CHANCELLOR OF JUSTICE AS NATIONAL PREVENTIVE MECHANISM On this basis, the Chancellor proposed to ensure that all the staff whose tasks involve communicating with patients and taking care of their needs are sufficiently able to communicate with patients who speak only Estonian, so as to ensure their right to the protection of health and treatment in line with human dignity.113 9. Providers of general care services During the reporting year, the Chancellor inspected one provider of general care services: Aa Care Home of Häcke Ltd (case No 7-9/130528). PART II PART III The Chancellor is of the opinion that providers of nursing care services must ensure that the staff who come into contact with the patients are able to communicate with them to the necessary extent in a language understood by them. If a provider of nursing care service does not understand the language spoken by a patient and the concerns expressed by them, a risk of misinterpreting a patient may occur and they might not receive the necessary assistance.112 By using next of kin as interpreters a provider of nursing care services takes a risk that a patient’s consent is not based on relevant and complete information or the patient did not actually give the consent. PART IV To better guarantee the right to the protection of health arising from § 28(1) of the Constitution, it is necessary that hospital staff are able to communicate with the patients in a language understood by them. The skill and ability to communicate with patients is also necessary to ensure their human dignity during the provision of the service, so as to understand the concerns of the patients and offer them the best possible assistance. Language barrier may also be an obstacle to repeating essential information to the patients. PART I not speak Estonian. In addition, during the inspection visit one of the nursing care patients only spoke a foreign language which none of the hospital staff spoke, and in case of need the assistance of the patient’s relative was used to be able to communicate. The aim of the inspection was to assess whether the service provider unlawfully restricts the liberty of service recipients. During the Chancellor’s 2007 inspection visits it was found that the general care home had a department with reinforced supervision where clients were secluded in a seclusion room not conforming to the requirements.114 The inspection revealed that the institution had a seclusion room although recipients of general care services may not be secluded and the institution did not have an operating permit for the provision of 24-hour special care service. The furnishings of the seclusion room were such that they could enable people staying in the room to cause injuries, the room had poor general lighting, it smelled of tobacco, and it was generally dirty. According to the service provider, the seclusion room was not used. The Chancellor reached the opinion that the existence of a seclusion room in an institution where seclusion is not allowed constitutes a potential danger to the fundamental right to liberty and leaves a possibility for unjustified restriction of this right. On this basis, the Chancellor proposed to change the furnishings and function of the seclusion room in the general care home so as to eliminate the danger of restricting the fundamental right to liberty. 112 See also the European Court of Human Rights judgment of 8 July 2004 in case No 53924/00, Vo v. France, para 10–12. 113 In case of patients speaking only foreign languages the Chancellor recommended using such ways of communicating and exchanging information with a patient that ensure the patient’s right to the protection of health and human dignity, including in obtaining the pertinent consent for the provision of the nursing care service and in satisfying the patient’s daily needs. 114 The Chancellor’s inspection visits of 18 June 2007 and 2 August 2007 to Aa Care Home of Ltd Häcke (case No 7-9/071015). 39

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