own request and a person may not be held in a general care home against their will.
A major problem in all the care homes inspected is shortage of staff, which can in particular
be felt in the evening and at night. Although the Social Welfare Act does not say how many
carers must be at work when providing the general care service, the law requires that an
operator of a care home must ensure sufficient staff numbers, so that in view of staff
preparation and workload it is possible to offer people the necessary care and assistance.
When planning staff numbers, it is necessary to assess how much assistance and attention
the residents of a care home need, and also consider other circumstances (particular features
of buildings, the existence of an assistance call system, etc.). Care home residents are in a
vulnerable situation due to their poor health and/or advanced age. Therefore, in a judgment
delivered in 2019, the Supreme Court emphasised that the operator of a care home has an
elevated duty of care in respect of residents. If staff are overburdened they do not have
sufficient attention for all care home residents (for example, to empty bedpans and change
diapers without delay), which may lead to inhumane treatment.
A general problem is that care plans are not properly filled out. A care plan is an effective tool
for staff in their day-to-day work, but for this the plan must be filled out clearly, thoroughly
and with careful consideration. A care plan must offer easy access to information about a
resident’s ability to cope, as well as activities planned for preserving or improving a person’s
health. A care plan should also describe what activities could be offered to a person with a
view to making their days more meaningful. The Chancellor recommended that, inter alia, the
explanatory memorandum to the Social Welfare Act, explaining the principles of drawing up a
care plan, could be consulted while preparing and assessing a care plan.
Special care homes
The twenty-four-hour special care service is intended for people with mental disorders or
severe or profound disability who are in need of daily guidance, counselling, assistance, and
supervision due to their mental health disorders.
The 24-hour special care service is provided to 2241 people in 47 locations. During the
reporting year, the Chancellor’s advisers carried out an inspection visit to Vääna-Viti Home
operated by AS Hoolekandeteenused, and also inspected the activities of the non-profit
association South-Estonian Special Care Services Centre, which provides a 24-hour special
care service, inter alia, to people with a severe, profound or permanent mental disorder with