do največjega s 33 posteljami. Sobe so praviloma eno- ali dvoposteljne, v dveh domovih pa še imajo tudi štiriposteljne sobe. V domovih smo preverjali delovanje klicnih zvončkov in odzivni čas osebja. Odzivnost je bila dobra. DPM sicer spodbuja zavode, da vzpostavijo tak klicni sistem oziroma računalniško podprtost klicnega sistema, da bi bilo mogoče preverjati, kako hiter je odziv zaposlenih na klic. Glede odzivnosti osebja so nam v enem zavodu pojasnili, da so kot najdaljši reakcijski čas dovolili odziv osebja v 15 minutah. DPM je presodil, da je ta čas predolg, glede na to, da naj bi se zvončki uporabljali tudi kot klic na pomoč. V odzivnem poročilu je zavod pojasnil, da je upošteval predlog DPM in da je že vzpostavil računalniški sistem, ki omogoča nadzor nad odzivnim časom pri klicih z varovanega oddelka. 48 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 nursing homes In 2011, we visited Nova Gorica Nursing Home (17 February 2011), Laško Nursing Home (16 March 2011), St. Martin Institution in Srednja vas v Bohinju (9 June 2011), Lambrechtov dom Nursing Home in Slovenske Konjice (8 September 2011) and Dom pod Gorco Maribor Nursing Home (13 December 2011). All visits to nursing homes were unannounced, and representatives of the selected nongovernmental organisations participated in all of them. The visits included an interview with the management, the inspection of secure wards and other rooms of the institution, and interviews with randomly chosen residents, notwithstanding that communication with the residents was often difficult because of their problems with expression and unreliable memory. A preliminary report was prepared after each visit and sent to the visited institution; we suggested they consider it and notify us of their views on 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. We observe that the institutions consider the preliminary reports of the DPM promptly and with due care, and usually respond adequately to the findings and proposals of the DPM. Two of the homes are public institutions and three are private institutions with a concession to perform the services of institutionalised care of people aged over 65. The homes were recently constructed or partially renovated, so the secure wards offer good living conditions, although some particularities were noticed, which are mentioned below. In one of the newer institutions, we had to criticise unsuitable architectural and technical solutions, which make the ward unacceptably hot in summer months. The DPM supported the institution in finding a solution or making a commitment to eliminate the established defects and to promptly regulate cooling of the rooms. In another institution, where the secure ward is organised in rooms originally designed and constructed for the needs of sheltered housing, we found that there is no direct access to outdoor areas. We were particularly disturbed by the fact that the hall and multi-purpose room where the residents stay during the day were rather small and rather confining. In the opinion of the DPM, they are not appropriate for restless residents, particularly because the movement of residents is restricted to the ward for most of the day. This institution plans to construct an extension and the secure ward is to be transferred to its ground floor. All secure wards were clean and without unpleasant odours during our visit. The capacities of the secure wards in the visited institutions ranged from the smallest, with 12 beds, to the largest, with 33 beds. The rooms have usually one or two beds, and two homes have four-bed rooms. We checked the functioning of call bells and the response time of personnel. The responsiveness was good. The DPM encourages the institutions to establish such a call system or computer-aided call system to enable verification of the responsiveness of the employees. With respect to the responsiveness of personnel, one of the institutions explained that the maximum reaction time was set to 15 minutes. The DPM considered this too long, as these bells are also intended for calls for help. In its response report, the institution explained that they had implemented the DPM proposal and established a computer system allowing surveillance of reaction times for calls from the secure ward. 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 49