inside.72 In the third institution73 the department for persons with mental problems has a room
which could be locked from the outside with a key without the possibility of opening it from
the inside.
The Chancellor is still of the opinion that seclusion of a client of 24-hour special care services
in their bedroom or another room adjusted for that purpose is inadmissible. In order to prevent
arbitrary restriction of the liberty of service recipients the Chancellor proposed to stop locking
clients in their rooms, use seclusion only when all the conditions for seclusion are fulfilled and,
should a need for seclusion appear, seclusion should take place only in a specially designated
seclusion room.
In addition, the Chancellor recommended to analyse which lawful measures can be taken to
ensure the safety of a client who may quickly become violent as well as other clients at night
and, in order to ensure safety, take measures which, in proportion to the threat, cause least
interference with the rights of the clients and also raise the awareness of the staff about the
admissibility of restricting the clients’ fundamental right to liberty.
7.4. The number of activity supervisors
Insufficient number of activity supervisors in special care homes continued to be a problem
during the reporting year. In two special care homes74 only one activity supervisor was on duty
at night. During the evening tour of one of the institutions it was found that none of the activity
supervisors on duty were constantly present in the department and thus the department had been
left unsupervised.
In the Chancellor’s opinion, the number of activity supervisors significantly affects the quality
of special care services. Inspections carried out during the reporting year give reason for a
concern that providers of 24-hour special care services are still unable to ensure the statutory
minimum number of activity supervisors. Moreover, the Chancellor is also of the opinion that,
for example, in view of the location and arrangement of the rooms of an institution and the
distribution of the clients between the departments, the nature and severity of mental problems
of the clients, even compliance with the minimum requirements might sometimes not be
sufficient.
In order to ensure a safe living environment for the recipients of 24-hour special care services
and maintain or increase their ability to cope independently, taking account of their condition
and skills, the Chancellor proposed to guarantee that at any time the institution has at least the
required number of activity supervisors on duty and that service recipients are not left without
supervision in any situation.
The staff member conducting the tour for the Chancellor’s advisers did not have doubts about the admissibility
of locking the door. The staff claimed that the client was preventively locked in their room for their own
protection, and explained further that the staff locked service recipients in their rooms for ensuring the clients’
own safety.
73
Narva-Jõesuu Care Home.
74
Erastvere Home of Hoolekandeteenused Ltd and Valkla Home of Hoolekandeteenused Ltd.
72
40
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