VIII)  Permanently unemployable convicts 4) Provision of care and the role of “carers“ Assistance and support in coping with everyday tasks, meal, personal hygiene, moving around and some nursing tasks concerning PUCs who need them on account of their medical condition, are generally ensured in prisons by employed convicts, or they are provided on an informal (volunteer) basis. In light of ECtHR case law, provision of care by fellow convicts on a volunteer basis must be resolutely rejected. 112 While the Convention does not stipulate the right to social care, the ECtHR has repeatedly concluded that the duties of the State in ensuring adequate conditions in detention include addressing the special needs of convicts with disabilities. Moreover, the State cannot relieve itself of the duty by transferring it to the other prisoners. 113 I have encountered cases where convicts dependent on care were cared for by another convict, one who was not assigned to the position of carer and was rewarded for these activities in terms of disciplinary steps. I documented a case of a convict who suffered from faecal incontinence and was in need of assistance with bathing. He was cared for by a fellow convict who cleaned the toilet after him, helped him exchange incontinence aids and bathed him. The dependent convict gave him money (approx. CZK 800) for which the carer bought things in the canteen. If a convict is dependent on care (needs assistance with bathing, exchanging incontinence aids, etc.), he should receive it only from convicts officially employed by the prison as carers. In cases where care is provided by another convict informally, there is an increased risk the carer would abuse this dependence relationship. I consider the above-described case as impermissible. Convicts employed as carers are designated as carers or medical assistants, sometimes as carers for immobile convicts. These are employed convicts who are not considered orderlies in the sense of RDG No. 17/2013, stipulating the conditions for the activities of an orderly by imprisoned persons in health care facilities of the Prison Service of the Czech Republic that provide in-patient care. 114 The aforementioned activities of carers as I encountered them in the visits to the three relevant prisons are not covered by any special internal regulation of the Prison Service. The responsibilities of a carer, or a medical assistant, as observed in practice in the visited blocks, include assistance to the convicts in need with basic self-maintenance tasks – personal hygiene, exchanging incontinence aids, bringing in and distributing food, preparing insulin pens, etc. The scope of the working tasks of carers is not defined by internal regulations 115, there are no qualification requirements (e.g. training for certain tasks, etc.). In one case, care for the convicts was always provided by two carers whose standard working time was 8 hours. However, there was nobody to substitute for them, which meant they were providing care continuously. Moreover, in order to be always available, the carers were living in the same bedroom (joint bedrooms with barrier-free toilet) as the convicts who needed maximum assistance. The carers did not have time to rest nor 8 hours of undisturbed sleep.��116 112 Cf. judgements of the European Court of Human Rights in cases Farbtuhs v. Latvia, par. 60; Kaprykowski v. Poland, of 3 February 2009, no. 23052/05, par. 74; D. G. v. Poland, par. 147; Grimailovs v. Latvia of 25 June 2013, no. 6087/03, par. 161; Semikhvostov v. Russia, par. 84. 113 For more details, see Grimailovs v. Latvia. 114 The individual activities that can be carried out by convict orderlies are specified in Section 4 of the above-mentioned RDG. 115 Cf. Section 116 of Act No. 108/2006 Coll., on social services, as amended. 116 SCf. Section 16 (5) of the Imprisonment Act. /38/