1.4 Obiski v domovih za starejše 96 1.4 Visits to retirement homes Trije od obiskanih varovanih oddelkov so tehnično varovani z elektronsko ključavnico, vrata se odpirajo bodisi z magnetno kartico bodisi na kodo oziroma s ključem. Three of the visited secure wards were technically secured with electronic locks with doors which are opened with a magnetic card, a code or a key. Dom starejših Kranjska Gora je imel sprva prilagojeno kljuko, ki pa jo je kasneje, na podlagi odločitve za integrirano obliko oskrbe in našega priporočila, nadomestil z navadno, kot so zapisali v odzivnem poročilu. The retirement home in Kranjska Gora had an adjusted door handle which was later replaced with a regular one on the basis of the decision on an integrated form of care and our recommendation as was stated in the response report. Sobe so eno- ali dvoposteljne, prostorne in svetle, ponekod nadstandardne, vse z lastno kopalnico. Prostorni in svetli so tudi večnamenski prostori s čajnimi kuhinjami. Negovalne kopalnice so funkcionalno opremljene. Ustrezni so tudi prostori za zdravstveno dejavnost. Rooms have one or two beds; they are spacious and bright; some are above-standard and all have their own bathroom. Multi-purpose halls are also spacious and bright and have kitchenettes. Bathrooms include functional equipment. Premises for medical activities are also suitable. Sobe v nekaterih domovih sicer delujejo nekoliko brezosebno in hladno, zato smo predlagali, da se stanovalci spodbujajo k njihovemu opremljanju, predvsem z osebnimi predmeti, ki jih še prepoznajo. Predlagali smo tudi, da se hodniki opremijo tako, da bo stanovalcem olajšana orientacija v prostoru. The rooms in some homes were somewhat impersonal and cold, and we suggested that the residents should be encouraged to decorate them, particularly with objects they still recognise. We also proposed that corridors be equipped in order to facilitate the residents’ orientation in space. Na naš predlog so se domovi odzvali s pojasnilom, da stanovalcem ponudijo možnost in jih spodbujajo, da si sobe opremijo s slikami in osebnimi predmeti, da pa se le redki odzovejo. The retirement homes responded that their residents were given the opportunity and were encouraged to decorate rooms with pictures and personal objects, but only a few responded. V enem od obiskanih domov (Center starejših Pristan) smo ugotovili, da nekateri stanovalci čez dan nimajo vedno zagotovljenega nemotenega dostopa do svojih sob. Takrat, ko so v večnamenskem prostoru, se namreč občasno zapirajo vrata na hodnik, ki vodi do njihovih sob. S tem se poskuša preprečiti, da bi se nenadzorovano sprehajali po tem hodniku in hodili v sobe (saj nekateri od njih urinirajo po tleh), predvsem pa se poskuša preprečiti, da bi odtavali z oddelka takrat, ko so na koncu tega hodnika odprta vrata, ki vodijo z oddelka. Na varovanem oddelku ima namreč svoje prostore tudi pedikerka, zato z odprtimi vrati oddelka tudi drugim stanovalcem doma želijo omogočiti prost dostop do njenih prostorov. Menili smo, da je dodatno omejevanje gibanja stanovalcem v VO nedopustno, pa tudi v nasprotju z Zakonom o duševnem zdravju (ZDZdr), pa naj gre za izjemo ali stalnost, še posebej, ker se s to omejitvijo stanovalcem onemogoča dostop do njihovih sob. Predlagali smo, da dom najde drugačno rešitev, ki ne bo omejujoča za stanovalce VO. We established that in one retirement home (Pristan Retirement Home), some residents did not always have uninterrupted access to their rooms throughout the day. When they were in the multi-purpose room, the door in the corridor leading to their rooms was occasionally locked in order to prevent people from unsupervised walking along this corridor and entering rooms (some people urinate on the floor), and to particularly prevent them from wandering off the ward when the doors at the end of the corridor, which lead from the ward, are open. The pedicurist also had her premises in the secure ward, and by keeping the door open, other residents also had free access to her premises. We believe that additional restriction of movement of residents in the secure ward was inadmissible and also contrary to the Mental Health Act (ZDZdr), whether an exception or regular practice, particularly because such restriction denies residents to access their rooms. We proposed that a different solution be found which would not restrict residents of the secure ward. Dom na naša priporočila ni imel pripomb in je sporočil, da se bo trudil, da bo priporočila in predloge DPM za izboljšanje stanja čim prej uvedel v delo na varovanem oddelku. The retirement home did not comment, and informed us that they would make every effort to implement the NPM recommendations and proposals in the secure ward as soon as possible. Ob naših obiskih so bili VO primerno ogrevani in čisti, neprijetnih vonjav praviloma ni bilo zaznati. V nasprotnem primeru smo predlagali, da se pogostost prezračevanja prostorov prilagodi razmeram na oddelku oziroma da se ustrezneje ravna z rabljenimi inkontinenčnimi pripomočki. During our visits, secure wards were suitably heated and clean; no unpleasant odours were detected. We suggested that the frequency of airing rooms be adjusted to conditions in the ward, or that used incontinence products be handled accordingly. Na naše priporočilo se je dom odzval s pojasnilom, da je prezračevanje redno organizirano s strani osebja in da se oddelek, kjer stanovalka urinira po kotih in po tleh, pogosteje čisti, vendar se je urin že zažrl v talno PVC-oblogo, zato se vonja ne da več odstraniti. Tako razmišlja, da bi poleg prezračevanja na oddelke vnesel tudi osvežilce oziroma nevtralizatorje vonja. Glede ravnanja z odpadnimi inkontinenčnimi pripomočki pa je pojasnil, da so za njihovo odnašanje trikrat dnevno zadolžene strežnice. Če se večje število tovrstnih odpadkov pojavi tudi po kopanju, imajo zaposleni možnost in navodilo, da odpadke iz prostorov oddelka redno odstranjujejo. V času, ko je dom pošiljal svoj odziv na predhodno poročilo DPM, je potekal tudi poostren nadzor in kontrola zaposlenih nad ravnanjem z odpadki. The retirement home responded to our recommendation that the staff regularly air the rooms and that the ward, where a resident was urinating in corners and the floor, was cleaned more frequently, but the urine had already eaten into the PVC flooring and the odour could no longer be removed. They thus considered that in addition to airing, air-fresheners or odour neutralisers would also be used in the wards. Relating to the used incontinence products, the retirement home explained that attendants were responsible for their disposal three times a day. In the case of larger quantities of such waste during bathing, staff were ordered to regularly remove waste from the premises. At the time the retirement home was replying to the NPM preliminary report, tighter supervision and control of the staff’s treatment of waste were being implemented. K varovanim oddelkom sodi tudi ograjena zunanja površina, ki je namenjena varnemu zadrževanju stanovalcev na svežem zraku. Stanovalci so pri zapuščanju oddelka oziroma doma omejeni, saj ga praviloma lahko zapuščajo le v spremstvu, zato ocenjujemo, da je zanje toliko bolj pomembna funkcionalna ureditev varovane zunanje površine. Ocenili smo, da bi lahko bile tako v centru v Notranjih Goricah, Centru starejših Pristan in Domu starejših Kranjska Gora te površine bolje izkoriščene. Pogrešali smo npr. več zelenja, živo mejo, ki bi zakrila varovalno (žičnato) ograjo, krožne poti in dovolj primerno zasenčenih prostorov za posedanje. Secure wards also include enclosed outdoor surfaces intended for the safe movement of residents in the fresh air. The movement of residents in the ward or the home is limited, since they may only leave the home when escorted. We thus assess that a functional arrangement of a secure outdoor surface is even more important. We evaluated that these surfaces in Notranje Gorice Residential Centre for the Elderly, Pristan Retirement Home and the retirement home in Kranjska Gora could be utilised more. There was insufficient greenery and no hedgerow to cover the safety (wire) fence, circular paths and an insufficient number of suitably shaded areas for sitting. V vseh treh domovih smo v zvezi s tem prejeli pojasnilo, da na videz vrta vpliva letni čas in da se zunanja površina še ureja ter da bo prava podoba vidna čez nekaj let. Nekateri domovi so poudarjali, da je ureditev povezana tudi z (omejenimi) finančnimi zmožnostmi. In this regard, all three retirement homes explained that seasons affect the appearance of the garden and that outdoor surfaces were still being arranged and would acquire the proper appearance in a few years. Some retirement homes emphasised that the arrangement was also connected to their (limited) financial means. poročilo o izvajanju nalog DPM v letu 2014 DržavnI preventivnI mehanizEm 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 NPM IN 2014 National Preventive Mechanism under the Optional Protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 97