used. The Chancellor also assessed the living conditions in these institutions and checked whether staffing was sufficient, the food was good and the residents were offered enough meaningful free-time activities. Dispensing of medications and access to healthcare services were reviewed. A general practitioner was involved as an expert in both inspection visits. During the visits, rooms were inspected, documents perused, and staff and clients were interviewed. In Sõmera Home, the Chancellor assessed how assistance is provided to clients in transfer to smaller social welfare institutions under the reorganisation plan for special care institutions. Preparations for the changes were thorough, and the dedication of the staff left a good impression – this had not faltered, despite uncertainty arising from the plan to close down the institution. The Chancellor asked that residents be involved as much as possible in making reorganisation decisions, that they be kept informed and their opinions heard within the decisionmaking process. In reference to Sõmera Home, the Chancellor noted that residents’ freedom of movement must not be restricted without a legal basis. Without a court ruling, a client’s freedom of movement may be restricted in specific and exceptional conditions, and only for up to three hours by placing them in a secure seclusion room. In doing so, the client may not be left or locked in just any room but in a room that complies with the requirements for a seclusion room. In both of the care homes inspected, many residents were not involved in dynamic activities contributing to development of skills, which would help residents spend time by engaging in their preferred activities. The inspections revealed that, in view of the specific nature of their clients, neither special care institution might have a sufficient number of competent activity supervisors constantly present. Their numbers should be sufficient and their work organised in such a way as to enable an individual approach to all clients and, if necessary, keep a constant eye on their movement and activities. Staffing should be sufficient so as to enable swift and safe resolution of tense and dangerous situations. The minimum staffing level laid down in legislation might not always be sufficient to provide quality service and ensure the fundamental rights of clients. In comparison to the previous inspection visit, Valkla Home had not significantly improved conditions in the seclusion room – the room was not secure, nor did it create a calming environment. To ensure security, Valkla Home still extensively uses metal grids and barbed wire, which the Chancellor had already found inappropriate in 2015. 7

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