SOCIAL INSTITUTIONS FOR THE ELDERLY • The eldercare system remained unreformed in 2015 despite the fact that all existing problems had been repeatedly brought to the attention of all competent institutions. • There exist legislative proposals in the works aimed at positive changes designed to improve access to elderly care and the quality of eldercare services, as well as to assure the rights and protections of eldercare beneficiaries. • The NPM believes that the time has come to undertake root-and-branch reform of the entire social service system. It is incumbent upon the competent authorities to develop monitoring and control systems and to improve existing planning and funding mechanisms, with an overall aim to improve the quality of the social services provided. The NPM visited in 2015 five homes for elderly persons with mental retardation and dementia. The team conducted both repeat inspections and first-time visits. The repeat inspections at long term eldercare institutions revealed ample evidence that most NPM recommendations had indeed been implemented:  The NPM team identified some positive changes at the Home for Elderly Persons with Mental Retardation (HEPMR) in the ‘Kachulka’ locality associated with the social service management, the physical environment and equipment, and the overall condition of the resident beneficiaries. The NPM gave credit for this positive development to the institution’s new management and the regular and efficient oversight over their performance. The NPM highlighted as an example of good practice the fact that in the event of the death of an eldercare beneficiary, a patho-anatomical post-mortem examination would be invariably performed; It needs to be pointed out though that sustainability of the good practices at the elderly home could only be achieved with the active involvement and commitment of the municipality of Sliven so that all the necessary repairs would be carried out in a reasonable timeframe.  The visit to the Home for Elderly Persons with Dementia (HEPD) in the village of Opanets also provided evidence that most NPM recommendations had been implemented by the social service provider;  The repeat inspection at the HEPD in the village of Ognen revealed that notwithstanding the recommendations previously made by the NPM inspection teams, the home still had no wheelchair ramp or elevator for persons with mobility deficits. An ad hoc group including representatives of the municipality of Karnobat had examined the feasibility of installing a ramp and had concluded that it had to be electric rather than permanent, but no action had been taken yet to have it installed. The service provider’s excuse was, once again, that there were no residents with mobility impairments. The NPM finds the argument that creating an accessible environment is irrelevant where the social service is not intended for persons with physical disabilities unacceptable. Similar arguments have been suggested previously in response to the same recommendation. The NPM, therefore, needs to point out, once again, the obligation to create an enabling environment in any place where social services are provided regardless of the type or profile of services. 75