Annual Report 2012: Spain’s National Preventive Mechanism An interdisciplinary assessment and individualized treatment plans are necessary Psychological services must be reinforced with a psychiatrist The occupational therapy services must be enhanced 138 181. The interdisciplinary assessment of cases is essential, which must be in­ cluded in the Departments of Psychology, Medicine and Nursing, as well as Indi­ vidualized Treatment Plans, aspects of which must be discussed with the inter­ ested parties, in line with the content of paragraph 37 of the CPT 8th General Report [CPT/Inf (98) 12]. In contrast, in the case of the «San José» Residence, the intervention plan and progress reports for residents are drawn up by each depart­ ment separately, which should be corrected with the individualized and interdis­ ciplinary assessment of residents. 182. Psychological and psychiatric services perform important therapeuti­ cally and rehabilitative work, which is essential for these centers. This is why the standardized minimum personnel ratios established for this purpose must be satisfied. However, the «San José» Residence only has one psycholo­ gist, who works mainly at the day center. In respect to the residence, the psy­ chologist only performs psychological assessments for judicial incapacita­ tions. In consequence, there are no psychological therapies for patients, no protocols for the psychological management of patients with behavior disor­ ders, neuropsychological diagnoses are not performed and cognitive/neu­ ropsychological rehabilitation programs are not established. Moreover, it was noted that many residents are not periodically reassessed from a psychologi­ cal or psychiatric point of view, with diagnoses and treatments going un­ changed, contrary to the provisions of paragraph 40 of the CPT 8th General Report [CPT/Inf (98) 12]. In consequence, it is essential to correct these major deficiencies, enhancing the psychological service, including a psychiatrist to review the files and update diagnoses and treatments of psychiatric patients at least twice a year. 183. Occupational therapy is a social and health care discipline that evalu­ ates a person’s capacity to carry out standard daily activities and aims at en­ hancing said capacity, by means of appropriate treatment, to reach the high­ est possible level of independence in his/her daily life. The Occupational Therapy Department at «San José» Residence evaluates patients and draws up rehabilitation and physiotherapy actions in conjunction with the Medical Department. However, seven occupational therapists, who do not have the support of assistants and only work mornings, are not sufficient for the cur­ rent population of 320 residents, most of whom are dependents. Moreover, most of their work is carried out without any kind of external supervision or coordination, and lacks an interdisciplinary approach. All of this explains why the results of the program are scarce in respect to the center’s size. In consequence, necessary measures should be adopted to enhance this area of work, which would have a considerable impact on the quality of the care, in accordance with paragraph 43 of the aforementioned CPT 8th General Re­ port [CPT/Inf (98) 12]. THE OMBUDSMAN OF SPAIN

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