Poročilo Varuha človekovih pravic Republike Slovenije o izvajanju nalog državnega preventivnega mehanizma za leto 2011 V drugem izmed zavodov, kjer so na varovanem oddelku klicni zvonci ob vratih sobe, ne pa vedno tudi ob posteljah, pa smo kritizirali, da ni izdelanega protokola glede nameščanja klicnih zvoncev k postelji. DPM namreč meni, da mora biti vsaka odstranitev oziroma nenamestitev klicnega zvonca, predvsem pri nepomičnih stanovalcih (ki ne morejo doseči klicne tipke na steni), ustrezno protokolirana, tako da je omogočen nadzor, na čigavo pobudo in na podlagi čigave presoje je bil klicni zvonec odstranjen ali ni bil nameščen. V dveh zavodih varovana oddelka nimata neposrednega izhoda na zelene površine urejene okolice, ker sta v nadstropju. Je pa v enem od njiju v sklopu oddelka večji odprt balkon (terasa), kamor pospremijo stanovalce, da so na svežem zraku. Dve stanovalki sta v tej zvezi v pogovoru s predstavniki DPM povedali, da so sprehodi zunaj tega oddelka redkejši, kakor bi si želele. DPM meni, da je zadrževanje stanovalcev na svežem zraku izjemno pomembno za njihovo dobro počutje in splošno zdravstveno stanje. Zato je DPM v tem primeru zavodu predlagal, da nameni posebno pozornost izhodom stanovalcev na svež zrak in zapisuje tovrstne izhode, da se ne bi kakšen stanovalec pri takšnih izhodih (ne) namerno izpustil. Drugi zavod pa že načrtuje svojo širitev oziroma dograditev prizidka, v pritličje katerega naj bi selil tudi varovani oddelek. Ko stanovalcem ni omogočen neposreden dostop do zunanjih površin in so pri zadrževanju na svežem zraku v celoti odvisni od osebja ali svojcev, DPM sicer preverja tudi, kako se omogočajo stanovalcem izhodi na svež zrak in ali jih zapisujejo. V enem izmed obiskanih varovanih oddelkov, kjer stanovalci nimajo neposrednega dostopa na svež zrak, smo tako ugotovili, da vsakemu stanovalcu omogočijo, da v spremstvu zaposlenih vsaj enkrat na dan odide v okolico doma. O sprehodih pa se vodi tudi evidenca. Najpogosteje ugotovljena nepravilnost pri obiskih domov za starejše se nanaša na postopek sprejema stanovalca na varovani oddelek. Ugotovili smo, da zavodi ne ravnajo po določbah ZDZdr. Glede na pojasnila, ki smo jih dobili od pristojnih, in iz dokumentacije, ki smo jo pregledali, lahko podamo splošno ugotovitev, da večina sprejemov na varovane oddelke še vedno temelji na soglasju svojcev ali skrbnikov za poseben primer, čeprav ZDZdr določa, da se sprejem lahko opravi le na podlagi privolitve stanovalca (če je stanovalcu odvzeta poslovna sposobnost, pa s soglasjem zakonitega zastopnika) ali na podlagi sklepa sodišča. V enem izmed obiskanih zavodov, kjer so bili vsi sprejemi opravljeni zgolj na podlagi soglasja skrbnikov (za poseben primer), smo zavodu predlagali, da o osebah, nameščenih na varovani oddelek, nemudoma obvesti sodišče, kar je zavod nato tudi storil. V drugem zavodu so nekateri sprejemi sicer temeljili tudi na privolitvah stanovalcev, vendar se nam je v pogovorih s stanovalci vzbudil dvom, ali so bili ti stanovalci sposobni razumeti svoj položaj in pomen privolitve. Na to smo opozorili zavod, ki je pojasnil, da so nekatere osebe že več let (tudi šest) nastanjene na varovanem oddelku in da se je njihovo zdravstveno stanje šele v zadnjem času toliko poslabšalo, da ne razumejo več svojega položaja in nam zato niso bili sposobni izraziti privolitve. Ker so bile v tem zavodu nekatere osebe sprejete tudi na podlagi soglasja skrbnikov za poseben primer, smo zavodu predlagali, da preveri vse postopke namestitev stanovalcev na varovani oddelek in o namestitvah, ki niso v skladu z ZDZdr, obvesti sodišče. Zavod je nato sporočil, da je predlog DPM upošteval in sodišče obvestil o dveh namestitvah: pri prvi namestitvi je šlo za primer, ko je soglasje za sprejem podpisala le skrbnica za poseben primer, pri drugi pa za stanovalko, ki je z varovanim oddelkom sicer zadovoljna, vendar ga občasno želi zapustiti. 50 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 In another institution, where call bells in the secure ward were located next to the door of the room, but not always next to beds, we criticised the absence of a protocol specifying the installation of bells next to beds. In the opinion of the DPM, each removal or non-installation of a call bell, particularly in immobile residents (who cannot reach the bell on the wall), must be specified in a protocol to monitor upon whose initiative and based upon whose assessment the bell was removed or not installed. Because they are located on the higher floor, the secure wards in two institutions lack a direct exit to the green surfaces of the surrounding arranged area. In one of them, there is a larger balcony (terrace) within the ward where residents are escorted to enjoy the fresh air. In this respect, two residents told the DPM representatives that walks outside the ward are less frequent than they would like. In the opinion of the DPM, being in the fresh air is extremely important for the well-being and general health of the residents. In this case, the DPM suggested to the institution that they dedicate more attention to residents being in the fresh air and keep a record of such periods so that none of the residents is (un)intentionally left out. The second institution plans to construct an extension and the secure ward is to be transferred to its ground floor. When residents do not have direct access to outdoor areas and are dependent entirely personnel or relatives in order to go outside, the DPM also verifies how these exits are organised and whether records are kept. In one of the visited secure wards without direct access to outside, we learned that each resident is escorted at least once per day to walk around the institution. Records are kept of the walks. The most commonly established irregularity observed in nursing homes concerns the procedure for admitting a resident to the secure ward. We found that the institutions do not observe the provisions of ZDZdr. Considering the explanations received by the competent staff and the reviewed documentation, we may make the general observation that the majority of admissions to the secure ward is still based on the consent of relatives, or custodians in special cases, although ZDZdr requires that admission may be carried out only with the resident’s consent (or that of their legal representative if their contractual capacity has been discontinued) or based on a court decision. In one of the institutions we visited, where all admissions were carried out only with the consent of custodians (in special cases), we proposed that they notify the court of the persons accommodated to the secure ward, which the institution later did. In another institution, some admissions were based on the residents’ consent; however, when we talked to the residents, we doubted that they had been able to understand their situation and the meaning of consent. We warned the institution thereof, and they explained that some persons had been accommodated in the secure ward for several (up to six) years and that their health had deteriorated recently so as to prevent them from understanding their situation, and they were thus not able to give consent. Because some persons were admitted to this institution based on the consent of custodians for special cases, we proposed that the institution check all procedures for accommodating residents to the special ward and notify the court of any accommodation not in accordance with ZDZdr. The institution later informed us that it had observed the DPM proposal and notified the court of two accommodations: the first was a case where consent was given only by a custodian for special cases, and the other was a resident who is otherwise satisfied with the secure ward, but who occasionally wants to leave. 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 51