Visits to places of deprivation of liberty change the fact that residents themselves were unable to open the door and leave the Home without another person’s assistance. It also added that the definition of a secure ward in point 17 of Article 2 of the ZDZdr stipulated that a secure ward was a ward which residents of the institution (and not only of an individual ward) are unable to leave on their own accord. The NPM thus insisted on its recommendation on due conduct when restricting residents’ liberty. During the visit to Metlika Retirement Home, we noticed several examples of good practice. Among other things, we examined medical records of several residents and examined the prescription of occasional medications. It was usually written at what time, how many times a day and what dosage a resident may receive, which was certainly positive. The staff are suitably trained to work with residents with advanced dementia. We commended the staff’s attitude towards residents since friendliness and understanding are the most important if not the only form of successful mutual communication with dementia patients. On 27 February 2018, we visited Ljubljana Šiška Retirement Home where we were told that there was no secure ward in the sense of point 17 of Article 2 of the Mental Health Act and that persons with various stages of cognitive impairment (dementia) who are usually accommodated on secure wards were staying on various wards in the Home. We nevertheless wanted to examine whether the right to personal freedom was being restricted for the residents of the Home, particularly dementia patients. We gave two (general) recommendations regarding the implementation of the Mental Health Act, and in the response to the preliminary report, it was stated that both would be observed. We also proposed that in cases when residents do not consent to be accommodated and are unable to leave the institution, the Home immediately proposes to the court to issue a decision as per Article 75 of the Mental Health Act. We also suggested that Article 29 of the Mental Health Act be observed consistently when using a belt in a wheelchair in the case of simultaneous physical impairment of a resident (e.g. blockage of wheels of a wheelchair) and their reduced higher nerve functions since the effect in the above case is the same as when applying special protection measures. On 5 March 2018, we paid a visit to Ormož Retirement Home. This was the first visit to this social care institution where we proposed 18 recommendations, and after the response from the Home’s management to the preliminary report of the NPM visit, we were pleased to discover that the majority of them (12) had already been realised. These recommendations referred to the placement of suitable signs on the doors of residents’ rooms to facilitate their orientation, installation of bedside reading lights if the residents want them, organisation of activities also during weekends and holidays, and monitoring the satisfaction of all three target groups (residents, relatives and staff). The Home also realised recommendations which referred to a resident signing a statement on being accommodated on a secure ward and understanding what they have signed, suitable supplementing of the relevant statement with the legal caution and the possibility of revoking it, the observance of provisions of the ZDZdr regarding special protection measures also in the case of a blockage of a wheelchair and simultaneous installation of a pelvic belt or when tying down an arm when a nasogastric tube is installed. They also realised recommendations about more suitable positioning of the collection box for complaints, keeping a suitable record of complaints, updating the house rules and making data on the representatives of persons with mental health disorders more visible. The Home had not yet managed to realise individual recommendations, particularly those referring to exceeding capacity, reducing the number of beds in individual rooms, ventilating and giving residents’ privacy when speaking on the phone with a mobile receiver. The Home did not accept a recommendation relating to more appropriate recordkeeping of residents who require periodic check-ups with a psychiatrist. As a reason, the management explained in the response to the preliminary report that the Home had been cooperating with the same psychiatrist since its establishment in 2002 and the system of making appointments and the keeping of records of regular check-ups had been agreed upon with the psychiatrist. These records were kept manually in a special notebook, and it had not yet happened that a periodic check-up of a resident would be overlooked. Together with the psychiatrist, they examined the recommendation and decided to proceed with their present record-keeping system since the outpatient nurse and the psychiatrist were used to it. We also noticed several things that were particularly commendable, i.e. the premises of the ward and residents’ rooms were well-maintained, clean and light. We were pleasantly surprised by the residents’ involvement, including those with severe mobility difficulties, into daily activities on the ward organised throughout the day. A notice board is in the common area where it is written where residents are located, and what time of the year and what day it is to facilitate orientation in time and space. The staff informed us that they change information on this notice board every morning together with the residents, which is commendable because this is also important for the residents who cannot or are unable to read this information. An agreement was made with smokers on the dementia ward that cigarettes and a lighter are stored by the nurse, and they get a key to the terrace after lunch where they go to smoke. Such practice is considered positive since smoking is supervised and there is no IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2018 NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT 31

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