In one institution58 extensive video surveillance was used for monitoring the patients in the rooms in one department, including in all the wards. Similarly to 2013, the Chancellor found that such extensive restriction of human dignity and the right to privacy without a person’s consent and without consideration of its necessity and justification in each case cannot be purposeful. On this basis, the Chancellor recommended to ensure that in a situation where a person has not given a consent for using video surveillance in a ward the necessity and extent of applying video surveillance will be considered on a case-by-case basis.59 The institution did not agree with the Chancellor’s recommendations concerning video surveillance. 7. Providers of 24-hour special care services In 2014, the Chancellor inspected six providers of 24-hour special care services: - Valkla Home of Hoolekandeteenused Ltd (case No 7-9/140773) - Räpina Hospital Ltd (case No 7-9/140420) - NGO Paunküla Care Centre (case No 7-9/140418) - Imastu residential educational institution of Hoolekandeteenused Ltd (case No 79/140852) - Erastvere Home of Hoolekandeteenused Ltd (case No 7-9/141288) - Narva-Jõesuu Care Home Foundation (case No 7-9/150129) All the inspection visits to the providers of 24-hour special care services were unannounced. The Chancellor found no shortcomings in Räpina Hospital. In the inspection visit to Erastvere Home of Hoolekandeteenused Ltd a general practitioner was involved as an expert to assess the conformity with the statutory requirements for the 24-hour special care service and the accompanying independent nursing care service provided by the institution. Inter alia, the expert had to assess and give a reasoned opinion with regard to illtreatment, the situation of the clients as well as quality and documentation of the nursing care and its availability. The expert found no signs of ill-treatment but pointed out that constant presence of a staff member with special medical training should be ensured when providing the service for clients with special needs, because an activity supervisor without specialised training is not competent to dispense medications and assess medical interference. Some institutions60 were visited repeatedly within a short period by the Chancellor’s advisers, including unannounced visits in the evening, in order to verify compliance with the Chancellor’s recommendations. In 2014, the Chancellor in his visits to providers of 24-hour special care services paid particular attention to the handling and administration of medications and found problems in this respect in three institutions. During the reporting year, one of the problems in the special care homes was also the risk of violating human dignity and unlawful restriction of the fundamental right to liberty of the recipients of special care. Insufficient number of activity supervisors continued to be a concern during the reporting year. 58 Tartu University Hospital. In the interests of transparency and verifiability, such a decision should be made in a reproducible form in writing in each case and in respect of each person. The decision to apply video surveillance should be valid only within a specific period after which it should be reviewed. 60 Valkla Home and Erastvere Home of Hoolekandeteenused Ltd. 59 37