1.4 Obiski v domovih za starejše 1.4 Visits to retirement homes 1.4 Obiski v domovih za starejše 1.4 Visits to retirement homes V letu 2014 je DPM obiskal pet domov za starejše: Center starejših Pristan v Vipavi, Center starejših Notranje Gorice, Center starejših Zimzelen v Topolšici, Dom starejših Kranjska Gora in Dom starejših Idila, d. o. o. Pri vseh obiskih so sodelovali predstavniki Varuha, izbranih nevladnih organizacij in zunanji izvedenec – specialist psihiater. We visited five retirement homes in 2014: Pristan Retirement Home in Vipava, Notranje Gorice Residential Centre for the Elderly, Zimzelen Retirement Home in Topolšica, Viharnik Retirement Home in Kranjska Gora and Retirement Home Idila d. o. o. The representatives of the Ombudsman, selected NGOs and an external expert, specialist/psychiatrist participated in all visits. Vsem obiskanim domovom smo v začetku leta 2014 poslali vprašalnik, s katerim smo pridobili osnovne podatke glede organizacije varovanega oddelka, postopka sprejema stanovalca v oddelek, uporabe posebnih varovalnih ukrepov, kadrovske zasedbe, zdravstvene in druge oskrbe stanovalcev ipd. Odgovore na vprašanja smo prejeli še pred samim obiskom, ki je bil nato opravljen nenapovedano. At the beginning of 2014, we sent a questionnaire to all visited institutions, from which we obtained basic information about the organisation of secure wards, the procedure for admitting a new resident to the ward, the application of special protection measures, staffing, health and other care for the residents and similar. Replies to our questions were received before the visits, which were unannounced. Ob vseh obiskih smo s pristojnimi osebami v domu opravili uvodni in končni razgovor – najpogosteje z direktorjem oziroma direktorico, vodjo zdravstvene nege in oskrbe in/ali socialno delavko. Izvedenec DPM se je pogovoril tudi z zdravnikom splošne medicine, ki ima v domu ambulanto, in/ali z domskim psihiatrom. An introductory and concluding discussions were held with the relevant persons in the institutions; these were most frequently directors, heads of health care and/or social workers. The NPM expert also held a discussion with the general practitioner at the institution and/or the resident psychiatrist. Ob obiskih smo si ogledali varovane oddelke, se pogovorili z nekaterimi naključno izbranimi stanovalci in zaposlenimi na oddelku. Ogledali smo si skupne prostore izven varovanega oddelka, ki jih lahko uporabljajo stanovalci varovanih oddelkov (npr. večnamensko dvorano, prostore fizioterapije, prostor za verske obrede), in prostore, v katerih se izvaja zdravstvena dejavnost. Po opravljenem obisku smo pripravili predhodno poročilo, ki smo ga poslali obiskanemu domu s predlogom, da se z njim seznani, ga obravnava in nas obvesti o svojih stališčih glede naših ugotovitev in predlogov. Odziv doma smo vključili v končno poročilo o obisku, s katerim smo seznanili Socialno inšpekcijo in Ministrstvo za delo, družino, socialne zadeve in enake možnosti – slednjega s predlogom, da nam posreduje svoja stališča o ugotovitvah in predlogih, podanih v poročilu, ter morebitne ukrepe, ki bi jih na podlagi poročila sprejelo. A preliminary report was prepared after each visit and sent to the visited institution; we suggested they consider it and notify us on their views on our findings and proposals. The response of the institution was included in the final report on the visit which we submitted to the Social Affairs Inspection Service and the Ministry of Labour, Family, Social Affairs and Equal Opportunities, which we asked to submit positions on the findings and proposals provided in the report and possible measures which they would adopt on the basis of the report. Living conditions in secure wards Bivalni pogoji v varovanih oddelkih Vsi obiskani domovi za starejše so zasebni zavodi, ki imajo koncesijo za izvajanje storitve institucionalnega varstva starejših. Odprti so bili v zadnjih letih, od 2008 dalje, zato so bivalni pogoji na varovanih oddelkih teh domov zelo dobri. Domovi so manjših kapacitet (od 104 do 205 postelj). Varovani oddelki (VO) obiskanih domov imajo po 12 postelj, v Centru starejših Pristan varovani oddelek sestavljata dve varovani enoti, vsaka z 12 posteljami in skupnim večnamenskim prostorom, v Domu starejših Idila pa sta prav tako dva oddelka oseb z demenco, ki sprejmeta od 18 do 23 stanovalcev. Dom starejših Kranjska Gora je nekoliko drugačen, saj nima klasičnih oddelkov, temveč t. i. gospodinjske skupnosti. Dve od njih sta bili v času našega obiska še t. i. skupini s povečano pozornostjo za osebe z demenco. Skladno z Dopolnitvami k Usmeritvam za delo z osebami z demenco na področju institucionalnega varstva starejših (Usmeritve), ki jih je MDDSZ konec marca 2014 poslalo vsem domovom, se oddelki s povečano pozornostjo dokončno ukinjajo. Tudi omenjeni zavod se je odločil, da obe gospodinjski skupnosti za osebe z demenco opredeli kot integrirano obliko oskrbe, in ne kot varovane oddelke. Ker se je to zgodilo šele po našem obisku, bomo v tem poročilu kot varovana oddelka v tem domu razumeli omenjeni dve gospodinjski skupnosti. Dom starejših Kranjska Gora lahko sprejme 27 oseb z demenco (v eni enoti 14 oseb, v drugi 13). Dom starejših Idila verifikacije oddelkov nima, Center starejših Zimzelen je pridobil verifikacijo za VO aprila 2013, v Centru starejših Pristan in Centru starejših Notranje Gorice pa sta bila postopka pridobivanja verifikacije na dan, ko smo opravili obisk, še v teku. 94 We reviewed secure wards and spoke to some randomly selected residents and staff at the ward. We reviewed common areas outside secure wards, which can also be used by residents of secure wards (e.g. multi-purpose hall, physiotherapy facilities, area for religious service), and premises where medical activities are implemented. 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 All visited retirement homes are private institutions with concessions to implement services of institutional care for the elderly. They have opened in recent years, from 2008 onwards, and have very good living conditions in secure wards. The homes have small capacities (between 104 and 205 beds). Secure wards have 12 beds; two secure wards at Pristan Retirement Home have 12 beds each and a common multi-purpose room; Retirement Home Idila has two units for persons with dementia, which can accommodate between 18 and 23 residents. The retirement home in Kranjska Gora is somewhat different, because it does not have classic units, but so-called household communities. Two of these communities at the time of our visit were so-called groups dedicated to residents affected by dementia. As per the Amendments to the Guidelines on working with persons with dementia in the field of institutional care for the elderly (Guidelines), which the Ministry of Labour, Family, Social Affairs and Equal Opportunities submitted to all retirement homes at the end of March 2014, high-level supervision wards are being terminated. The aforementioned institution also decided to define the two household communities for persons with dementia as an integrated form of care and not as secure wards. Since this happened after our visit, the secure wards of this retirement home mentioned in this report will be understood as the aforementioned household communities. The retirement home in Kranjska Gora can accommodate 27 persons with dementia (14 persons in one unit and 13 in the other). Retirement Home Idila does not have certification; Zimzelen Retirement Home obtained certification for secure wards in April 2013, and on the day of the visits, Pristan Retirement Home in Vipava and Notranje Gorice Residential Centre for the Elderly were still in the process of obtaining certification. 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 95