explained that the unit is locked so as to ensure the safety of individual residents wandering, and that the residents can leave the unit only if accompanied by staff,27 but that otherwise SEWCC does not have a secure department. We therefore recommended: • that the unit act in accordance with the ZDZdr and notify the court of people who are unable to leave the Polž and other units of their own free will and of people for whom such a regime will be set up in the future, if these are people defined by Article 2 of the ZDZdr and who do not or cannot provide their consent (independently or through their legal representative if these are people who have been deprived of their legal capacity) in accordance with Article 74 of the ZDZdr. In this way, SEWCC would leave the (final) judgement on whether it meets the conditions under Article 2 of the ZDZdr to the court. In its response to our preliminary report, the institution explained: “SEWCC will search for different possible solutions of how to ensure users’ safe and unrestricted movement in their environment. In the light of the type of our activities (work and care centre), we are aware that, with appropriate approaches and staff structure within individual units accommodating users, we can ensure optimal care and control over people who are unable to independently take care of themselves and who have been deprived of their legal capacity. Problems arise occasionally during the night and on weekend duties and in the event of increased absence of staff due to sick or annual leave. In such cases, the shortage of space within the crammed central building of Črna SEWCC becomes even more evident. We believe that in the light of the above, notifying the court is not an optimal solution for solving such cases. We anticipate that investments in the refurbishment of the entire building and the already presented investments will allow us to humanely reduce or eliminate these problems, which also appear due to ageing, which, in addition to the main disorder, also brings emerging dementia and consequently a fast decline in users’ psycho-physical capacities, for which more appropriate work programmes and content will have to be arranged in the future.”28 Enclosure beds were noticed in this institution but no (medical) records were being kept on their use as stipulated by the ZDZdr for the implementation of special precautionary measures. One of these beds is shown in the photo:: One of the five enclosure beds We asked the opinion of external expert, Associate Professor Dr Peter Pregelj MD, Psychiatry Specialist, on the appropriate use of enclosure beds, who said: “In light of what was stated, there is no professional justification for using enclosure beds even though the outdated guidelines on the use of special precautionary measures in psychiatry do not prevent the use of enclosure beds (Dernovšek and Novak Grubič, 2001). The use of enclosure beds does not provide sufficient safety (the danger of bringing 27  We agree that restricting independent exits can be necessary for individual residents so as to ensure their safety. However, we also believe that the valid restrictions of movement in the Polž unit, especially that of residents who can leave only in the company of staff, can encroach upon the freedom of individual residents, resulting in actually restricting their freedom of movement. 28  With regard to the use of enclosure beds, SEWCC explained that these beds are used exclusively for ensuring the safety of users at rest time, and exceptionally for providing a safe environment if working individually with another user, but they are never used, and nor is it allowed to use them as any kind of educational measure. These beds are used for the rest and sleep of users who are unable to predict the consequences of their movements, which could mean that such a user, if an employee is not present (especially during night or daytime rest), could suffer an injury due to falling out of bed. SEWCC emphasised that they were aware that users must be provided with ample opportunity for movement and other activities; however, they are limited in doing so due to staffing standards, which is especially evident with users who require someone to help them with the majority of the activities. SEWCC believes that these beds still allow users more activity and the possibility of changing positions than sitting strapped in a wheelchair, while they also provide safety to the user and their environment. The ZDZdr does not foresee the use of enclosure beds as a special precautionary measure. The third paragraph of Article 29 of this Act stipulates only two special precautionary measures: “Special precautionary measures are physical restraint using belts and restricting movement to a single room. Enclosure beds cannot be classified into either of these two measures. Restricting movement to a single room foresees the use of a room where an individual’s movements are restricted.” IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2017 NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT 81

Select target paragraph3

Connect to a paragraph
Connect to an entity
Disable highlights
Add to table of contents