These shortcomings and the Chancellor’s recommendations for remedying them are described in more detail below. Several of the shortcomings pointed out by the Chancellor were eliminated by the time of writing this report. 7.1. Handling and administration of medications Problems with the handling of medications were found in two special care homes. In one institution61 no records of medications were kept. Therefore, it was impossible to establish what quantity of medications should be available in the care home, for whom they were prescribed and to whom they were actually administered.62 In another institution63 in principle all the staff had access to the nurse’s office where all the medications, including prescription medications, were kept. It was also found that medications were not kept in conformity with the requirements64, the medications were in different departments in unlocked cupboards and the institution kept medications which were no longer administered to the clients. Also a suspicion arose that the departments kept prescription medications prescribed to the patients who had left, and such medications were administered to other clients whenever necessary. As the principles for the handling of medications were not in line with the requirements, the Chancellor found that such a practice of handling could endanger the health and life of the clients.65 The practice where there is no real control over the existence, quantity and records of prescription medications may also lead to the misuse of medications. Therefore, the Chancellor recommended to ensure that the handling of medications takes place in conformity with the requirements and that third parties have no access to the medications. With regard to the administration of medications, in several institutions66 a suspicion arose that the medications were administered to the clients against their will. In two special care homes67 also a suspicion arose that the administration of medications had been left for the activity supervisors to decide. In the opinion of the Chancellor, the providers of 24-hour special care services must ensure compliance with the client’s treatment scheme with the help of measures whereby the persons voluntarily take the medications prescribed for them. This means that if a resident of a special care home refuses to take medications they cannot be forced to do this. Administration of medications involuntarily and as not part of the treatment scheme may amount to restraint by means of medications which is not allowed in the provision of 24-hour special care services. However, according to the Chancellor’s assessment it is conceivable that a person does not have to take medications constantly but only, for example, when the illness becomes more acute. 61 Narva-Jõesuu Care Home. In addition to the fact that there were no daily records on which medications were dispensed to the departments for administering to the persons, there was also no clear and traceable documentation as to which medications and under which treatment scheme the doctor had prescribed to the clients. 63 Erastvere Home of Hoolekandeteenused Ltd. 64 For example, during the inspection there was a medication in the nurse’s office which should be kept in a fridge, and despite the remark made by the representative of the State Agency of Medicines, the medication had not been placed in the fridge by the time of the evening inspection. 65 Administering of a prescription medication to a person to whom it has not been described may endanger their right to the protection of the health as it may happen that the medication is not suitable for the particular person due to their state of health or is incompatible with other medications prescribed to the person. 66 Paunküla Care Centre, Erastvere Home of Hoolekandeteenused Ltd, Valkla Home of Hoolekandeteenused Ltd. 67 Valkla Home of Hoolekandeteenused Ltd and Erastvere Home of Hoolekandeteenused Ltd. 62 38