CHANCELLOR OF JUSTICE AS NATIONAL PREVENTIVE MECHANISM 8. Providers of nursing care services During the reporting year, the Chancellor inspected 8 institutions providing nursing care services: −− Kiviõli Health Centre Foundation (case No 7-9/130607); −− Sillamäe Hospital Foundation (case No 7-9/130437); −− PJV Nursing Care Foundation (case No 7-9/140101); −− East Tallinn Central Hospital Ltd (case No 7-9/131500);84 −− Kilingi-Nõmme Health and Care Centre (case No 7-9/131307); −− Abja Hospital Foundation (case No 7-9/131308); −− Kallavere Hospital Ltd (case No 7-9/131434); −− Pärnu-Jaagupi Care Home Foundation (case No 7-9/140001). PART II PART III The Chancellor also recommended to introduce a register of seclusion, as this helps to prevent the risk of ill-treatment first and foremost for those carrying out the seclusion and also offers a possibility of retroactive analysis of the cases of seclusion based on the information in the register. On the other hand, purposeful maintenance of the register provides a possibility for supervisory authorities to carry out effective review of the lawfulness of seclusion to protect the rights of clients. In order for the register of seclusion to serve its purpose, i.e. provide a quick and general overview of the cases of seclusion, it is important that all the information necessary for establishing the lawfulness of seclusion is entered in it.82 The register must also be accessible to external supervisory authorities to ensure effective control.83 PART IV In the reply to the Chancellor, four of the institutions81 did not consider it necessary to create a permanent seclusion room as they have no need to seclude their clients. PART I by the entrance to a seclusion room should not pose a danger to the person taken to the room or to the staff. On this basis, the Chancellor proposed to ensure the existence of a proper seclusion room in case a need for seclusion arises. The choice of the providers of nursing care services was based on the aim to inspect a diverse range of service providers and on the information available about the institutions in the media.85 In case of nursing care hospitals, the aim was to assess first and foremost the guarantee of the fundamental right to liberty, and in case of five of the inspected institutions the Chancellor also assessed the guarantee of human dignity and obtaining of consent for the provision of health services. Three of the visits to the providers of nursing care services were announced in advance86, while the rest were unannounced. In one of the unannounced inspections, a general practitioner was involved as an expert to assess the quality of the provision of nursing care services and assist the Chancellor’s advisers in carrying out the interviews.87 81 See the inspection visits to Pariisi Special Care Centre Ltd (case No 7-9/131299), Sõmera Home of Hoolekandeteenused Ltd (case No 7-9/130603), South Estonian Care Centre Ltd (case No 7-9/130904) and Haapsalu Welfare Centre Foundation (case No 7-9/130477). 82 See the inspection visits to non-profit association Paju Boarding Houses (case No 7-9/130478), Pariisi Special Care Centre Ltd (case No 7-9/131299), Sõmera Home of Hoolekandeteenused Ltd (case No 7-9/130603), Viljandi Hospital Foundation (case No 7-9/130865) and Kehra Home of Hoolekandeteenused Ltd (case No 7-9/130902). The register of seclusion should contain the following fields: a) description of the situation prior to seclusion, b) time of beginning and end of seclusion, c) cause of seclusion, d) name of the person making the decision, e) sustained injuries, f) information on notifying the ambulance or the police, g) time of notifying the police or the ambulance, h) note on explaining the purpose and cause of seclusion to the secluded person. 83 See the inspection visits to Erastvere Home of Hoolekandeteenused Ltd (case No 7-9/130438) and Viljandi Hospital Foundation (case No 7-9/130865). 84 Järve unit of the nursing care clinic. 85 See the pieces of media coverage in the Introduction to Part I of the report. 86 See the inspection visits to Kilingi-Nõmme Health and Care Centre Foundation (case No 7-9/131307), Abja Hospital Foundation (case No 7-9/131308) and Kallavere Hospital Ltd (case No 7-9/131434). 87 See the inspection visit to East Tallinn Central Hospital Ltd (case No 7-9/131500). 35